title: Perforation of metastatic melanoma to the small bowel with simultaneous gastrointestinal stromal tumor.
abstract: The gastrointestinal tract (GIT) is a common site of metastases for malignant melanoma. These metastatic tumors are often asymptomatic. We describe a case of a 58-year-old male who presented with a sudden onset of generalized abdominal pain. The patient's past medical history was significant for lentigo melanoma of the right cheek. Laparotomy was performed and two segments of small bowel, one with a perforated tumor, the other with a non-perforated tumor, were removed. Histology and immunohistochemical staining revealed the perforated tumor to be a metastatic malignant melanoma and the non-perforated tumor was found to be a gastrointestinal stromal tumor (GIST). The patient was discharged 7 d postoperatively. To the best of our knowledge, this is the first reported case in the literature of a simultaneous metastatic malignant melanoma and a GIST. Surgical intervention is warranted in patients with symptomatic GIT metastases to improve the quality of life or in those patients with surgical emergencies.
authors.affiliation: University of Missouri School of Medicine, Department of Surgery, Mc Haney Hall 413, One Hospital Drive, Columbia, MO 65211, USA.
authors.forename: Nathan
authors.initials: N
authors.lastname: Brummel
authors.forename: Ziad
authors.initials: Z
authors.lastname: Awad
authors.forename: Shellaine
authors.initials: S
authors.lastname: Frazier
authors.forename: Jiafan
authors.initials: J
authors.lastname: Liu
authors.forename: Nitin
authors.initials: N
authors.lastname: Rangnekar
mesh_terms: D046152:Gastrointestinal Stromal Tumors / Q000150:complications / Q000473:pathology*; D006801:Humans; D007416:Intestinal Perforation / Q000209:etiology*; D007421:Intestine, Small / Q000473:pathology; D008297:Male; D008545:Melanoma / Q000150:complications / Q000556:secondary*; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000150:complications / Q000473:pathology; D012878:Skin Neoplasms / Q000473:pathology*