Malignant Melanoma Disguised as Biliary Obstruction

Abstract

In melanoma, symptomatic involvement of the small bowel is exceedingly rare. When melanoma spreads to the gastrointestinal tract, the prognosis worsens significantly. We present the case of a 70-year-old woman with secondary malignant melanoma of the gastrointestinal tract. Our patient, who had been treated for a stage I melanoma 4 years prior, presented with symptoms of frequent constipation, heartburn, and nausea. A biopsy of the masses on her back and axilla showed malignant melanoma. Computed tomography showed marked dilation of the common bile duct. Endoscopic retrograde cholangiopancreatography was unsuccessful owing to malignant infiltration of the ampulla. Biliary drainage via percutaneous port placement and immunotherapy were initiated.