Kasuga Kengo, Sakamoto Taku, Takamaru Hiroyuki, Sekiguchi Masau, Yamada Masayoshi, Yamazaki Naoya, Hashimoto Taiki, Uraoka Toshio, Saito Yutaka
Endoscopy Division, National Cancer Center Hospital, Tokyo 104-0045, Japan.
Department of Dermatologic Oncology, National Cancer Center Hospital, Tokyo 104-0045, Japan.
World J Clin Cases. 2020 Nov 26;8(22):5816-5820. doi: 10.12998/wjcc.v8.i22.5816.
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.
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.
This report suggests that endoscopic reduction and elective surgery constitute a treatment option for colocolonic intussusception of metastatic malignant melanomas.
肠套叠在成人中很少引起肠梗阻。转移性恶性黑色素瘤是成人小肠套叠的主要原因。然而，恶性黑色素瘤很少引起结直肠套叠。此外，此类病例通常需行急诊手术。在此，我们报告一例由恶性黑色素瘤引起的结肠结肠套叠患者，对此患者进行了内镜复位及择期手术。
该患者为一名64岁女性，曾因恶性黑色素瘤接受多次手术及化疗和免疫治疗。在免疫治疗期间，她出现腹痛、腹泻及便血。体格检查和实验室检查未发现任何需要急诊手术的指征。计算机断层扫描显示降结肠套叠，无肠坏死及穿孔。通过内镜对套叠进行了复位，并进行了择期手术。
本报告提示，内镜复位及择期手术是转移性恶性黑色素瘤所致结肠结肠套叠的一种治疗选择。
