Melanoma involving the gastrointestinal tract

We studied 19 patients, 12 males and 7 females of a median age of 49 years (range 26-76) with clinical manifestations of gastro-intestinal (GI) involvement from malignant melanoma. Their records were available from an electronic database of 2163 patients registered between 1977 and 1998 with the Melanoma Unit initially at Westminster and currently at Charing Cross Hospital. Time interval from initial presentation of melanoma to the development of GI involvement ranged from 6 to 183 months (median 44 months). Twelve patients had a laparotomy and in eight of these resection of metastatic sites was complete. Ten patients received systemic treatment. Median survival from GI involvement for patients who had resection of metastases was 21.5 months (range 1 to 253 months). Enterectomy, especially in the presence of solitary intestinal metastases, can palliate and may prolong survival. The role of adjuvant chemotherapy is less well defined but is worthy of consideration.