부산대학교 도서관

A 39-year-old man underwent tumor resection for a left upper arm malignant melanoma in 2011, and was treated with nivolumab for recurrence in the lung and brain. In July 2017, he had an emergency check-up at our hospital because of a terrible abdominal pain in his right hypochondrium. Contrast-enhanced CT showed target signs suggesting multiple small intestinal intussusceptions, so we decided to perform emergency surgery. Upon laparoscopic observation, there were brown tumors and multiple small intestinal intussusceptions in several places in the small intestine. We finally confirmed 8 brown tumors and multiple intussusceptions in 5 places by palpation. All intussusceptions occurred due to the presence of tumors, and laparoscopy-assisted partial resection of the small intestine was performed. Histopathological diagnosis revealed melanin granules in atypical cells of the tumors, and immunostaining was positive for S-100, Melan-A, and HMB45. All these findings were consistent with small intestinal metastasis of cutaneous malignant melanoma. We report this case as a rare example of malignant melanoma with small intestinal metastases resulting in 5 multiple intussusceptions.