Capsule enteroscopy (CE) can identify primary [1] and metastatic intestinal melanoma, as previously described [2] and illustrated with surgical and histological verification [3]. However, capsule enteroscopic identification of the characteristic coal-black appearance of malignant melanoma has not been described previously in intestinal tumors.
A 56-year-old man receiving dendritic cell-based therapy for metastatic malignant melanoma presented with anemia and black stools. Abdominal computer tomography suggested peritoneal carcinomatosis. There were no clinical or radiological signs of intestinal obstruction. Gastroscopy and colonoscopy were normal. CE revealed a localized area with whitish tissue and characteristic coal-black, sharply demarcated circular areas, consistent with metastatic melanoma. This area was located in the ileum, centrally in the abdomen, after 6 hours 19 minutes ([Figure 1], Video 1). Because of the disseminated disease and the absence of obstructive symptoms, the dendritic cell-based therapy was continued without surgical intervention. The patient passed away 2 months later.
Figure 1 Capsule endoscopic appearance of a metastatic malignant melanoma in the small intestine.
Video 1 Capsule endoscopic appearance of a metastatic malignant melanoma in the small intestine.
online content including video sequences viewable at:
www.thieme-connect.de/ejournals/abstract/endoscopy/doi/
Endoscopy_UCTN_Code_CCL_1AC_2AC
