Murawa Dawid, Spychała Arkadiusz
1st Department of Surgical Oncology and General Surgery, Greater Poland Cancer Center in Poznań.
Pol Przegl Chir. 2012 Aug;84(8):415-9. doi: 10.2478/v10035-012-0070-8.
Melanoma of unknown primary applies to 1-8% of all diagnosed melanomas, whereas primary melanoma of the small intestine is a extremely rare case. One of the melanoma characteristics is its capability of forming metastases in the small intestine which very often are diagnosed during autopsy.We present a case report of diagnosed melanoma of unknown primary, whose first symptom was intestinal obstruction. Before admission to the hospital cause of intestinal obstruction, the patient didn't present any signs and symptoms. All typical localizations of primary melanoma were excluded during diagnostic procedure. Palliative right hemicolectomy and segmental small intestine resection were performed. There were no complications in the postoperative course. On the ninth day the patient was discharged from hospital.Quick identification and radical resection of melanoma metastases in the alimentary tract may improve the survival rate in this group of patients. Resection, even if it is palliative by assumption, is not only the best method of elimination of persistent symptoms but it also gives hope for longer survival.
原发灶不明的黑色素瘤占所有确诊黑色素瘤的1% - 8%，而小肠原发性黑色素瘤则极为罕见。黑色素瘤的特征之一是其有能力在小肠形成转移灶，这些转移灶常在尸检时被诊断出来。我们报告一例原发灶不明的黑色素瘤病例，其首发症状为肠梗阻。在因肠梗阻入院前，患者未出现任何体征和症状。在诊断过程中排除了原发性黑色素瘤的所有典型发病部位。实施了姑息性右半结肠切除术和小肠节段切除术。术后过程无并发症。患者于术后第九天出院。快速识别并根治消化道黑色素瘤转移灶可能会提高这类患者的生存率。切除手术，即使按设想是姑息性的，不仅是消除持续症状的最佳方法，也为延长生存期带来希望。
