Primary Jejunal Melanoma Presenting With Intussusception in a Patient With Chronic Iron Deficiency Anemia.

Abstract

Primary gastrointestinal (GI) melanomas (PGIMs) are rare, accounting for a small fraction of GI malignancies and particularly uncommon in the small bowel. Diagnosing PGIMs is challenging due to its varied presentations and the difficulty in distinguishing it from metastatic melanoma. We present the case of an 84-year-old man with chronic anemia and intussusception due to primary jejunal melanoma. The patient reported fatigue, dizziness, and chronic anemia. Initial evaluations, including esophagogastroduodenoscopy and colonoscopy, were nondiagnostic. A video capsule endoscopy revealed scattered aphthous ulcers without active bleeding, and computed tomography enterography identified a jejunal mass causing intussusception. Exploratory laparotomy confirmed a 3.5 cm polypoid mass, identified histologically as high-grade malignant melanoma. This case, the first reported instance of primary jejunal melanoma with chronic anemia and intussusception, underscores the diagnostic complexities of PGIMs and emphasizes the importance of imaging and surgical intervention. Awareness of PGIMs in elderly patients with nonspecific GI symptoms is essential.