Case Report
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Mar 14, 2015; 21(10): 3114-3120
Published online Mar 14, 2015. doi: 10.3748/wjg.v21.i10.3114
Recurrent intussusception as initial manifestation of primary intestinal melanoma: Case report and literature review
Konstantinos Kouladouros, Daniel Gärtner, Steffen Münch, Mario Paul, Michael R Schön
Konstantinos Kouladouros, Daniel Gärtner, Steffen Münch, Mario Paul, Michael R Schön, Department of General Surgery, Städtisches Klinikum, Karlsruhe 76133, Germany
Author contributions: Kouladouros K, Gärtner D, Münch S, Schön MR and Paul M were the attending physicians for the length of the patient’s treatment at the Department of General Surgery; Gärtner D was the operating surgeon in both operations; Kouladouros K reviewed the literature and wrote the paper; Kouladouros K, Gärtner D and Schön MR revised the paper.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Konstantinos Kouladouros, MD, Resident Physician, Department of General Surgery, Städtisches Klinikum, Moltkestrasse 90, Karlsruhe 76133, Germany. kouladou@otenet.gr
Telephone: +49-721-9742101 Fax: +49-721-9742190
Received: August 17, 2014
Peer-review started: August 18, 2014
First decision: September 15, 2014
Revised: October 17, 2014
Accepted: November 7, 2014
Article in press: November 11, 2014
Published online: March 14, 2015
Processing time: 210 Days and 23 Hours
Abstract

Enteric intussusception caused by primary intestinal malignant melanoma is a very rare cause of intestinal obstruction. We herein present a case of a 42-year-old female patient with no prior medical history of malignant melanoma, who was admitted with persistent abdominal pain, nausea, and vomiting. A computed tomography scan revealed an intestinal obstruction due to ileocolic intussusception. An emergency laparoscopy and subsequent laparotomy revealed multiple small solid tumors across the whole small bowel. An oncologic resection was not feasible due to the insufficient length of the remaining small bowel. Only a small segment of ileum, which included the largest tumors causing the intussusception, was resected. The pathologic examination revealed two intestinal malignant melanoma lesions. A systematic clinical examination, endoscopic procedures, and fluorodeoxyglucose positron emission tomography-computed tomography scan all failed to reveal any indication of cutaneous, anal, or retinal melanoma. Hence, the tumor was classified as a primary intestinal malignant melanoma with multiple intestinal metastases. Since a complete oncologic resection of tumors was not possible, in order to prevent future intestinal obstruction, a surgical resection of the largest lesions was performed with palliative intention. The epidemiology, clinical manifestations, diagnosis and management of primary intestinal malignant melanoma, and intestinal intussusception in adults are discussed along with a review of the current literature.

Keywords: General surgery; Intestinal neoplasms; Intestinal obstruction; Intussusception; Melanoma

Core tip: We report a case of primary intestinal melanoma presented with an ileocecal intussusception in an adult female patient. Intussusception is an unusual cause of intestinal obstruction in adults with primary intestinal melanoma being a rare intestinal neoplasia. To the best of our knowledge, very few cases of primary intestinal melanoma presenting with enteric intussusception in adults have been reported thus far. In addition to discussing clinical presentations, diagnostics and treatment of the primary intestinal malignant melanoma, and intestinal intussusception in adults, we also performed a comprehensive review of the current literature.