Presentation
Patient presents with abdominal distention and pain.
Patient Data
There are multiple infiltrative heterogeneously enhancing lesions involving the heart apex, gastric mucosa, duodenum, left adrenal gland and pancreas tail. There is also a sclerotic area on right posterior arch of T10. Small bowel obstruction is likely due to a solid mass involving the proximal ileum.
Annotated CT images showing the multiple secondary lesions
Annotated images showing the solid enhanced lesions on heart apex, gastric mucosa, duodenum, left adrenal and pancreas tail. Proximal ileum mass that is the probable cause of small bowel obstruction.
Previous PET-CT from some wk before admission in the emergency department
The PET-CT shows metabolic activity on lesions at gastric and duodenum wall, in the heart apex and pancreatic tail. There is also metabolic activity in muscles on medial right thigh as well on bone lesions on first and second left metatarsal bones, femora and tibiae, and in the posterior aspect of 7th left rib and on T10 vertebral arch. Small pulmonary nodules and subcutaneous lesions are also identified and compatible with secondary involvement.
Case Discussion
The patient has a known to have cutaneous melanoma relapsed after oncology treatment.
Gastric and duodenum metastases are rare and have been encountered more often as haematogenous spread from melanoma or breast or lung carcinomas. Gastric metastases have been shown in more than a fifth of those patients who died from melanoma 1.
Unable to process the form. Check for errors and try again.