Metastatic malignant melanoma of the gastrointestinal tract

Kelly V. Liang, Schuyler O. Sanderson, Grzegorz S Nowakowski, Amindra S. Arora

Research output: Contribution to journalArticle

91 Citations (Scopus)

Abstract

Malignant melanoma is one of the most common malignancies to metastasize to the gastrointestinal (GI) tract. Metastases to the GI tract can present at the time of primary diagnosis or decades later as the first sign of recurrence. Symptoms may include abdominal pain, dysphagia, small bowel obstruction, hematemesis, and melena. We report 2 cases of malignant melanoma metastatic to the GI tract, followed by a review of the literature. The first case is a 72-year-old man who underwent resection of superficial spreading melanoma on his back 13 years previously who presented with dysphagia. A biopsy specimen of a mucosal fold in a gastric fundus noted during endoscopy was taken and revealed metastatic malignant melanoma, which was resected 1 month later. Three weeks later, the patient was found to have an ulcerated jejunal metastatic melanoma mass, which was also resected. The second case is a 63-year-old man with an ocular melanoma involving the choroid of the left eye that had been diagnosed 4 years previously, which had been excised several times, who presented with anorexia, dizziness, and fatigue. He was found to have cerebellar and stomach metastases. He underwent adjuvant radiation therapy, chemotherapy, and surgical resection of the gastric melanoma metastasis. In patients with a history of melanoma, a high index of suspicion for metastasis must be maintained if they present with seemingly unrelated symptoms. Diagnosis requires careful inspection of the mucosa for metastatic lesions and biopsy with special immunohistochemical stains. Management may include surgical resection, chemotherapy, immunotherapy, observation, or enrollment in clinical trials. Prognosis is poor, with a median survival of 4 to 6 months.

Original languageEnglish (US)
Pages (from-to)511-516
Number of pages6
JournalMayo Clinic Proceedings
Volume81
Issue number4
DOIs
StatePublished - 2006

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Gastrointestinal Tract
Melanoma
Neoplasm Metastasis
Deglutition Disorders
Stomach
Gastric Fundus
Melena
Biopsy
Hematemesis
Drug Therapy
Choroid
Anorexia
Dizziness
Immunotherapy
Abdominal Pain
Endoscopy
Fatigue
Mucous Membrane
Coloring Agents
Radiotherapy

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Metastatic malignant melanoma of the gastrointestinal tract. / Liang, Kelly V.; Sanderson, Schuyler O.; Nowakowski, Grzegorz S; Arora, Amindra S.

In: Mayo Clinic Proceedings, Vol. 81, No. 4, 2006, p. 511-516.

Research output: Contribution to journalArticle

Liang, Kelly V. ; Sanderson, Schuyler O. ; Nowakowski, Grzegorz S ; Arora, Amindra S. / Metastatic malignant melanoma of the gastrointestinal tract. In: Mayo Clinic Proceedings. 2006 ; Vol. 81, No. 4. pp. 511-516.
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