English

Abstract

Malignant melanomas mostly begin as an oculocutaneous lesion and then metastasise to other sites over time. Gastrointestinal melanomas are rare but primary intestinal melanomas are extremely rare. They account for 1 - 3 % of malignant tumours of GI tract.1,2 Although few cases have been reported, the existence of primary intestinal melanoma is still doubtful. It is difficult to differentiate between primary and secondary intestinal melanomas based on their clinical picture alone. Some authors believe that the metastatic melanoma into the intestine manifest symptoms in the patient after complete regression of some old cutaneous lesion.3,4 But some believe that primary melanoma of small intestine originates from Schwannian neuroblast cells, neural crest melanoblasts, or amine-precursor uptake and decarboxylation (APUD) cells through neoplastic changes.5,6 They are unrecognized until late due to absence of symptoms, but if symptoms occur, they include abdominal pain, gastrointestinal bleeding and sometimes with intestinal obstruction and few present acutely with perforation. By any origin, malignant melanoma is an aggressive tumour with very poor prognosis and low survival rates, even after surgery. Here we report a case of primary intestinal melanoma in a young patient who presented as intussusception of small intestine.