Intestinal obstruction due to melanoma metastasis: a diagnostic challenge

Roque-Roque J.S.; Calderón de la Cruz C.A.; Alcántara C.E. · Revista del Cuerpo Medico Hospital Nacional Almanzor Aguinaga Asenjo (2023) · DOI: 10.35434/rcmhnaaa.2023.163.1885

Resumen

Background: Melanoma is one of the main neoplasms with metastasis to the digestive system and needs a high index of diagnostic suspicion. Case report: A 64-year-old male patient with abdominal pain, vomiting and liquid stools. The admission diagnosis was gastrointestinal bleeding, ruled out by endoscopy and colonoscopy. Fifteen days after hospitalization, he presented symptoms of intestinal obstruction, confirmed by tomography, and incidentally, a tumor in the right hemithorax. The surgery finding was a polypoid mass in the ileum. Extended anamnesis reveals a history of cutaneous melanoma on the face. The immunohistochemistry demonstrated the melanocytic lineage of the lesion. The final diagnosis was intestinal obstruction due to intestinal polypoid metastatic melanoma. Conclusion: Intestinal obstruction due to melanoma metastasis is a diagnostic challenge due to the nonspecific clinical and radiologic presentation. The suspicion of the etiology should start from the anamnesis and confirm the tumor cellular lineage trough histopatology.

Instituciones: Universidad Nacional Mayor de San Marcos; Universidad Privada Antenor Orrego