A Case of Jejunal Metastasis from a Malignant Melanoma Resected by Laparoscopic Surgery

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  • 腹腔鏡補助下に切除した悪性黒色腫小腸転移の1例
  • 症例 腹腔鏡補助下に切除した悪性黒色腫小腸転移の1例
  • ショウレイ フククウキョウ ホジョ カ ニ セツジョ シタ アクセイ コクショク シュ ショウチョウ テンイ ノ 1レイ

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Abstract

A man in his sixties was diagnosed with malignant melanoma of the nasal cavity for which he had been treated with heavy ion radiotherapy and chemotherapy in 2010, and he underwent surgery for local recurrence in 2011. Due to melena, he was examined with upper gastrointestinal endoscopy and colonoscopy, but no abnormalities were seen. Enhanced abdominal CT and transanal double-balloon endoscopy revealed a small intestinal tumor, but the result of the biopsy indicated necrotic tissue. However, we suspected a malignant tumor and performed laparoscopic surgery, placing 1 port each in the left and right lower abdomen and the umbilicus. Distant metastases and peritoneal dissemination were not observed. We extracted the small intestine from the abdominal cavity by extending the umbilical wound and performed resection and reconstruction. The postoperative course was uneventful, and he was discharged at postoperative day 11. The resected specimen was a type 2 tumor that spanned the entire intestinal circumference, measuring 7 cm × 6 cm, and the patient was histologically diagnosed with metastatic malignant melanoma of the nasal cavity. Cases of distant metastases of malignant melanoma have a poor prognosis. However, when curative resection is possible in a solitary metastasis, the less invasive laparoscopic surgery may prolong survival in a patient.

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