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Endoscopic reduction of colocolonic intussusception due to metastatic malignant melanoma: A case report
Kengo Kasuga1, Taku Sakamoto2, Hiroyuki Takamaru1
1Endoscopy Division, National Cancer Center Hospital, Tokyo 104-0045, Japan.
Background:
Intussusception rarely causes intestinal obstruction in adults. Metastatic malignant melanoma is the main cause of intussusception of the small intestine among adults. However, malignant melanoma rarely causes intussusception of the colorectum. Moreover, emergent surgery is usually performed for such cases. Here, we report a case of a patient with colocolonic intussusception caused by a malignant melanoma, for which endoscopic reduction and elective surgery were performed.
Case Summary:
The patient was a 64-year-old woman who underwent multiple surgeries and received chemotherapy and immunotherapy for a malignant melanoma. During immunotherapy, she had abdominal pain, diarrhea, and bloody stool. Physical examination and laboratory studies did not reveal any findings that warranted emergent surgery. Computed tomography revealed intussusception in the descending colon without intestinal necrosis and perforation. Intussusception was reduced endoscopically, and elective surgery was performed.
Conclusion:
This report suggests that endoscopic reduction and elective surgery constitute a treatment option for colocolonic intussusception of metastatic malignant melanomas.
Insights
Malignant melanoma rarely causes colocolonic intussusception in adults. This case demonstrates successful endoscopic reduction and elective surgery for this rare condition, offering a viable treatment alternative.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Oncology
Background:
- Intussusception is an uncommon cause of intestinal obstruction in adults, with metastatic malignant melanoma being the primary etiology for small intestine intussusception.
- Colorectal intussusception caused by malignant melanoma is rare, and typically necessitates emergent surgical intervention.
Observation:
- A 64-year-old woman with a history of malignant melanoma presented with abdominal pain, diarrhea, and bloody stool during immunotherapy.
- Computed tomography revealed colocolonic intussusception without signs of necrosis or perforation, and without findings warranting emergent surgery.
Findings:
- Endoscopic reduction of the colocolonic intussusception was successfully performed.
- The patient subsequently underwent elective surgery.
Implications:
- This case suggests that endoscopic reduction followed by elective surgery is a feasible treatment option for colocolonic intussusception secondary to metastatic malignant melanoma.
- This approach may offer an alternative to emergent surgery in select adult patients with malignant melanoma-induced intussusception.
