부산대학교 도서관

Multiple small bowel metastases from cutaneous malignant melanoma with gastrointestinal bleeding are rarely treated surgically. Moreover, the procedure for the control of such bleeding has not been established. A case of malignant melanoma leading to gastrointestinal bleeding secondary to small bowel metastasis that was treated by intestinal resections is reported. A 70-year-old man presented with dizziness and palpitations. Abdominal enhanced computed tomography showed multiple small bowel tumors, swelling of the abdominal lymph nodes, and stones in the gallbladder. Laparoscopic lymph node biopsy and cholecystectomy were performed. Microscopic examination of the resected small bowel mesenteric lymph node specimen showed malignant melanoma. Furthermore, at the time of the operation, cutaneous black tumors were noted on the back. Based on these findings, multiple cutaneous and small bowel metastases from malignant melanoma were diagnosed. Subsequently, continuous gastrointestinal bleeding warranted frequent transfusions. Hemorrhagic scintigraphy showed the source of bleeding, and small bowel resections were performed. The patient's postoperative course was unremarkable. Hemorrhagic scintigraphy and small bowel resections were useful for the diagnosis and control of gastrointestinal bleeding secondary to small bowel metastases from cutaneous malignant melanoma. This enabled successful administration of immunotherapy and chemotherapy to the patient.