Malignant melanoma metastases to the alimentary tract.

Abstract

SUMMARY Seven patients are presented each with symptomatic malignant melanoma metastases to the alimentary tract. Where practicable, surgical excision of the metastases is justified because two patients have had worthwhile periods of survival.The metastases ofmalignant melanoma are notorious for appearing many years after the primary and for their myriad clinical manifestations. Even so, symptomatic metastases to the alimentary tract are uncommon. Seven patients are described who presented with alimentary tract lesions which proved to be late metastases from malignant melanoma.These patients were all initially treated at Frenchay Hospital during the last 20 years. In each case, the primary malignant melanoma of the skin was excised widely, subsequently confirmed histologically, and the defect covered with a split skin graft. The patients were regularly re-examined. However, from two to 12 years later each patient was urgently referred to a general surgeon or physician, usually with symptoms of weight loss, cachexia, and anaemia. The case histories are summarized in the Table. Two patients (cases 4 and 5) were unfit for surgery and soon died; the diagnosis of metastases in the

Melanoma Metastatic to the Colon

“…2,3,7, Before this review, only eight cases of isolated metastatic melanoma to the colon had been reported. 8,[17][18][19][20][21][22][23][24][25][26][27][28][29][30] The mean age of these 23 patients was 63.9. In addition to the 24 patients listed in this study, 23 patients had enough data published for complete comparable review.…”

Management of Symptomatic Malignant Melanoma of the Gastrointestinal Tract

“…Lesions involving the colon, stomach, and duodenum are less common, and metastases to the esophagus, pancreas, spleen, and gallbladder are rare. 4,16,17 FIG. 3.…”

Metastatic Malignant Melanoma of the Gastrointestinal Tract

“…Other authors have also reported improved survival and palliation of symptoms after resection of both solitary and multiple small bowel metastatic melanoma lesions. 23,24,[45][46][47][48][49][50][51][52] Taking into account the results of these studies collectively, in patients with melanoma metastatic to the GI tract, particularly if the GI metastasis is the first site of stage IV disease, curative surgical resection should be strongly considered both for palliation of symptoms and improvement in mortality.…”