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Query: UMLS:C0278883 (metastatic melanoma)
 6,224 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 46-year-old woman presented with abdominal pain, nausea vomiting and abdominal distention. Small bowel x-rays and CT scan of the abdomen revealed small bowel obstruction due to malignant melanoma. The diagnosis of cutaneous melanoma was performed 8 years prior to admission on one lesion in the back. Patient received surgical treatment. Completed resection of an involved jejunal [correction of ileal] segment was performed. Three tumor masses were found at laparotomy. Metastasis from malignant melanoma at the gastrointestinal tract occurs frequently though rarely are these intestinal lesions symptomatic. The efficacy of surgical treatment for symptomatic metastatic melanoma is justified to relief symptoms and prolonged survival.
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PMID:[Symptomatic malignant melanoma of the small intestine]. 134 Nov 16

2 patients with unusual presentations of malignant melanoma involving the small intestine, a 75-year-old woman and a 78-year-old man, are described. One underwent laparotomy for diagnosis and removal of a retroperitoneal mass, with no preoperative evidence of the primary disease. The other underwent emergency laparotomy for small bowel obstruction due to intussusception, which was found to result from a metastatic melanoma. A melanoma had been completely resected from the patient's thigh a month previously, but full investigation before the operation for intussusception failed to establish the diagnosis. Malignant melanoma tends to spread to the small intestine, but tumors of this organ are very rare. Preoperative diagnosis is important since it may improve the outcome of surgical intervention, as well as the prognosis in general.
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PMID:[Unusual presentation of malignant melanoma of the small intestine]. 152 41

An unusual case of intestinal obstruction due to ileal metastatic melanoma is reported. An ileocolic intussusception led to intestinal obstruction. The patient underwent palliative surgery to re-establish intestinal continuity.
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PMID:[Intestinal occlusion caused by ileo-colic invagination in a patient with intestinal metastasis of melanoma]. 276 43

Intussusception is an uncommon cause of intestinal obstruction in adults. Unlike children, the diagnosis of intussusception in adults is often difficult due to its usually chronic history. A case of adult ileocolic intussusception secondary to metastatic melanoma is presented to discuss the efficiency of ultrasonography, characteristic CT features and the etiology of this disease.
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PMID:[Computed tomographic diagnosis of an ileocolic invagination in an adult]. 279 51

Eighteen of 1420 patients with primary cutaneous melanoma presented with symptomatic small bowel metastases and were reviewed to establish the role and efficacy of surgical intervention. The median interval between treatment of the initial skin lesion and detection of the intestinal metastases was 4.4 years (range, 2 months to 15 years). Most patients presented with either anemia, abdominal pain, bowel obstruction, or intussusception. In six patients, small bowel involvement was the first sign of metastatic disease. Seventeen of the 18 patients underwent laparotomy, and all overt metastases were completely excised in 12. Three patients died postoperatively. Fourteen of the 17 patients had satisfactory palliation with complete symptomatic relief. Median survival after resection was 13 months (range, 2 days to 300 months). Median survival of the 12 patients in whom all macroscopic disease was resected was 44.5 months (range, 2-300 months), whereas the median survival in the four with incompletely resected tumors was 4 weeks (range, 2 days-24 weeks). Five of 12 patients who underwent complete resection of small bowel metastases survived more than 6 years, 3 of whom remain well and free of disease at 6, 14, and 25 years. These results justify active surgical intervention in patients with symptomatic small bowel metastatic melanoma, both for relief of symptoms and prolongation of life.
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PMID:Surgical treatment of metastatic melanoma of the small bowel. 871 64

Malignant melanoma shows an unusual predilection to metastasize to the small intestine. Three patients with malignant melanoma involving the small bowel are reported. One patient was operated on for small bowel obstruction and the other two for gastrointestinal bleeding. Two patients remained well 6 and 2 years, respectively, after surgery. One patient died of metastatic melanoma 4 years post-operation. Metastatic melanoma in the small bowel should be suspected in any patient with a previous history of malignant melanoma who develops GI symptoms or chronic blood loss. Surgical treatment was the first choice; the prognosis after surgical resection was much better than for other organ metastases or simultaneous metastases of the small bowel and other organs.
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PMID:Small bowel metastases of malignant melanoma: palliative effect of surgical resection. 1056 99

From post-mortem case records, the small bowel is the most frequent site of metastatic melanoma in the gastrointestinal (GI) tract, with gallbladder involvement occurring in 15% of cases. However, few cases have been documented in living patients and, when found, are associated with a poor prognosis. We report a case of a Caucasian man with metastatic gallbladder and small bowel melanoma from an unknown primary. He presented with diffuse abdominal pain, vomiting and progressive asthenia; subsequently, intestinal obstruction occurred. He had no past history of malignant melanoma and the primary lesion was not found. The multiple lesions, together with the absence of mucosal involvement in both the gallbladder and small bowel, led us to believe that the lesions were metastatic deposits from a probably regressed primary melanoma. It should be emphasized that surgical resection for melanoma metastatic to the GI tract is recommended for palliative reasons and can be performed safely. The clinical presentation, diagnosis, treatment and prognosis of previously reported cases of melanoma metastatic to the gallbladder and small bowel are reviewed. The differences between primary and secondary GI tract melanomas are also discussed.
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PMID:Melanoma metastatic to the gallbladder and small bowel: report of a case and review of the literature. 1545 2

Malignant melanoma is one of the most common malignancies to metastasize to the gastrointestinal (GI) tract. Metastases to the GI tract can present at the time of primary diagnosis or decades later as the first sign of recurrence. Symptoms may include abdominal pain, dysphagia, small bowel obstruction, hematemesis, and melena. We report 2 cases of malignant melanoma metastatic to the GI tract, followed by a review of the literature. The first case is a 72-year-old man who underwent resection of superficial spreading melanoma on his back 13 years previously who presented with dysphagia. A biopsy specimen of a mucosal fold in a gastric fundus noted during endoscopy was taken and revealed metastatic malignant melanoma, which was resected 1 month later. Three weeks later, the patient was found to have an ulcerated jejunal metastatic melanoma mass, which was also resected. The second case is a 63-year-old man with an ocular melanoma involving the chorold of the left eye that had been diagnosed 4 years previously, which had been excised several times, who presented with anorexia, dizziness, and fatigue. He was found to have cerebellar and stomach metastases. He underwent adjuvant radiation therapy, chemotherapy, and surgical resection of the gastric melanoma metastasis. In patients with a history of melanoma, a high index of suspicion for metastasis must be maintained if they present with seemingly unrelated symptoms. Diagnosis requires careful inspection of the mucosa for metastatic lesions and biopsy with special immunohistochemical stains. Management may include surgical resection, chemotherapy, immunotherapy, observation, or enrollment in clinical trials. Prognosis is poor, with a median survival of 4 to 6 months.
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PMID:Metastatic malignant melanoma of the gastrointestinal tract. 1661 May 71

Intussusception has been considered an operative indication in adults as a result of the risk of ischemia and the possibility of a malignant lead point. Computed tomographic (CT) scans can reveal unsuspected intussusception. All CT reports from July 1999 to December 2005 were scanned electronically for letter strings to include the keyword intussusception. Identified CT scans were analyzed to characterize the intussusception and associated findings. Clinical, laboratory, pathological, and follow-up variables were gleaned from medical records. Findings were analyzed by treatment and findings at operation. Review of 380,999 CT reports yielded 170 (0.04%) adult patients (mean age, 41 years) with intussusceptions described as enteroenteric in 149 (87.6%), ileocecal in eight (4.7%), colocolonic in 10 (5.9%), and gastroenteric in three (1.8%). Radiological features included mean length of 4.4 cm (range, 0.8-20.5 cm) and diameter of 3.2 cm (range, 1.6-11.5 cm). Twenty-nine (17.1%) had a lead point, and 12 (7.1%) had bowel obstruction. Clinically, 88 (48.2%) patients reported abdominal pain, 52 (30.6%) had nausea and/or vomiting, and 74 (43.5%) had objective findings on abdominal examination. Thirty of 170 (17.6%) patients underwent operation, but only 15 (8.8%) patients had pathologic findings that correlated with CT findings. Seven had,enteroenteric intussusceptions from benign neoplasms (two), adhesions (one), local inflammation (one), previous anastomosis (one), Crohn's disease (one), and idiopathic (one). Three had ileocolic disease, including cecal cancer (one), metastatic melanoma (one) and idiopathic (one; whereas five patients had colocolonic intussusception from colon cancer (three), tubulovillous adenoma (one), and local inflammation (one). Of the 15 without intussusception at exploration, five had pathology related to trauma, four had nonincarcerated internal hernia after Roux-en-Y gastric bypass, four had negative explorations, one had adhesions, and one had appendicitis that did not correlate with CT findings. No patient in the observation group required subsequent operative exploration for intussusception at mean 14.1 months (range, 0.25-67.5 months) follow up. All operative patients demonstrated gastrointestinal symptoms versus 55.3 per cent of the observation group (P < 0.006). Analysis of CT features demonstrated differences among patients observed without operation, those without intussusception at exploration, and confirmed intussusception with regard to mean intussusception length 3.8 versus 3.8 versus 9.6 cm, diameter 3.0 versus 3.2 versus 4.8 cm, lead point 12.1 per cent versus 30 per cent versus 53.3 per cent, and proximal obstruction 3.8 per cent versus 0 per cent versus 46.7 per cent, respectively. Intussusceptions in adults discovered by CT scanning do not always mandate exploration. Most cases can be treated expectantly despite the presence of gastrointestinal symptoms. Close follow up is recommended with imaging and/or endoscopic surveillance. Length and diameter of the intussusception, presence of a lead point, or bowel obstruction on CT are predictive of findings that warrant exploration.
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PMID:Approach to management of intussusception in adults: a new paradigm in the computed tomography era. 1809 41

Metastatic melanoma remains a disease associated with poor outcomes. Traditionally, surgical intervention plays a minimal role in its treatment. However, more recent studies document that complete surgical resection of distant metastases is associated with 5-year survival rates of 15% to 30%. These rates are greater than that reported for single-agent or combination chemotherapy, biologic agents or immunotherapy. This case report outlines a unique presentation of stage IV melanoma within the gastrointestinal tract located in 2 different organs. On the basis of the patient's clinical findings, laparoscopic surgery was performed for palliation of intestinal obstruction and bleeding. This approach resulted in less postoperative pain, earlier mobilization, and a faster return to daily activities. To our knowledge, this case details the only known account that uses a laparoscopic approach to palliate stage IV melanoma at 2 synchronous sites; the stomach and small bowel. The literature regarding the treatment of metastatic melanoma is also briefly reviewed.
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PMID:Laparoscopy for stage IV melanoma in two organs. 2072 7


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