Metastatic Malignant Melanoma Presenting as Small Bowel Obstruction: A Report of a Case

Abstract

Small intestinal metastasis of any malignancy is rare. Cutaneous or ocular malignant melanomas are the most common tumors that metastasize to gastrointestinal tract. Patient often present several years after the initial evaluation and treatment for a previous cutaneous malignant melanoma with intestinal obstruction symptoms. Rarely, small bowel melanomas occur with clinical picture of acute abdomen due to perforation. We present a 68 year old female patient with a 4 month history of recurrent colicky abdominal pain, distention, vomiting associated with weight loss and passage of small pellet stool. Imaging studies using abdominal ultrasound and CT scan revealed a large lobulated hypo echoic mass between the gastric antrum and pancreas. She had an exploratory laparatomy for bowel obstruction. Surgical pathology of the excised mass with resected obstructed jejunum revealed a metastatic malignant melanoma. Reported cases of metastatic small bowel melanoma are becoming increasingly common and should be considered in patients with a previous history of primary cutaneous malignant melanoma.