Solitary Metastatic Malignant Melanoma of the Small Intestine: Findings Obtained during Intraoperative Enteroscopy

A 59‐year‐old male with an established diagnosis of malignant melanoma of the nasal cavity plus multiple pulmonary metastases was referred to our hospital because of abdominal pain and vomiting. Double‐contrast study of the small intestine revealed a filling defect in the middle of the ileum. lntraoperative enteroscopy revealed that the ileal tumor was ulcerated, and that it was covered by ileal mucosa of normal appearance. Because no other lesions were identified within the intestine, the ileal segment with the tumor was surgically removed. The tumor was diagnosed as malignant melanoma with a histology similar to that of nasal mass. The patient has survived for the subsequent 13 months, during which no gastrointestinal symptoms recurred. Our case suggests that metastasis should be included in the differential diagnosis of a single small intestinal tumor. (Dig Endose 1999; 11: 47–51)