#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Metastatic affection of small intestine as the first symptom of generalization of malignant melanoma


Authors: Š. Hlava 1;  R. Keil 1;  J. Šťovíček 1;  M. Grega 2
Authors‘ workplace: Interní klinika – gastroenterologie FN v Motole 1;  Ústav patologie a molekulární medicíny 2. LF UK a FN v Motole 2
Published in: Gastroent Hepatol 2013; 67(2): 127-131
Category: Digestive Endoscopy: Case Report

Overview

Malignant melanoma is the most common tumour that metastatically spreads into the gastrointestinal tract. Metastatic process in the gastrointestinal tract is present in 60% of patients with generalised disease according to findings at sections. Metastases can appear many years after the primary tumour excision. A common symptom of the metastatic process in the gastro­intestinal tract is anaemia. We present a clinical case of a 79-year-old man whose first symptoms of generalisation, four years after melanoma excision, were associated with small bowel metastatic involvement. Throughthis clinical case we want to show that in patients with obscure gastrointestinal bleeding it is important to consider possible metastatic bowel involvement, even many years after the primary melanoma excision.

Key words:
melanoma – bleeding – polypus – small intestine – metastasis


Sources

1. Incidence a mortalita – vývoj v čase C 43 zhoubný melanom kůže 1977–2010. Národní onkologický registr [online] [cit. 2013-08-01]. Dostupné z: http://www.svod.cz/analyse.php?modul=incmor#.

2. Blecker D, Abraham S, Furth EE et al. Melanoma in the gastrointestinal tract. Am J Gastroenterol 1999; 94(12): 3427–3433.

3. Das Gupta TK, Richard D, Brasfield. Meta­static Melanoma of the Gastrointestinal Tract Arch Surg 1964; 88(6): 969–973.

4. Reintgen DS, Thompson W, Garbutt J et al. Radiologic, endoscopic, and surgical considerations of melanoma metastatic to the gastrointestinal tract. Surgery 1984; 95(6): 635–639.

5. Schuchter LM, Green R, Fraker D. Primary and metastatic diseases in malignant melanoma of the gastrointestinal tract. Curr Opin Oncol 2000; 12(2): 181–185.

6. Bender GN, Maglinte DD, McLarney JH et al. Malignant melanoma: patterns of metastasis to the small bowel, reliability of imaging studies, and clinical relevance. Am J Gastroenterol 2001; 96(8): 2392–2400.

7. Kadakia SC, Parker A, Canales L. Metastatic tumors to the upper gastrointestinal tract: Endoscopic experience. Am J Gastro­enterol 1992; 87(10): 1418–1423.

8. Prakoso E, Selby WS. Capsule endoscopy in patients with malignant melanoma. Am J Gastroenterol 2007; 102(6): 1204–1208.

9. Goláňová J, Hrdlička L., Šťovíček J et al. Akutní krvácení z horní části gastointestinálního traktu – přehled urgentních endo­skopií horní části trávicího traktu na našem pracovišti. Vnitř Lék 2004; 50: 274–277.

10. Caputy GG, Donohue JH, Goellner JR et al. Metastatic melanoma of the gastro­intestinal tract. Results of surgical management. Arch Surg 1991; 126(11): 1353–1358.

11. Tsao H, Atkins MB. Management of Cutaneous Melanoma. N Engl J Med 2004; 351(10): 998–1012.

12. Krige JE, Nel PN, Hudson DA. Surgical treatment of metastatic melanoma of the small bowel. Am Surg 1996; 62(8): 658–663.

13. Ihde J, Coit D. Melanoma metastatic to stomach, small bowel, or colon. Am J Surg 1991; 162(3): 208–211.

14. Ollia DW, Essner R, Wanek LA et al. Surgical resection for melanoma metastatic to the gastrointestinal tract. Arch Surg 1996; 131(9): 957–980.

15. Prosby T, Fish R. Systemic treatments for metastatic cutaneous melanoma. Cochrane Database Syst Rev 2000; (2): CD001215.

16. Champan PB, Einhorn LH, Mezera ML et al. Phase III multicenter randomized trial of Darmouth Regiment Versus Dacarbazepine in patiens with metastatic Melanoma. Clin Oncology 1999; 17(9): 2745–2751.

17. Atkins MB, Kunkel L, Sznol M et al. High dose recombinant interleukin 2 therapy in patiens with metastatic melanoma: long term surfoval update. Cancor Sci Am; 6 (Suppl 1): S11–S14.

18. Kaufmann R, Spieth K, Leiter U et al. Temozolomide in combination with interferon alfa versus temezolomide alone i patiens with advanced metastatic melanom: a randomized, phase III, multicenter study from Dermatologic Cooperative Oncology group. J Clin Oncol 2005; 23(35): 9001.

19. Davies H, Bignell GR, Cox C et al. Mutations of BRAF gene in human cancor; Nature 2002; 417(6892): 949–954.

20. Wellbrock C, Hurlstone A. BRAF as therapeutic target in melanoma. Biochem Pharmacol 2010; 80(5): 561–567.

21. Long GV, Menzies AM, Nagrial M et al. Prognostic and clinicopatholigic associations of oncogenic BRAF in metastatic melanoma. J Clin Oncol 2011; 29(10): 1239–1246.

22. Champan PB, Hauschild A, Robert C et al. Improved survival with vemurafenib in melanoma with BRAF V600E mutation. N Engl J Med 2011; 364(26): 2507–2516.

23. Anforth R, Fernandez-Penas P, Long GV. Cutaneous toxicity of RAF inhibitors. Lancet Oncol 2013; 14(1): e11–e18.

24. Balch CM, Gerschenwald JE, Soong SJ et al. Final Version of 2009 AJCC Melanoma Staging and Classificacion. J Clin Oncol 2009; 27(36): 6199–6206.

Labels
Paediatric gastroenterology Gastroenterology and hepatology Surgery

Article was published in

Gastroenterology and Hepatology

Issue 2

2013 Issue 2

Most read in this issue
Topics Journals
Login
Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account

#ADS_BOTTOM_SCRIPTS#