CASE REPORT
Acute ileo-ileal intussusception due to intestinal metastatic melanoma
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1
Department of Digestive Surgery, Tenon Hospital, Paris, France
 
2
Department of General Surgery, Habib Bourguiba Hospital, Sfax, Tunisia
 
 
Submission date: 2014-04-24
 
 
Acceptance date: 2015-03-09
 
 
Online publication date: 2015-04-19
 
 
Publication date: 2020-03-24
 
 
Corresponding author
Ahmed Guirat   

Department of Digestive Surgery, Tenon Hospital, 4 Rue de la Chine, 75020 Paris, France. Tel.: +33 633 72 62 05; fax: +33 156 01 70 00.
 
 
Pol. Ann. Med. 2015;22(1):41-44
 
KEYWORDS
ABSTRACT
Introduction:
Although gastrointestinal tract is a fairly frequent site of melanoma metastases, reports of small bowel intussusception caused by melanoma metastasis are very rare.

Aim:
To describe a rare complication of metastatic melanoma and to expose the difficulties to screen digestive metastases of melanoma.

Case study:
We report the case of a 69-year-old woman who was admitted for abdominal pain, melanoma and anemia. She had a history of surgery for a malignant vulval melanoma one year earlier and had been treated with adjuvant interferon a. Computed tomography (CT) concluded to a small bowel intussusception. Exploratory laparoscopy revealed a large tumor arising from the proximal small bowel. Jejunal resection with an end-to-end anastomosis was performed. Histological examination showed a metastasis of malignant melanoma. Regular postoperative follow-up did not show any sign of recurrence.

Results and discussion:
Gastrointestinal metastases are a vicious site of distant localization of melanoma, difficult to diagnose and life-threatening due to their potential complications. Symptoms are often nonspecific. Rarely complications such as intussusception can be the first clinical presentation. CT, CT enteroclysis, fluorodeoxyglucose-positron emission tomography scan and capsule endoscopy may result as very useful for detecting gastrointestinal metastases.

Conclusions:
Any gastrointestinal symptom in patients previously treated for cutaneous melanoma should lead to accurate research for metastases. We propose to use at follow-up abdominal CT scan in asymptomatic patients when the primary tumor has poor prognostic factors such as advanced stage or incomplete resection.

CONFLICT OF INTEREST
None declared.
 
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