Eva Mendes Serrao1,2, Emily Joslin3, Victoria McMorran4, Caroline Hough4, Cheryl Palmer5, Sarah McDonald3, Emma Cargill4, Ashley S Shaw6, Brent O'Carrigan4, Christine A Parkinson4, Pippa G Corrie4, Timothy J Sadler6. 1. Department of Radiology, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK. eva.serrao@cruk.cam.ac.uk. 2. Department of Radiology, University of Cambridge, Box 218, Cambridge, CB2 0QQ, UK. eva.serrao@cruk.cam.ac.uk. 3. Department of Pathology, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK. 4. Department of Oncology, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK. 5. Department of Oncology, Hinchingbrooke Hospital, Huntingdon, UK. 6. Department of Radiology, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
Abstract
BACKGROUND: Melanoma is the most aggressive form of skin cancer, with a tendency to metastasise to any organ of the human body. While the most common body organs affected include liver, lungs, brain and soft tissues, spread to the gastrointestinal tract is not uncommon. In the bowel, it can present with a multitude of imaging appearances, more rarely as an aneurysmal dilatation. This appearance is classically associated with lymphoma, but it has more rarely been associated with other forms of malignancy. CASE PRESENTATION: We report a case series of three patients with aneurysmal dilatation in the small bowel (SB) confirmed to be due to metastatic melanoma (MM). All patients had non-specific symptoms; most times being attributed initially to causes other than melanoma. On CT the identified aneurysmal SB dilatations were diagnosed as presumed lymphoma in all cases. In two cases, the aneurysmal dilatation was the first presentation of metastatic disease and in two of the cases more than one site of the gastrointestinal tract was concomitantly involved. All patients underwent surgical resection with histological confirmation of MM. CONCLUSIONS: Recognition of unusual SB presentation of MM, such as aneurysmal SB dilatation, is important to expedite diagnosis, provide appropriate treatment, and consequently improve quality of life and likely survival of these patients. As the most common cancer to metastasise to the SB and as a known imaging mimicker, MM should remain in any radiologist's differential diagnosis for SB lesions with aneurysmal dilatation.
BACKGROUND: Melanoma is the most aggressive form of skin cancer, with a tendency to metastasise to any organ of the human body. While the most common body organs affected include liver, lungs, brain and soft tissues, spread to the gastrointestinal tract is not uncommon. In the bowel, it can present with a multitude of imaging appearances, more rarely as an aneurysmal dilatation. This appearance is classically associated with lymphoma, but it has more rarely been associated with other forms of malignancy. CASE PRESENTATION: We report a case series of three patients with aneurysmal dilatation in the small bowel (SB) confirmed to be due to metastatic melanoma (MM). All patients had non-specific symptoms; most times being attributed initially to causes other than melanoma. On CT the identified aneurysmal SB dilatations were diagnosed as presumed lymphoma in all cases. In two cases, the aneurysmal dilatation was the first presentation of metastatic disease and in two of the cases more than one site of the gastrointestinal tract was concomitantly involved. All patients underwent surgical resection with histological confirmation of MM. CONCLUSIONS: Recognition of unusual SB presentation of MM, such as aneurysmal SB dilatation, is important to expedite diagnosis, provide appropriate treatment, and consequently improve quality of life and likely survival of these patients. As the most common cancer to metastasise to the SB and as a known imaging mimicker, MM should remain in any radiologist's differential diagnosis for SB lesions with aneurysmal dilatation.
Authors: Kumaresan Sandrasegaran; Arumugam Rajesh; Jonas Rydberg; Daniel A Rushing; Fatih M Akisik; John D Henley Journal: AJR Am J Roentgenol Date: 2005-03 Impact factor: 3.959
Authors: Zeev V Maizlin; Jacqueline A Brown; Miriam R E Buckley; Douglas Filipenko; Stuart A Barnard; Xing Wong; Robert Enns; Patrick M Vos Journal: Semin Roentgenol Date: 2006-10 Impact factor: 0.800
Authors: Eva Mendes Serrao; Ana Maria Costa; Sergio Ferreira; Victoria McMorran; Emma Cargill; Caroline Hough; Ashley S Shaw; Brent O'Carrigan; Christine A Parkinson; Pippa G Corrie; Timothy J Sadler Journal: Insights Imaging Date: 2022-10-04