Small bowel melanoma causing obstruction: A case report and a literature review

Primary small bowel melanoma (PSBM) is a rare form of melanoma that originates from the intestinal mucosa. It is typically asymptomatic; however, it can present with non-specific symptoms, which pose challenges in accurately diagnosing the condition. In rare cases, it may manifest as small bowel obstruction, further adding challenges with diagnosis and management.

A 57-year-old male presented to the hospital with complaints of chronic constipation, abdominal pain, and abdominal enlargement. Computed tomography (CT) scan revealed thickening of the jejunum wall, while endoscopy and biopsy revealed nothing. During surgery, surgeons identified and excised a jejunal mass. Subsequent pathological analysis confirmed the diagnosis of melanoma, and post-surgical examination failed to identify primary cutaneous melanoma.

PSBM is a rare and aggressive tumor often misdiagnosed due to non-specific symptoms and challenging imaging interpretations. Obstruction and intussusception are uncommon presentations. Surgical resection offers symptom control and improved prognosis, but achieving negative margins can be challenging. Early recognition and diagnosis are crucial for optimal management.

The lack of data in the literature presents challenges in identifying and selecting the optimal approach for managing PSBM. Physicians should increase their awareness of this specific type of tumor to facilitate early-stage diagnosis and provide appropriate care for patients.