Case Report

Primary Malignant Melanoma of the Duodenum: Aggressive Management and Long-Term Survival of an Unusual Oncologic Entity

Authors: Dimitris P. Korkolis, MD, PhD, Katerina Apostolaki, MD, Emmanuel Gontikakis, MD, George D. Plataniotis, MD, Dimitris Siskos, MD, Dimitris Xinopoulos, MD, Dimitris Dimitroulopoulos, MD, Nikitas Papantoniou, MD, Maria Biteli, MD, Perikles P. Vassilopoulos, MD

Abstract

Primary malignant melanoma originating in the small bowel is extremely rare. We report the case of a 55-year-old man who presented with a preoperative bleeding duodenal tumor. A standard pancreaticoduodenectomy was performed. Histopathological examination ascertained the diagnosis of a duodenal malignant melanoma with locoregional lymphatic spread. A thorough postoperative investigation did not reveal any primary melanotic lesions. Thus, the diagnosis of a primary melanoma originating from the duodenum was suggested. Fourteen months after surgery, the patient had no evidence of recurrence. Primary malignant melanoma of the duodenum is an existing, though unusual, oncologic entity. Aggressive surgery remains the treatment of choice offering both symptom palliation and long-term survival.


Key Points


* Malignant melanoma is the most common tumor metastatic to the gastrointestinal tract.


* Primary malignant melanoma originating in the small intestine and particularly in the duodenum is extremely rare.


* Before making the diagnosis of malignant melanoma of the small bowel, other primary melanomas have to be excluded.


* Curative surgical resection of the tumor remains the treatment of choice.

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