title: Primary colonic melanoma presenting as ileocecal intussusception: case report and literature review.
abstract: Primary malignant melanoma originating in the colon is an extremely rare disease. Herein, we report a case of primary melanoma of the ascending colon. The patient was a 57-year-old male who was admitted to our hospital for persistent abdominal pain and episodes of bloody stool, nausea and vomiting. A computed tomography scan revealed lower intestinal intussusception and enlarged lymph nodes in the abdominal cavity and retroperitoneum. During laparoscopic operation, multiple enlarged lymph nodes were found. Several segments of the proximal small intestine were incarcerated into the distal small intestine, forming an internal hernia and obstruction. The necrotic terminal ileum was invaginated into the ascending cecum. Subsequently, adhesive internal hernia reduction and palliative right hemicolectomy were performed. Pathologic examination of the excised specimen revealed a polypoid mass in the ascending colon. Histological examination showed epithelioid and spindle tumor cells with obvious cytoplasmic melanin deposition. Immunohistochemical staining revealed that the tumor cells were positive for S-100, HMB-45 and vimentin, confirming the diagnosis of melanoma. The patient history and a thorough postoperative investigation excluded the preexistence or coexistence of a primary lesion elsewhere in the skin, anus or oculus or at other sites. Thus, we consider our case to represent an aggressive primary colon melanoma presenting as ileocecal intussusception and intestinal obstruction.
authors: Wen-Xiang Li, Ye Wei, Yi Jiang, Li Ren, Yun-Shi Zhong, Le-Chi Ye, De-Xiang Zhu, Wei-Xin Niu, Xin-Yu Qin, Jian-Min Xu, Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
authors: Wen-Xiang
authors: WX
authors: Li
authors: Wen-Xiang Li, Ye Wei, Yi Jiang, Li Ren, Yun-Shi Zhong, Le-Chi Ye, De-Xiang Zhu, Wei-Xin Niu, Xin-Yu Qin, Jian-Min Xu, Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
authors: Ye
authors: Y
authors: Wei
authors: Wen-Xiang Li, Ye Wei, Yi Jiang, Li Ren, Yun-Shi Zhong, Le-Chi Ye, De-Xiang Zhu, Wei-Xin Niu, Xin-Yu Qin, Jian-Min Xu, Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
authors: Yi
authors: Y
authors: Jiang
authors: Wen-Xiang Li, Ye Wei, Yi Jiang, Li Ren, Yun-Shi Zhong, Le-Chi Ye, De-Xiang Zhu, Wei-Xin Niu, Xin-Yu Qin, Jian-Min Xu, Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
authors: Ya-Lan
authors: YL
authors: Liu
authors: Wen-Xiang Li, Ye Wei, Yi Jiang, Li Ren, Yun-Shi Zhong, Le-Chi Ye, De-Xiang Zhu, Wei-Xin Niu, Xin-Yu Qin, Jian-Min Xu, Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
authors: Li
authors: L
authors: Ren
authors: Wen-Xiang Li, Ye Wei, Yi Jiang, Li Ren, Yun-Shi Zhong, Le-Chi Ye, De-Xiang Zhu, Wei-Xin Niu, Xin-Yu Qin, Jian-Min Xu, Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
authors: Yun-Shi
authors: YS
authors: Zhong
authors: Wen-Xiang Li, Ye Wei, Yi Jiang, Li Ren, Yun-Shi Zhong, Le-Chi Ye, De-Xiang Zhu, Wei-Xin Niu, Xin-Yu Qin, Jian-Min Xu, Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
authors: Le-Chi
authors: LC
authors: Ye
authors: Wen-Xiang Li, Ye Wei, Yi Jiang, Li Ren, Yun-Shi Zhong, Le-Chi Ye, De-Xiang Zhu, Wei-Xin Niu, Xin-Yu Qin, Jian-Min Xu, Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
authors: De-Xiang
authors: DX
authors: Zhu
authors: Wen-Xiang Li, Ye Wei, Yi Jiang, Li Ren, Yun-Shi Zhong, Le-Chi Ye, De-Xiang Zhu, Wei-Xin Niu, Xin-Yu Qin, Jian-Min Xu, Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
authors: Wei-Xin
authors: WX
authors: Niu
authors: Wen-Xiang Li, Ye Wei, Yi Jiang, Li Ren, Yun-Shi Zhong, Le-Chi Ye, De-Xiang Zhu, Wei-Xin Niu, Xin-Yu Qin, Jian-Min Xu, Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
authors: Xin-Yu
authors: XY
authors: Qin
authors: Wen-Xiang Li, Ye Wei, Yi Jiang, Li Ren, Yun-Shi Zhong, Le-Chi Ye, De-Xiang Zhu, Wei-Xin Niu, Xin-Yu Qin, Jian-Min Xu, Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
authors: Jian-Min
authors: JM
authors: Xu
mesh_terms: D014408:Biomarkers, Tumor / Q000032:analysis; D001706:Biopsy; D003082:Colectomy; D003110:Colonic Neoplasms / Q000737:chemistry / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D006801:Humans; D007077:Ileal Diseases / Q000209:etiology; D007080:Ileocecal Valve / Q000601:surgery; D007150:Immunohistochemistry; D007443:Intussusception / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D010535:Laparoscopy; D008297:Male; D008545:Melanoma / Q000737:chemistry / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D008875:Middle Aged; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D014408:Biomarkers, Tumor
keywords: Colon; HMB-45; Ileocecal intussusception; Melanoma; Metastasis; S-100; Vimentin