A case of severe anemia which lead to the detection of malignant melanoma metastasis to the gastrointestinal tract

Abstract

The 77-year-old men underwent resection for the malignant melanoma of the right buccal region. Six months later, it recurred in a cervical lymph node and he underwent lymphadenectomy. One year later, he was complained of left lower quadrant pain, appetite loss and weight loss. He consulted neighboring doctor’s office. A blood test revealed anemia. He was admitted to our hospital to undergo treatment. Contrast enhanced abdominal CT showed expansion of the proximal jejunum to a diameter 63×60mm size in left kidney ventral aspect.
Double balloon endoscopy showed lesions similar to the submucosal tumor in the duodenum and proximal jejunum. We diagnosed gastrointestinal metastasis of malignant melanoma from histopathology findings and a history of malignant melanoma. Malignant melanoma has few cases that gastrointestinal metastasis is found in during the life time. Approximately half of patients with malignant melanoma who held an autopsy metastasized to gastrointestinal tract particularly a small intestine. When we detected the lesion similar to the submucosal tumor occurring frequently at endoscopy, we think about a malignant melanoma first, and it is necessary to perform the hearing of the medical history and a pathological search.