Successful treatment of primary melanoma of the ascending colon: a case report and literature review
Location
Moultrie, GA
Start Date
9-5-2024 1:00 PM
End Date
9-5-2024 4:00 PM
Description
Introduction: Malignant melanoma typically originates from the skin. Gastrointestinal melanomas are rare, representing 1-3% of neoplasms of the gastrointestinal tract. Cases of primary melanoma originating de-novo from the gastrointestinal (GI) tract are exceptionally rare. Of those cases originating from the GI tract, only 37 cases of primary colonic melanoma have been reported to date.
Case Presentation: Herein, we present the case of a 66-year-old Caucasian male presenting with Stage IV metastatic primary malignant melanoma of the ascending colon found on routine surveillance colonoscopy. The patient’s past medical history was significant for hypertension, dyslipidemia, and pulmonary embolism. Upon initial presentation, the physical exam, including a full-body scan, was unremarkable. Histopathological examination of the polyp confirmed malignant melanoma. Immunohistology revealed diffuse expression of S100, SOX1, and HMB 45, with a lack of reactivity of Melan-A. Given the patient’s lack of a personal history of malignant melanoma and any ocular or cutaneous lesions, as well as an unremarkable physical examination, the patient was diagnosed with primary malignant melanoma of the ascending colon. On initial positron emission tomography (PET) scan, abnormal PET activity was noted in mediastinal lymph nodes, lung bases, and right side of the lower thoracic esophagus. The final diagnosis was made of a Stage IV metastatic malignant melanoma of the ascending colon. A right hemicolectomy was completed subsequently followed by successful treatment with nivolumab/ipilimumab and nivolumab maintenance therapy. At most recent visit, two years since the diagnosis, the patient’s restaging PET scan showed no evidence of metastatic malignancy.
Discussion: Our findings delineate the benefit of utilizing a multi-disciplinary approach in the treatment and diagnosis of primary colonic melanoma. Our findings further demonstrate the efficacy of PD-1 inhibitors, such as nivolumab, in the successful treatment of primary melanoma of the ascending colon.
Embargo Period
6-12-2024
Included in
Successful treatment of primary melanoma of the ascending colon: a case report and literature review
Moultrie, GA
Introduction: Malignant melanoma typically originates from the skin. Gastrointestinal melanomas are rare, representing 1-3% of neoplasms of the gastrointestinal tract. Cases of primary melanoma originating de-novo from the gastrointestinal (GI) tract are exceptionally rare. Of those cases originating from the GI tract, only 37 cases of primary colonic melanoma have been reported to date.
Case Presentation: Herein, we present the case of a 66-year-old Caucasian male presenting with Stage IV metastatic primary malignant melanoma of the ascending colon found on routine surveillance colonoscopy. The patient’s past medical history was significant for hypertension, dyslipidemia, and pulmonary embolism. Upon initial presentation, the physical exam, including a full-body scan, was unremarkable. Histopathological examination of the polyp confirmed malignant melanoma. Immunohistology revealed diffuse expression of S100, SOX1, and HMB 45, with a lack of reactivity of Melan-A. Given the patient’s lack of a personal history of malignant melanoma and any ocular or cutaneous lesions, as well as an unremarkable physical examination, the patient was diagnosed with primary malignant melanoma of the ascending colon. On initial positron emission tomography (PET) scan, abnormal PET activity was noted in mediastinal lymph nodes, lung bases, and right side of the lower thoracic esophagus. The final diagnosis was made of a Stage IV metastatic malignant melanoma of the ascending colon. A right hemicolectomy was completed subsequently followed by successful treatment with nivolumab/ipilimumab and nivolumab maintenance therapy. At most recent visit, two years since the diagnosis, the patient’s restaging PET scan showed no evidence of metastatic malignancy.
Discussion: Our findings delineate the benefit of utilizing a multi-disciplinary approach in the treatment and diagnosis of primary colonic melanoma. Our findings further demonstrate the efficacy of PD-1 inhibitors, such as nivolumab, in the successful treatment of primary melanoma of the ascending colon.