Ann Surg Treat Res.  2018 May;94(5):274-278. 10.4174/astr.2018.94.5.274.

Primary malignant melanoma of the small intestine: a report of 2 cases and a review of the literature

• Yang KM
• Kim CW
• Kim SW
• Lee JL
• Yoon YS
• Park IJ
• Lim SB
• Yu CS
• Kim JC

• KMID: 2410272
• DOI: http://doi.org/10.4174/astr.2018.94.5.274

Abstract

The majority of malignant melanomas in the small intestine are metastases from primary cutaneous lesions, it can also develop as a primary mucosal tumor in the gastrointestinal tract. In this report, we present rare cases of primary small bowel melanoma and review the current literature. A 78-year-old male presented with abdominal pain and CT enterography identified a ileal mass. A 79-year-old female presented with signs and symptoms of partial small bowel obstruction. Abdominopelvic CT and small bowel series revealed a obstructing mass in the distal jejunum. The masses were confirmed on laparotomy and histologically diagnosed as melanoma. Extensive postoperative clinical examination revealed no cutaneous lesions. A primary small bowel melanoma is an extremely rare neoplasm. A definite diagnosis can only be made after a thorough investigation has been made to exclude the coexistence of a primary lesion. Curative resection of the tumor remains the treatment of choice.

Keyword

Melanoma; Gastrointestinal tract; Small intestine

MeSH Terms

Abdominal Pain
Aged
Diagnosis
Female
Gastrointestinal Tract
Humans
Intestine, Small*
Jejunum
Laparotomy
Male
Melanoma*
Neoplasm Metastasis

Figure

• 

  Fig. 1 Surgical specimen (A, case 1; C, case 2) and macroscopic image of the tumor cut in half (B, case 1; D, case 2).

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  Fig. 2 Histologic feature of malignant melanoma. (A) The lesion shows diffuse atypical cells infiltration forming solid sheet (H&E, ×40). (B) The cells are medium-to large-sized with irregular nuclear contours, macronucleoli, and numerous mitotic activities (×400). Immunohistochemical staining showed that the malignant cells were strongly positive for Melan A (C) and S100 (D) (×200).

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