Gastrointestinal melanosarcoma

Abstract

Summary o.1.Eighteen cases of melanoma involving the small and large intestine are presented. The typical clinical and roentgenologic findings, results of surgery and combined therapy, and eventual course are presented. 2.The data indicate that intestinal melanosarcoma may occur in two distinct clinicopathologic types. More commonly, melanoma presents as intestinal obstruction due to intussusception of multiple, amelanotic, polypoid, submucosal, and mucosal metastatic lesions. The lesions may be associated with slow and continuous intestinal bleeding. Surgical therapy with resection of all the involved segments, if possible, should be performed. Rapid death in a few weeks can be anticipated. Chemotherapy with hydroxyurea may significantly prolong life and merits serious consideration. 3.Less commonly, intestinal melanoma presents as a solitary infiltrative melanotic lesion with hemorrhage or obstruction or simply with a vague and troublesome abdominal pain. Treatment should be wide resection of the tumor with adjacent mesentery. Prognosis in this situation may be fairly good. 4.Further study indicates that metastatic intestinal melanoma may have a greater incidence than heretofore appreciated. Follow-up study of patients with cutaneous melanoma should include gastrointestinal x-ray studies at regular intervals and frequent studies of blood and stool in an effort to recognize intestinal metastases early. Summary o.1.Eighteen cases of melanoma involving the small and large intestine are presented. The typical clinical and roentgenologic findings, results of surgery and combined therapy, and eventual course are presented. 2.The data indicate that intestinal melanosarcoma may occur in two distinct clinicopathologic types. More commonly, melanoma presents as intestinal obstruction due to intussusception of multiple, amelanotic, polypoid, submucosal, and mucosal metastatic lesions. The lesions may be associated with slow and continuous intestinal bleeding. Surgical therapy with resection of all the involved segments, if possible, should be performed. Rapid death in a few weeks can be anticipated. Chemotherapy with hydroxyurea may significantly prolong life and merits serious consideration. 3.Less commonly, intestinal melanoma presents as a solitary infiltrative melanotic lesion with hemorrhage or obstruction or simply with a vague and troublesome abdominal pain. Treatment should be wide resection of the tumor with adjacent mesentery. Prognosis in this situation may be fairly good. 4.Further study indicates that metastatic intestinal melanoma may have a greater incidence than heretofore appreciated. Follow-up study of patients with cutaneous melanoma should include gastrointestinal x-ray studies at regular intervals and frequent studies of blood and stool in an effort to recognize intestinal metastases early.