Primary malignant melanoma of the small bowel: A case report.

Malignant melanoma comprises 1%-3% of all malignant tumors of the gastrointestinal tract. The small bowel melanoma is an extremely rare malignancy. Very few cases have been reported in the literature. The small intestine is mostly affected by the metastatic tumors of the primary lesions especially cutaneous. This malignancy is diagnosed at the late stages as the patient remains asymptomatic. In this report we present a case of malignant melanoma arising from the small bowel in a 58-year-old male. There was no primary lesion in the eye, skin, anus, rectum or elsewhere in the body. The patient was treated with surgery. Afterward the patient presented to the emergency room with respiratory distress for which he was on ventilator support, sadly the patient died after 10 days. Malignant melanoma is an aggressive tumor and does not respond well to chemotherapy or radiotherapy.

Primary anorectal amelanotic melanoma with liver, lungs and lymph nodal metastases.

Anorectal melanoma (ARM) is an exceedingly rare and very aggressive malignancy. It originates from the melanocytic cells in the anorectal mucosa, which produces melanin. Other mucosal melanomas commonly found in the mucosa of the oral cavity, vulvovaginal, pharynx and urinary tract. Patients usually present with bleeding per rectum, perianal pain and difficulty in defaecation. Distinction of primary anorectal melanoma from other tumours of this region is difficult because of the lack of common imaging features. MRI is the modality of choice for its better tissue characterisation and resolution. There is no standard treatment protocol available mainly due to scarcity of data. Surgery is the mainstay therapy. Herein we present a case of a male patient in his 30s who presented with rectal bleeding and perianal pain. Haematological analysis revealed normocytic normochromic anaemia. MRI detected a mass lesion in the anorectal region. Contrast enhanced CT revealed multiple metastases in the liver, lungs, periportal, mesorectal and inguinal lymph nodes. The diagnosis of the ulcerated anorectal melanoma was established on histopathological examination. The patient underwent abdominoperineal resection (APR) followed by chemotherapy. Afterward the patient presented to the emergency room with respiratory distress for which he was on ventilator support. Sadly, the patient died after four days.

Neuroendocrine tumor of the gall bladder: A rare case report with review of literature.

Neuroendocrine tumor of the gall bladder is an extremely rare malignancy, accounting for only 0.2% of all neuroendocrine tumors. Gall Bladder-Neuroendocrine Tumors (GB-NETs) are mainly diagnosed on histological examination of GB samples after cholecystectomy or after any biliary pathology surgery since it is very difficult to diagnose based on imaging. The overall outcome of gallbladder NET is worse than the adenocarcinoma of the gallbladder. No focused approach towards its treatment is available in literature due to its rarity. We share our experience of gall bladder NET in a 37-year-old female who was successfully managed at our institution.