Beyond the Surface: A Case Report of a Patient with Small Bowel Metastasis and Melanoma History. Diagnosis and Management.

Background: Malignant melanoma (MM) is one of the most prevalent and deadliest forms of skin cancer, resulting from the malignant transformation of melanocytes. It accounts for approximately 1.7% of global cancer diagnoses and is the fifth most common cancer in the US. MM can metastasize to almost any part of the body, with early detection significantly improving prognosis. Case presentation: We report the case of an 81-year-old female with a history of malignant melanoma (primary lesion on the left calf) and various comorbidities. She presented with severe anemia of unknown origin. A CT scan was performed due to her medical history, revealing a circumferential, asymmetrical parietal thickening at the level of a hypogastric ileal loop. The lesion suggested a tumoral substrate. Subsequent colonoscopy showed no metastatic lesions, but surgical intervention confirmed a malignant melanoma ileal metastasis. The patient underwent laparoscopic segmental resection with favorable post-surgery outcomes. Histopathological examination of the resected tissue confirmed the diagnosis of small intestine secondary lesions from the malignant melanoma. Conclusion: This case underscores the necessity of considering metastatic melanoma in patients with a history of MM and vague gastrointestinal symptoms. Early and accurate diagnosis through advanced imaging and endoscopic techniques can significantly improve patient outcomes.

Difficulties in Treating a Patient with Multiple Cancers in the COVID-19 Pandemic.

In the actual pandemic context, cancer patients are at additional risk, and protocols are always changing. We present the case of a 62-year-old patient who develops three types of cancer over four years and who was admitted to the hospital in the Emergency Room for hematemesis, melena, and abdominal pain. We know from the pathological antecedents that he was operated in 2017 for a left scapular tumour (basal cell carcinoma). The current clinical examination reveals another right scapular tumour (malignant melanoma), and the hematemesis comes from a gastro-esophageal junction tumour (squamous cell carcinoma). SARS CoV2 infection changes the rules of treatment in such a case. Thus, the patient is operated for the right scapular tumour, the gastrectomy being delayed due to the lung lesions given by SARS CoV2. Finally, the patient undergoes surgery for the gastric tumour, the RT-PCR retest being negative.

Breast Metastasis as a Presentation of Malignant Melanoma.

The majority of malignant breast lesions are primary tumors originated from breast tissue. These primary breast cancers usually metastasize to lymph nodes, lungs, bones and brain. Metastases from cancers of other organs to the breast are very rare, but have been encountered in patients with malignant melanoma, carcinoid tumors or lung carcinoma. The present paper reports a case of mammary metastasis from malignant melanoma.

Prognostic factors of daily blood examination for advanced melanoma patients treated with nivolumab.

Biomarkers to distinguish patients with advanced melanoma responsive to nivolumab are of great interest. Therefore, we examined the possibility that laboratory data of daily blood examination become novel biomarkers. Laboratory data of 16 melanoma patients who were treated with nivolumab were retrospectively analyzed. Patients were classified as responder group or non-responder group. Examined were: white blood cell count (WBC), absolute lymphocyte counts (ALC), absolute neutrophil count (ANC), absolute monocyte count (AMC), absolute eosinophil count (AEC), and absolute basophil count (ABC), as well as levels of lactate dehydrogenase (LDH), C-reactive protein (CRP), one hour value of erythrocyte sedimentation rate (ESR), and 5-S-cysteinydopa (5-S-CD). Responder group showed significantly higher baseline levels of ESR or CRP and significantly lower ALC level before nivolumab treatment. Additionally, nivolumab treatment decreased the levels of CRP, ESR, and ANC, while it increased ALC level in the responder group. CRP was the most effective in distinguishing responder group from non-responder group both before and during treatment, according to the receiver operating characteristic (ROC) curve. We firstly showed that ESR is also the baseline biomarker of the efficacy of nivolumab. Furthermore, we confirmed that CRP is useful to predict the efficacy both before and during the treatment, and suggested that CRP is the most effective biomarker among daily blood examination by using ROC curve analysis. There is a possibility that nivolumab treatment may be more effective for malignant melanoma with stronger inflammation.