title: Malignant melanoma metastasis as a cause of small-bowel perforation.
abstract: BACKGROUND
  Malignant melanoma is a disease with an increasing rate of incidence, currently at 10 cases per 100,000. In most cases, malignant melanoma metastasizes over the lymph vessels to parenchymal organs. Symptomatic metastases are found in the gastrointestinal tract in only about 2% of the patients.
  
  
  METHODS
  A 43-year-old patient with a known metastasized malignant melanoma (brain, liver, bones) was admitted to the department of dermatology due to fatigue, headache and unspecified abdominal symptoms. Because of persistent abdominal symptoms, a computed tomography (CT) scan of the abdomen was performed, showing a perforation of the ileum with an abscess on the basis of multiple small-bowel metastases. A segmental small-bowel resection with primary anastomosis was performed. The postoperative course of the patient was complicated by a subcutaneous wound infection and a prolonged period of convalescence (due to multiple brain metastases).
  
  
  CONCLUSIONS
  Novel therapy concepts and medication in the treatment of patients with malignant melanoma have improved life expectancy. These patients are therefore expected to suffer more frequently from complications of the primary disease. Interdisciplinary management and cooperation is required to adequately diagnose and handle such cases.
authors.affiliation: Klinik für Allgemein-, Visceral-, Gefäss- und Thoraxchirurgie, Charité Campus Mitte, Universitatsmedizin Berlin, Germany. nikolaos.tsilimparis@charite.de
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Tsilimparis
authors.forename: Charalampos
authors.initials: C
authors.lastname: Menenakos
authors.forename: Patrick
authors.initials: P
authors.lastname: Rogalla
authors.forename: Chris
authors.initials: C
authors.lastname: Braumann
authors.forename: Jens
authors.initials: J
authors.lastname: Hartmann
mesh_terms: D000328:Adult; D006801:Humans; D007414:Intestinal Neoplasms / Q000150:complications* / Q000556:secondary*; D007416:Intestinal Perforation / Q000175:diagnosis* / Q000209:etiology*; D007421:Intestine, Small / Q000293:injuries*; D008297:Male; D008545:Melanoma / Q000175:diagnosis* / Q000556:secondary*; D012878:Skin Neoplasms / Q000150:complications* / Q000175:diagnosis*