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GastroenterologySmall intestine

Malignant diseases

Small bowel melanoma.
A 51-year-old woman who presented with a two-week history of colicky abdominal pain and change in bowel habit - with intermittent diarrhoea. Her abdominal pain was brought on by eating. Fifteen years earlier a malignant melanoma had been excised from under her left breast. Four years ago she underwent a left mastectomy for cutaneous melanoma. Two months before the current admission she underwent cardiac surgery for what was thought to be an atrial myxoma - and proved to be melanoma.

On this occasion the examination was unremarkable, with no evidence of metastatic disease. A CT scan was performed. This slice shows an intussusception. There is contrast in the small bowel surrounding (the intussuscipiens) the intussusceptum.

At operation she was found to have a mid-jejunal intussusception. An enlarged (and black) mesenteric node can be seen.

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