Cargando…

Small Bowel Metastatic Melanoma: An Emblematic “Coal-Black” Appearance at Videocapsule Endoscopy

A 80-year-old woman underwent vulvar melanoma resection and segmental lung resection for pulmonary metastasis. Immunotherapy with Nivolumab was performed. One year later, the patient was admitted for gastrointestinal (GI) recurrent bleeding and severe anemia. Esophagoastroduodenoscopy and colonoscop...

Descripción completa

Detalles Bibliográficos
Autores principales: Todeschini, Alessia, Loconte, Ilaria, Contaldo, Antonella, Ierardi, Enzo, Di Leo, Alfredo, Principi, Mariabeatrice
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8707397/
https://www.ncbi.nlm.nih.gov/pubmed/34946258
http://dx.doi.org/10.3390/medicina57121313
_version_ 1784622426864222208
author Todeschini, Alessia
Loconte, Ilaria
Contaldo, Antonella
Ierardi, Enzo
Di Leo, Alfredo
Principi, Mariabeatrice
author_facet Todeschini, Alessia
Loconte, Ilaria
Contaldo, Antonella
Ierardi, Enzo
Di Leo, Alfredo
Principi, Mariabeatrice
author_sort Todeschini, Alessia
collection PubMed
description A 80-year-old woman underwent vulvar melanoma resection and segmental lung resection for pulmonary metastasis. Immunotherapy with Nivolumab was performed. One year later, the patient was admitted for gastrointestinal (GI) recurrent bleeding and severe anemia. Esophagoastroduodenoscopy and colonoscopy did not show any abnormality, while videocapsule endoscopy (VCE) revealed an irregular and exophytic whitish area with a “coal-black” central depression. Small bowel resection was performed and histological examination revealed S100 protein strongly positive melanoma metastasis. The patient died six months later from disease progression. A “coal-black” appearance of intestinal metastatic melanoma has been described only twice before this report. In one case the patient had been treated by immunotherapy with interferon A and dendritic cell-based vaccination. In our patient, it is presumable that the picture we observed was a consequence of Nivolumab treatment inducing the disappearance of melanocytes in the area surrounding the metastasis with the onset of the central coal-black lesion encircled by whitish tissue. This picture should be emblematic of intestinal metastatic melanoma in subjects treated with immunotherapy showing occult/obscure bleeding.
format Online
Article
Text
id pubmed-8707397
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-87073972021-12-25 Small Bowel Metastatic Melanoma: An Emblematic “Coal-Black” Appearance at Videocapsule Endoscopy Todeschini, Alessia Loconte, Ilaria Contaldo, Antonella Ierardi, Enzo Di Leo, Alfredo Principi, Mariabeatrice Medicina (Kaunas) Case Report A 80-year-old woman underwent vulvar melanoma resection and segmental lung resection for pulmonary metastasis. Immunotherapy with Nivolumab was performed. One year later, the patient was admitted for gastrointestinal (GI) recurrent bleeding and severe anemia. Esophagoastroduodenoscopy and colonoscopy did not show any abnormality, while videocapsule endoscopy (VCE) revealed an irregular and exophytic whitish area with a “coal-black” central depression. Small bowel resection was performed and histological examination revealed S100 protein strongly positive melanoma metastasis. The patient died six months later from disease progression. A “coal-black” appearance of intestinal metastatic melanoma has been described only twice before this report. In one case the patient had been treated by immunotherapy with interferon A and dendritic cell-based vaccination. In our patient, it is presumable that the picture we observed was a consequence of Nivolumab treatment inducing the disappearance of melanocytes in the area surrounding the metastasis with the onset of the central coal-black lesion encircled by whitish tissue. This picture should be emblematic of intestinal metastatic melanoma in subjects treated with immunotherapy showing occult/obscure bleeding. MDPI 2021-11-30 /pmc/articles/PMC8707397/ /pubmed/34946258 http://dx.doi.org/10.3390/medicina57121313 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Todeschini, Alessia
Loconte, Ilaria
Contaldo, Antonella
Ierardi, Enzo
Di Leo, Alfredo
Principi, Mariabeatrice
Small Bowel Metastatic Melanoma: An Emblematic “Coal-Black” Appearance at Videocapsule Endoscopy
title Small Bowel Metastatic Melanoma: An Emblematic “Coal-Black” Appearance at Videocapsule Endoscopy
title_full Small Bowel Metastatic Melanoma: An Emblematic “Coal-Black” Appearance at Videocapsule Endoscopy
title_fullStr Small Bowel Metastatic Melanoma: An Emblematic “Coal-Black” Appearance at Videocapsule Endoscopy
title_full_unstemmed Small Bowel Metastatic Melanoma: An Emblematic “Coal-Black” Appearance at Videocapsule Endoscopy
title_short Small Bowel Metastatic Melanoma: An Emblematic “Coal-Black” Appearance at Videocapsule Endoscopy
title_sort small bowel metastatic melanoma: an emblematic “coal-black” appearance at videocapsule endoscopy
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8707397/
https://www.ncbi.nlm.nih.gov/pubmed/34946258
http://dx.doi.org/10.3390/medicina57121313
work_keys_str_mv AT todeschinialessia smallbowelmetastaticmelanomaanemblematiccoalblackappearanceatvideocapsuleendoscopy
AT loconteilaria smallbowelmetastaticmelanomaanemblematiccoalblackappearanceatvideocapsuleendoscopy
AT contaldoantonella smallbowelmetastaticmelanomaanemblematiccoalblackappearanceatvideocapsuleendoscopy
AT ierardienzo smallbowelmetastaticmelanomaanemblematiccoalblackappearanceatvideocapsuleendoscopy
AT dileoalfredo smallbowelmetastaticmelanomaanemblematiccoalblackappearanceatvideocapsuleendoscopy
AT principimariabeatrice smallbowelmetastaticmelanomaanemblematiccoalblackappearanceatvideocapsuleendoscopy