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Cutaneous malignant melanoma is the extra-abdominal neoplasia most frequently metastasized to the gastrointestinal tract. Although it can be located in any segment, it is most frequently established in the small intestine (51-71%), stomach (27%), large intestine (22%) and the oesophagus (5%). These metastases can occur synchronically with the primary tumour or appear decades later, as the first sign of a relapse of the disease in the form of: abdominal pain, dysphagia, intestinal obstruction, haematemesis, melaenas, etc. which require urgent surgery, justified by the improvement in the quality of life it provides with low morbidity and mortality (1). The differential diagnosis between primary and metastatic intestinal malignant melanoma may be complicated with routine examinations such as a barium study and CT scan, as their sensitivity is limited. The Positron emission tomography, however, can improve the detection of melanoma metastasis to the gastrointestinal tract. Despite the different therapeutic strategies, surgical removal is considered to be the treatment of choice in patients with resectable metastatic intestinal malignant melanoma (2). Prognosis is bad with an average survival rate of from 4 to 6 months (3), and is even worse in the case of primary intestinal malignant melanoma than when dealing with intestinal metastasis from extra-abdominal malignant melanoma (2). We present the clinical case of a young man who has undergone surgery for multiple intestinal perforations secondary to cutaneous malignant melanoma metastatic implants.

Intestinal perforation due to cutaneous malignant melanoma mestastatic implants