title: Recurrent intussusception as initial manifestation of primary intestinal melanoma: Case report and literature review.
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.
authors.affiliation: Konstantinos Kouladouros, Daniel Gärtner, Steffen Münch, Mario Paul, Michael R Schön, Department of General Surgery, Städtisches Klinikum, Karlsruhe 76133, Germany.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Kouladouros
authors.affiliation: Konstantinos Kouladouros, Daniel Gärtner, Steffen Münch, Mario Paul, Michael R Schön, Department of General Surgery, Städtisches Klinikum, Karlsruhe 76133, Germany.
authors.forename: Daniel
authors.initials: D
authors.lastname: Gärtner
authors.affiliation: Konstantinos Kouladouros, Daniel Gärtner, Steffen Münch, Mario Paul, Michael R Schön, Department of General Surgery, Städtisches Klinikum, Karlsruhe 76133, Germany.
authors.forename: Steffen
authors.initials: S
authors.lastname: Münch
authors.affiliation: Konstantinos Kouladouros, Daniel Gärtner, Steffen Münch, Mario Paul, Michael R Schön, Department of General Surgery, Städtisches Klinikum, Karlsruhe 76133, Germany.
authors.forename: Mario
authors.initials: M
authors.lastname: Paul
authors.affiliation: Konstantinos Kouladouros, Daniel Gärtner, Steffen Münch, Mario Paul, Michael R Schön, Department of General Surgery, Städtisches Klinikum, Karlsruhe 76133, Germany.
authors.forename: Michael R
authors.initials: MR
authors.lastname: Schön
mesh_terms: D000328:Adult; D014408:Biomarkers, Tumor / Q000032:analysis; D001706:Biopsy; D018450:Disease Progression; D058582:Double-Balloon Enteroscopy; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007077:Ileal Diseases / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D007078:Ileal Neoplasms / Q000737:chemistry / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D007150:Immunohistochemistry; D007443:Intussusception / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D010535:Laparoscopy; D008545:Melanoma / Q000737:chemistry / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D009378:Neoplasms, Multiple Primary / Q000737:chemistry / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D010166:Palliative Care; D049268:Positron-Emission Tomography; D011237:Predictive Value of Tests; D012008:Recurrence; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D014408:Biomarkers, Tumor
keywords: General surgery; Intestinal neoplasms; Intestinal obstruction; Intussusception; Melanoma