Haemorrhagic small bowel melanoma metastasis: a clinical rarity

BMJ Case Rep. 2019 Sep 11;12(9):e230454. doi: 10.1136/bcr-2019-230454.

Abstract

We report on a clinical case with haemorrhagic small bowel metastases in a malignant melanoma patient with anaemia, diagnosed using small bowel video capsule endoscopy (VCE). A 67-year-old male patient with a previous diagnosis of malignant melanoma presented with anaemia and vertigo on admission. The standard diagnostic protocol for gastrointestinal (GI) bleeding investigation including a gastroscopy, colonoscopy and small bowel capsule endoscopy, as well as abdominal sonography and a restaging protocol including chest-abdomen-pelvis CT (CAP-CT), echocardiography and ECG was applied. Gastroscopy and colonoscopy were not conclusive in determining the bleeding source. VCE provided evidence for numerous haemorrhagic small bowel metastases. The CAP-CT was unremarkable for small bowel findings. Due to a diffuse metastatic disease diagnosed in heart, brain, liver, spleen and bone metastasis, the patient was treated in a conservative/palliative manner. VCE can provide precious information about GI bleeding of unknown origin when classical diagnostic methods are non-conclusive.

Keywords: dermatology; endoscopy; gi bleeding; small intestine; small intestine cancer.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Anemia / etiology
  • Capsule Endoscopy
  • Fatal Outcome
  • Gastrointestinal Hemorrhage / etiology*
  • Humans
  • Ileal Neoplasms / complications*
  • Ileal Neoplasms / diagnostic imaging*
  • Ileal Neoplasms / secondary
  • Jejunal Neoplasms / diagnostic imaging*
  • Jejunal Neoplasms / secondary
  • Male
  • Melanoma / complications*
  • Melanoma / diagnostic imaging*
  • Melanoma / secondary
  • Skin Neoplasms / pathology*