Retrograde Balloon-Assisted Deep Enteroscopy in the Diagnosis of Metastatic Melanoma.

William Barge,Daniel Abbott,Mark R Albertini,Deepak Gopal,Christopher Cold,Matteo Neri

doi:10.1155/2021/5572230

Abstract

A 74-year-old male with a history of metastatic melanoma presents with persistently abnormal small bowel findings on PET-CT scan. The patient had persistent FDG uptake near the ileocolic junction on imaging, concerning for metastatic melanoma. Capsule endoscopy demonstrated ulcerated mucosa in the distal ileum. This area was biopsied and tattooed via retrograde double-balloon enteroscopy to confirm the diagnosis of metastatic melanoma and facilitate subsequent small bowel resection. The case illustrates a unique case of metastatic melanoma to the small bowel and the utility of capsule endoscopy and balloon-assisted enteroscopy to assist in diagnosis and management of metastatic disease.

Highlights

A 74-year-old male with a medical history of metastatic melanoma presents to the outpatient gastroenterology clinic due to persistently abnormal small bowel findings on positron emission tomography-CT (PET-CT) scan
A 74-year-old male with a history of previously excised melanoma metastatic to a mesenteric lymph node who had been in remission for 2 years before presenting for additional evaluation of persistently abnormal small bowel findings on a surveillance PET-CT scan
Discussion is case illustrates the utility of capsule endoscopy to identify small bowel metastasis, an atypical use in the current practice of capsule endoscopy. This case details how retrograde double-balloon enteroscopy, in combination with diagnostic modalities such as PET scans and capsule endoscopy, can assist in the diagnosis of distal small bowel associated with prolonged survival and symptom improvement and remains an important treatment of metastatic melanoma to the small bowel [7, 8]

Summary

Introduction

1. Introduction A 74-year-old male with a medical history of metastatic melanoma presents to the outpatient gastroenterology clinic due to persistently abnormal small bowel findings on positron emission tomography-CT (PET-CT) scan. E following case illustrates a unique and unusual case of metastatic melanoma to the small bowel and the utility of both capsule endoscopy and balloon-assisted deep enteroscopy to assist in diagnosis and preoperative management.

Results

Conclusion