Primary Jejunal Melanoma Presenting With Intussusception in a Patient With Chronic Iron Deficiency Anemia

Area of Science:

• Gastroenterology
• Oncology
• Pathology

Background:

• Primary gastrointestinal melanomas (PGIMs) are rare malignancies.
• PGIMs are particularly uncommon in the small bowel, presenting diagnostic challenges due to varied symptoms and mimicry of metastatic melanoma.

Observation:

• An 84-year-old male presented with chronic anemia, fatigue, and dizziness.
• Initial upper and lower endoscopy were inconclusive.
• Video capsule endoscopy showed aphthous ulcers, and CT enterography revealed a jejunal mass causing intussusception.

Findings:

• Exploratory laparotomy confirmed a 3.5 cm jejunal mass.
• Histological examination identified the mass as high-grade malignant melanoma.
• This is the first reported case of primary jejunal melanoma presenting with chronic anemia and intussusception.

Implications:

• This case underscores the diagnostic complexities of PGIMs.
• Highlights the importance of advanced imaging modalities and surgical intervention in diagnosing rare GI tumors.
• Emphasizes the need for increased awareness of PGIMs in elderly patients with nonspecific gastrointestinal symptoms.