P2–100 - Severe Iron-Deficiency Anemia Diagnosed as Having Malignant Melanoma of Unknown Origin

Abstract

Introduction: Gastrointestinal malignant tumors should be considered as a cause of iron-deficiency anemia especially in elderly people. Here we report a rare case of severe iron-deficiency anemia diagnosed as having malignant melanoma of unknown origin. Case: A 63-year-old female presented to a local hospital with dyspnea on effort and was referred to our facility for an investigation of the cause of severe anemia. After diagnosis of iron-deficiency anemia was fixed, she was hospitalized for further detailed examination. On admission her consciousness was impaired (Japan Coma Scale: between I-3 and II-10) and the head computed tomography (CT) revealed multiple metastatic lesions in her bilateral cerebral hemispheres. Furthermore, a 4-cm tumor was found in the occipital skin, whole body CT revealed multiple micronodules in the breasts, lungs and abdominal cavity, and upper gastrointestinal endoscopy showed neoplastic lesions in the duodenum. Although the primary lesion could not be determined, biopsy from the occipital, breast and duodenal tumors led to the diagnosis of malignant melanoma. Before the pathological results were established, her condition deteriorated and she died on the 12th day of hospitalization. Discussion: Malignant melanoma of unknown origin is rare disease and lymph node is considered to be the most common primary location in that case. Although we were unable to investigate the lesions in the colon, to our knowledge, this is a rare case of malignant melanoma where anemia was the first presented symptom. I will make a presentation with bibliographic consideration.