© Georg Thieme Verlag KG Stuttgart · New York
Metastatic malignant melanoma of the small intestine: capsule endoscopic appearance
05 July 2007 (online)
Capsule enteroscopy (CE) can identify primary  and metastatic intestinal melanoma, as previously described  and illustrated with surgical and histological verification . However, capsule enteroscopic identification of the characteristic coal-black appearance of malignant melanoma has not been described previously in intestinal tumors.
A 56-year-old man receiving dendritic cell-based therapy for metastatic malignant melanoma presented with anemia and black stools. Abdominal computer tomography suggested peritoneal carcinomatosis. There were no clinical or radiological signs of intestinal obstruction. Gastroscopy and colonoscopy were normal. CE revealed a localized area with whitish tissue and characteristic coal-black, sharply demarcated circular areas, consistent with metastatic melanoma. This area was located in the ileum, centrally in the abdomen, after 6 hours 19 minutes ([Figure 1], Video 1). Because of the disseminated disease and the absence of obstructive symptoms, the dendritic cell-based therapy was continued without surgical intervention. The patient passed away 2 months later.
Figure 1 Capsule endoscopic appearance of a metastatic malignant melanoma in the small intestine.
online content including video sequences viewable at:
- 1 Kruger S, Noack F, Blochle C, Feller A C. Primary malignant melanoma of the small bowel: a case report and review of the literature. Tumori. 2005; 91 73-76
- 2 Bailey A A, Debinsky H S, Appleyard M N. et al . Diagnosis and outcome of small bowel tumors found by capsule endoscopy: a three-center Australian experience. Am J Gastroenterol. 2006; 101 2237-2243
- 3 Lykke J, Hansen M B, Ovesen H, Meisner S. Capsule endoscopy detection of metastasis of a malignant melanoma in the small intestine. Ugeskr Læger. 2006; 168 3533-3534
S. Adamsen, MD
Department of Gastrointestinal Surgery
Copenhagen University Hospital Herlev
75, Herlev Ringvej