Do primary small intestinal melanomas exist? Report of a case,☆☆

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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.)

Section snippets

CASE REPORT

A 41-year-old white woman presented with signs and symptoms of a partial small bowel obstruction. She had a history of chronic and intermittently severe abdominal pain associated with weight loss and diarrhea for 5 years and had been treated unsuccessfully for peptic ulcer disease with antacids, omeprazole, sucralfate, metoclopramide, and H2 antagonists. The small bowel obstruction symptoms cleared spontaneously, but 1 week later she presented with similar symptoms and underwent an exploratory

DISCUSSION

The clinical findings of melanoma involving the gastrointestinal tract are variable ranging from clinically undetectable to symptomatic. The most frequent symptoms reported include cramping, abdominal pain related to obstruction, melena, anorexia, weight loss, vomiting, and constipation.4, 5, 8, 9 Gastrointestinal metastases are usually clinically undetectable in the early stages and require a high index of suspicion with a focused gastrointestinal review of symptoms. At autopsy, small

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