Primary Small Bowel Melanoma. Literature Review and a Case Report

Small bowel melanoma (SBM) is a rare entity, most of the time poorly diagnosed, and therefore it presents itself late in the course of the disease. Whether arise primarily or metastatically from a cutaneous melanoma, it is difficult to establish. In this report, we present a rare case of primary SBM and review of the current literature. A 50-year-old man is presented with melena and severe anemia in the emergency department. A series of investigations including abdominal ultrasonography (US), esophageal-gastro-duodenoscopy (EGDS) and colonoscopy were normal. Abdominal computed tomography showed a prominent mass which urged for immediate surgery. On laparotomy, the mass was resected, and histologically diagnosed as melanoma. Meticulous postoperative clinical examination revealed no cutaneous lesions. Review of the literature discusses gastrointestinal malignant melanoma and the possibilities of existence of true primary intestinal melanoma.