Primary Melanoma of the Right Colon Presenting With Gastrointestinal Bleeding

Published on Aug 5, 2013in The Open Gastroenterology Journal
· DOI :10.2174/1874259901307010001
Busuttil Gerald1
Estimated H-index: 1
Blazic Ivan1
Estimated H-index: 1
+ 2 AuthorsBabic Darko1
Estimated H-index: 1
A 73 year old female presented with painless fresh rectal bleeding and anaemia. At colonoscopy, a large mass arising from the right colon was visualised and biopsied. Histological evaluation established a diagnosis of melanoma. Thorough clinical examination confirmed the presence of primary localised melanoma which was amenable to resection. At laparotomy, right hemicolectomy and lymphadenectomy were performed. Two years after her surgery, our patient is well without any evidence of disease recurrence. Primary melanoma of the colon is a very rare clinical entity and limited data are available regarding its pathogenesis, treatment and outcome. Primary surgical resection in localised disease appears to be the mainstay of treatment, although the role of adjuvant therapy is still to be established.
#1Umair Khalid (Aga Khan University)H-Index: 9
#2Taimur Saleem (Aga Khan University)H-Index: 14
Last. Muhammad Rizwan Khan (Aga Khan University)H-Index: 11
view all 4 authors...
Background Melanomas within the alimentary tract are usually metastatic in origin. On the other hand, primary melanomas of the gastrointestinal tract are relatively uncommon. There are several published reports of melanomas occurring in the esophagus, stomach, small bowel, and anorectum. The occurrence of primary melanoma of the colon has, however, only been rarely reported. The optimum modus operandi for the management of primary colonic melanoma remains nebulous due to the limited number of re...
31 CitationsSource
: Gastrointestinal malignant melanomas, either primary or metastatic, are rare and overlooked tumors. There is also controversy regarding the actual existence of primary melanoma in the gastrointestinal tract apart from the esophagus and anorectal regions, where melanocytes normally exist. A case of malignant melanoma in the cecum is presented. The patient was a 30- year-old male who presented to the hospital for abdominal pain and diarrhea. The tumor was located mainly in the submucosa and meas...
12 CitationsSource
#1Daisuke MoriH-Index: 13
#2Toshimi SatohH-Index: 16
Last. Osamu TokunagaH-Index: 30
view all 6 authors...
Primary malignant melanoma originating in the digestive tract is extremely rare. A case of primary malignant melanoma in the descending colon is described. The tumor was an elevated mass with surface necrosis. Histologically, tumor cells were arranged with compact nests surrounded by fibrous stroma. The tumor cells had pleomorphic nuclei and rich cytoplasm. In some areas, cells of signet ring-like appearance were found. An immunohistochemical examination showed that most of the tumor cells were ...
13 CitationsSource
#1Shmuel Avital (UM: University of Miami)H-Index: 3
#1Shmuel Avital (Memorial Medical Center)H-Index: 1
Last. Michael D. Hellinger (UM: University of Miami)H-Index: 13
view all 5 authors...
The small and large intestines are the most common sites for metastases from cutaneous malignant melanoma. However, primary melanomas in these sites are exceedingly rare. There are several case reports of patients with primary melanoma of the small bowel, but finding of a solitary primary melanoma in the colon is exceedingly rare. We describe a patient that was operated on for bowel obstruction due to colonic intussusception resulting from a right colonic tumor. Histopathological examination con...
24 Citations
#1Deron J. Tessier (Mayo Clinic)H-Index: 20
#2Elizabeth J. McConnell (Mayo Clinic)H-Index: 5
Last. Bruce G. Wolff (Mayo Clinic)H-Index: 81
view all 4 authors...
PURPOSE: Symptomatic melanoma of the colon is rare. The aim of this study was to determine the incidence, presenting signs and symptoms, and survival correlation. METHODS: A retrospective review was performed of all patients treated in Mayo Clinic facilities from 1960 to 2000 for primary and metastatic melanoma. We identified 24 patients with metastatic melanoma to the colon. RESULTS: There were 24 patients (14 males) with an average age of 60.4 years at the time of metastatic involvement. The i...
49 CitationsSource
#1Rae J. Jacobs-Cohen (Columbia University)H-Index: 1
#2Paul R. Wade (Columbia University)H-Index: 10
Last. Michael D. Gershon (Columbia University)H-Index: 107
view all 3 authors...
The development of melanocytes from neural crest-derived precursors that migrate along the dorsolateral pathway has been attributed to the selection of this route by cells that are fate-restricted to the melanocyte lineage. Alternatively, melanocytes could arise from nonspecified cells that develop in response to signals encountered while these cells migrate, or at their final destinations. In most animals, the bowel, which is colonized by crest-derived cells that migrate through the caudal bran...
17 CitationsSource
#1Dana L. Sachs (UM: University of Michigan)H-Index: 14
#2Lori Lowe (UM: University of Michigan)H-Index: 44
Last. Timothy M. Johnson (UM: University of Michigan)H-Index: 64
view all 5 authors...
Abstract Metastatic melanoma to the gastrointestinal tract is not uncommon with the small intestine representing the most common site of gastrointestinal metastases. The occurrence of primary melanoma of the small intestine, however, is rare. We describe a case of primary melanoma of the small intestine and establish criteria for distinction between primary and metastatic small intestinal melanoma. (J Am Acad Dermatol 1999;41:1042-4.)
60 CitationsSource
#1Daniel B. FrostH-Index: 6
#2Philip D. MercadoH-Index: 1
Last. Jon S. TyrellH-Index: 1
view all 3 authors...
Background: Small bowel cancer is a relatively rare tumor with an incidence of 2,700 new cases and 900 deaths per year. The influence of stage on survival has been reported only once previously. Patterns of recurrence are unreported.
60 CitationsSource
#1Romano Delcore (KU: University of Kansas)H-Index: 20
#2Stanley R. Friesen (KU: University of Kansas)H-Index: 21
The amalgamation of the neural and endocrine physiologic mechanisms for functional homeostasis as a neuroendocrine system is brought into focus in this chapter on the embryologic concepts in the APUD system. The neuroendocrine system, now regarded as the third division of the nervous system, is a regulatory mechanism that links the functions of the autonomic nerves and the endocrine cells throughout the body. The current realization that both neural and endocrine actions are often involved in th...
10 CitationsSource
#1Douglas S. ReintgenH-Index: 90
#2William R. ThompsonH-Index: 62
Last. Hilliard F. SeiglerH-Index: 72
view all 4 authors...
Malignant melanoma is the most common malignancy to metastasize to the gastrointestinal tract. In a retrospective computer-assisted data search of over 2500 patients with melanoma registered over the past 10 years, 110 patients have been identified to have premortem gastrointestinal metastatic disease (metastatic disease identified at least 6 months before death). The small intestine (35%), colon (14.5%), and stomach (7%) are the most common sites for metastases. Polypoid or ulcerating masses an...
143 Citations
Cited By2
#1Motochika Endo (Okayama University)
#2Shuya Yano (Okayama University)H-Index: 25
Last. Toshiyoshi Fujiwara (Okayama University)H-Index: 63
view all 14 authors...
Targeted therapies for malignant melanoma have improved patients' prognoses. A primary gastrointestinal malignant melanoma is very rare, with no standard treatment strategy. We treated a 78-year-old Japanese female with advanced primary gastrointestinal melanoma of the descending colon and gallbladder. We administered a multidisciplinary treatment: surgical resection of the descending colon and gallbladder tumors, resection of the metastatic lymph nodes behind the pancreas head, and immune check...
#1S. Miliaras (A.U.Th.: Aristotle University of Thessaloniki)H-Index: 5
#2Ioannis A. Ziogas (A.U.Th.: Aristotle University of Thessaloniki)H-Index: 8
Last. Vasileios Papadopoulos (A.U.Th.: Aristotle University of Thessaloniki)H-Index: 12
view all 4 authors...
Malignant gastrointestinal melanoma is usually a metastatic lesion. We report the case of a 67-year-old female patient who presented with intermittent abdominal pain, fever, rigor and diarrhoea. CT scan of the abdomen revealed a large mass at the right iliac fossa with features concerning for intra-abdominal abscess. Exploratory laparotomy confirmed the preoperative diagnosis of abscess, and a right hemicolectomy was performed. Histopathological examination of the surgical specimen was indicativ...
2 CitationsSource