Title: Primary Malignant Melanoma of Jejunum with Perforation Peritonitis: A Case Report

Authors: Vivek Vasudeo, Madhu Smita, Nishant, Shital Malua

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i1.108

Abstract

Neuroendocrine tumours (NETs also known as carcinoid tumours), adenocarcinoma, GIST, lymphoma are the common malignant neoplasms of small bowel in that order. Malignant melanomas are the rare entities. They are found mostly as metastasis to small bowel. Primary malignant melanoma of small bowel is very rare with paucity of published reports. It can remain asymptomatic for long duration and is often diagnosed at an advanced stage or as in this case with perforation where no standardised management protocol is developed. The pathophysiology is debatable. It is currently challenging to differentiate primary and secondary gastrointestinal melanomas. In this case report, we have reported a case of primary malignant melanoma of jejunum presenting with perforation peritonitis. Laparotomyrevealed ablack, pigmented,ulceroproliferative jejunal massperoperatively. It was further confirmed on histopathology and immunohistochemistry as Malignant Melanoma. After ruling out the differentials and on retrograde specific clinical history and examination, the diagnosis of primary malignant melanoma of jejunum was made.

Keywords- primary malignant melanoma, jejunum, immunohistochemical, Gastrointestinal stromal tumour (GIST), metastasis, leiomyosarcomaand criteria.

References

1.      R. J. Bramhall, K. Mahady, A. H. Peach, “Spontaneous regression of metastatic melanoma - clinical evidence of the abscopal effect,” Eur J SurgOncol.,vol 40, pp. 34-41, 2014.

2.      K. S.Atmatzidis, T. E. Pavlidis, B. T. Papaziogas, “Primary malignant melano-ma of the small intestine: report of a case,” Surg Today,vol 32, no. 9, pp. 831-833, 2002. 

3.      E. J. Rummeny, P. Reimer, W. Heindel,“MR Imaging of the Body,”Thieme Medical Pub.(2009) ISBN:3131358416

4.      L. Baert, “Encyclopedia of Diagnostic imaging, ”Springer Verlag(2007) ISBN: 3540352783

5.      Y. Mishima, “Melanocytic and nevocytic malignant melanomas. Cellular and subcellular differentiation,”Cancer, vol. 20, pp. 632-649, 1967.

6.      M. Elsayed, M. Albahra,U. C. Nzeako, L. H.Sobin, “Malignant melanomas in the small intestine: a study of 103 patients,” Am J Gastroenterol., vol. 91, no. 5, pp. 1001-1006, May 1996.

7.      S. Kruger, F. Noack, C. Blochle, A. C. Feller, “Primary malignant melanoma of the small bowel: a case report and review of the literature,”Tumori, vol. 91, no. 1, pp.73-76, 2005.

8.      D. L.Sachs, L. Lowe, A. E. Chang, E. Carson, T. M. Johnson, “Do primary small intestinal melanoma exist? Report of a case,”J Am Acad Dermatol, vol. 41, pp. 1042–1044,1999.

9.      D. Blecker, S. Abraham, E. E. Furth, Kochman,“Melanoma in the gastrointestinal tract,”Am J Gastroenterol., vol. 94, no. 12, pp. 3427-3433,1999.

10.  T. K.Timmers, E. M. Schadd, J. F. Monkelbaan, et al, “Survival after resection of a primary malignant melanoma of the small intestine in a young patient: report of a case,” Case Rep Gastroenterol., vol. 7 no. 2,pp.251–260, May-Aug. 2013.

Corresponding Author

Vivek Vasudeo

Email: This email address is being protected from spambots. You need JavaScript enabled to view it., Mobile No. +919931704627