A case of jejunal metastasis of malignant melanoma diagnosed by oral double-balloon endoscopy

Abstract

A 62-year-old female underwent resection of malignant melanoma in the right lumbar region and sentinel lymph node biopsy of the right inguinal lymph node, resulting in a diagnosis of stage IIID (pT4bN3cM0). The patient received postoperative chemoradiotherapy but developed iron deficiency anemia and intermittent abdominal pain during the treatment. An abdominal CT scan revealed soft tissue shadows within the lumen of the jejunum, along with partial intestinal intussusception and dilatation of the proximal side. The enlargement of surrounding mesenteric lymph nodes was also noted. An antegrade double-balloon enteroscopy identified elevated lesions with black epithelium and ulceration in the proximal jejunum, which were prone to bleeding. Pathological examination revealed a dense proliferation of round atypical cells in the mucosal layer, with brown pigment observed in the spores of some atypical cells. Based on these findings, the patient was diagnosed with jejunal metastases of malignant melanoma.