Malignant melanoma arising from an end ileostomy

Area of Science:

• Oncology
• Gastroenterology
• Dermatology

Background:

• Ulcerative colitis (UC) patients undergoing proctocolectomy with end ileostomy are at risk for rare complications.
• A 65-year-old female with a history of UC and ileostomy presented with a perileostomy mass.

Observation:

• Physical examination revealed an exophytic mass around the ileostomy and palpable inguinal lymphadenopathy.
• Biopsy confirmed invasive melanoma.
• Positron emission tomography (PET) showed regional metastatic lymphadenopathy in the axilla and groins, with no distant metastases.

Findings:

• The patient underwent wide local excision, bowel resection, ileostomy re-siting, bilateral ilioinguinal lymphadenectomy, and axillary dissection.
• Adjuvant therapy with BRAF and MEK inhibitors was initiated.

Implications:

• This case highlights the importance of considering rare melanoma development in the perileostomy site.
• Multimodal treatment including surgery and targeted therapy can achieve favorable outcomes in such cases.
• Further research into the surveillance of ileostomy sites in UC patients may be warranted.