Document Type : Case Reports

Authors

1 Department of Pathology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

2 Surgical Oncology Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

10.30699/ijp.2023.1996329.3100

Abstract

Malignant melanoma of the small intestine is mostly a metastatic tumor of other primary lesions, especially of skin origin. Primary malignant melanoma of the small intestine is very uncommon. The clinical presentation is usually nonspecific, thus leading to late diagnosis.
We report a 42-year-old man who presented to the emergency department of Imam-Reza Hospital with symptoms and signs of peritonitis and was a candidate for emergency laparotomy and enterectomy. The medical and family history were unremarkable. A bulky mass was seen, 190 cm away from the Treitz band, and a diagnosis of malignant melanoma was confirmed by histologic and immunohistochemical study. Further clinical examination revealed no primary tumor elsewhere, so the diagnosis of primary small intestinal melanoma was concluded.
Although metastatic malignant melanoma in the GI tract is common, the primary one is a very rare entity. The diagnosis could be challenging because a thorough investigation is needed to rule out the possible initial origin.

Keywords

Main Subjects

  1. Safaei A, Masood Tabib S, Farzaneh MR, Shahryari J, Bahmaniar M. Primary Malignant Melanoma of the Gastrointestinal Tract: Report of Two Cases. Iranian Journal of Pathology. 2014;9(3):213-8.
  2. Sinagra E, Sciumè C. Ileal Melanoma, A Rare Cause of Small Bowel Obstruction: Report of a Case, and Short Literature Review. Curr Radiopharm. 2020;13(1):56-62. [DOI:10.2174/1874471012666191015101410] [PMID] []
  3. Yang KM, Kim CW, Kim SW, Lee JL, Yoon YS, Park IJ, et al. Primary malignant melanoma of the small intestine: a report of 2 cases and a review of the literature. Ann Surg Treat Res. 2018;94(5):274-8. [DOI:10.4174/astr.2018.94.5.274] [PMID]
  4. Juanmartiñena Fernández JF, Fernández-Urien I, Córdoba A. Primary anorectal malignant melanoma: an uncommon anorectal pathology. Rev Esp Enferm Dig. 2016;108(9):604-5. [DOI:10.17235/reed.2016.4347/2016] [PMID]
  5. Li H, Fan Q, Wang Z, Xu H, Li X, Zhang W, Zhang Z. Primary malignant melanoma of the duodenum without visible melanin pigment: a mimicker of lymphoma or carcinoma. Diagn Pathol. 2012;7:74. [DOI:10.1186/1746-1596-7-74] [PMID]
  6. Hadjinicolaou AV, Hadjittofi C, Athanasopoulos PG, Shah R, Ala AA. Primary small bowel melanomas: fact or myth? Ann Transl Med. 2016;4(6):113. [DOI:10.21037/atm.2016.03.29] [PMID]
  7. Timmers TK, Schadd EM, Monkelbaan JF, Meij V. Survival after resection of primary malignant melanoma of the small intestine in a young patient: report of a case. Case Rep Gastroenterol. 2013;7(2):251-60. [DOI:10.1159/000352017] [PMID]
  8. Vrable A, Chang R. Malignant melanoma of the small bowel presenting with intussusception in a woman: a case report. Melanoma Manag. 2017;4(2):99-104. [DOI:10.2217/mmt-2016-0028] [PMID]
  9. Spiridakis KG, Polichronaki EE, Sfakianakis EE, Flamourakis ME, Margetousakis TH, Xekalou AS, et al. Primary small bowel melanoma. A case report and a review of the literature. G Chir. 2015;36(3):128-32. [DOI:10.11138/gchir/2015.36.3.128]
  10. Ait Idir B, Riany A, Jahid A, Chad B. Primary small bowel melanoma revealed by gastrointestinal bleeding: a case report. J Med Case Rep. 2016;10(1):335. [DOI:10.1186/s13256-016-1119-9] [PMID]
  11. Woollons A, Derrick EK, Price ML, Darley CR. Gastrointestinal malignant melanoma. Int J Dermatol. 1997;36(2):129-31. [DOI:10.1111/j.1365-4362.1997.tb03072.x] [PMID]
  12. Patel RB, Vasava NC, Gandhi MB. Acute small bowel obstruction due to intussusception of malignant amelanotic melanoma of the small intestine. BMJ Case Rep. 2012;2012. [DOI:10.1136/bcr-2012-006352] [PMID]