小腸原発メラニン欠乏性悪性黒色腫（amelanotic melanoma）の1例

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  • A Case of Primary Malignant Melanoma of the Small Intestine (Amelanotic Melanoma)

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A 59-year-old man presented because of persistent general fatigue and fever for 1 month. Laboratory tests showed anemia (Hb 6.6 g/dl). Abdominal CT scan showed a tumor with a thickened wall of the small intestine, and many small nodules in both lobes of the liver. Gastric and colonic fiberscopic studies showed no lesion. We diagnosed malignant small intestinal tumor and multiple metastatic tumor in the liver, so laparotomy was performed. Operative findings showed a solid tumor from the small intestine, but no invasion to other organs, and no enlarged mesenteric lymph nodes were identified. Partial resection of the small intestine was performed. Histological findings showed undifferentiated carcinoma or sarcoma, but immunohistochemical findings showed malignant amelanotic melanoma. General skin and skin-mucosa junctions were observed, but no evidence of primary lesions of malignant melanoma was found. After discharge, chemotherapy was performed by DTIC.

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