Acute ileo-ileal intussusception due to intestinal metastatic melanoma

Abstract

Abstract Introduction Although gastrointestinal tract is a fairly frequent site of melanoma metastases, reports of small bowel intussusception caused by melanoma metastasis are very rare. Aim To describe a rare complication of metastatic melanoma and to expose the difficulties to screen digestive metastases of melanoma. Case study We report the case of a 69-year-old woman who was admitted for abdominal pain, melanoma and anemia. She had a history of surgery for a malignant vulval melanoma one year earlier and had been treated with adjuvant interferon α. Computed tomography (CT) concluded to a small bowel intussusception. Exploratory laparoscopy revealed a large tumor arising from the proximal small bowel. Jejunal resection with an end-to-end anastomosis was performed. Histological examination showed a metastasis of malignant melanoma. Regular postoperative follow-up did not show any sign of recurrence. Results and discussion Gastrointestinal metastases are a vicious site of distant localization of melanoma, difficult to diagnose and life-threatening due to their potential complications. Symptoms are often nonspecific. Rarely complications such as intussusception can be the first clinical presentation. CT, CT enteroclysis, fluorodeoxyglucose-positron emission tomography scan and capsule endoscopy may result as very useful for detecting gastrointestinal metastases. Conclusions Any gastrointestinal symptom in patients previously treated for cutaneous melanoma should lead to accurate research for metastases. We propose to use at follow-up abdominal CT scan in asymptomatic patients when the primary tumor has poor prognostic factors such as advanced stage or incomplete resection.