Recurrent intussusception as initial manifestation of primary intestinal melanoma:Case report and literature review

Enteric intussusception caused by primary intestinalmalignant melanoma is a very rare cause of intestinalobstruction.We herein present a case of a 42-yearold female patient with no prior medical history ofmalignant melanoma,who was admitted with persistentabdominal pain,nausea,and vomiting.A computedtomography scan revealed an intestinal obstruction dueto 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 m a n i fe s t a t i o n s,d i a g n o s i s a n d m a n a g e m e n t o f primary intestinal malignant melanoma,and intestinal intussusception in adults are discussed along with a review of the current literature.