Video Capsule Endoscopy is useful in the Management of Metastatic Malignant Melanoma

The incidence of melanoma has been increasing over the years. Mortality and morbidity remains high despite new therapies. Dissemination occurs primarily by the lymphatic route and than by hematogenous route. Gastrointestinal metastases do occur, but they are mainly intraluminal mucosal melanomas. We report a case of a man of 52 years old with a history of respected cutaneous melanoma who presented with rectal bleeding followed by recurrent episodes of melena, weight loss and severe anemia. Esophagogastroduodenoscopy and colonoscopy were performed without detecting any alteration except for the presence of a chronic atrophic gastritis, so a video capsule endoscopy was performed which showed, in the early jejunum, a substenosis from melanoma metastases associated with satellite lesions of whole jejunum. The patient was operated after being subjected to a computed tomography for staging the disease, but died after three months for the spread of disease. Since the melanoma incidence is rising, similar cases may present in the near future. This emphasizes the importance of a comprehensive study of the entire gastrointestinal tract endoscopy, highlighting the role of video capsule endoscopy as easy, noninvasive, and effective diagnostic procedures to carefully study the small bowel.