Abdominal Pain due to Primary Malignant Melanoma of the Small Intestine

To describe a patient presented with abdominal pain due to primary malignant melanoma of the small intestine. A 73-yr-old presented with anorexia, weight loss, colicky abdominal pain. Upper GI tract endoscopic and colonoscopic findings were normal. CT scan of the abdomen revealed a solid tumor, possibly originating from the distal jejenal segments as diffuse thickening of the intestinal wall, dilatation of the proximal segments of the intestine and mesenteric lymph node enlargement. Exploration laparotomy revealed a solid tumor, causing invagination, 4x3 cm. in size, approximately 60 cm. from the treitz.  Histopathological examination of the resected specimen made the diagnosis of malignant melanoma. The search for the primary site was negative. After the wide excision of the tumor and mesenteric lymph nodes, six months after the operation the patient remains well. Primary malignant melanoma of the small intestine is a rare condition that surgical intervention give the best chance for effective palliation and disease-free survival. KEY WORDS: Primary malignant melanoma, small intestine. OZET: Ince bagirsagin primer malign melanomu nedeniyle karin agrisi tanimlayan bir hasta sunuldu.73 yasinda erkek hasta anoreksi, kilo kaybi ve kolik abdominal agri ile basvurdu. Ust gastrointestinal endoskopisi ve kolonoskopisi normaldi. Abdomen CT’sinde distal jejenal ansi diffuz incelten ve proksimal segmentte dilatasyon yaratan solid kitle goruldu. Eksplorasyon laparatomisinde Treitz ligamanindan yaklasik 60cm mesafede 4x3cm solid tumore ulasildi. Histopatolojik tanisi malign melanom olarak konuldu. Primer tumor aramasi negatifti. Tumor ve lenf nodlari genis eksize edildi ve operasyondan 6 ay sonra hasta halen iyiydi. Ince bagirsaklarda primer malign melanom nadir bir durumdur ve efektif palyasyon ve hastaliksiz sag kalim icin cerrahi hastaya verilen en iyi sanstir. ANAHTAR KELIMELER: Primer malign melanom, ince bagirsak.