Presentation
Known metastatic melanoma. Now presents with weight loss and severe left iliac fossa pain.
Patient Data
Large mass of porta hepatis nodes associated with marked irregular mural thickening of small bowel in the LIF with resultant luminal dilatation (arrows). No features of intussusception.
Case Discussion
Metastasis to the gastrointestinal tract is a rare phenomenon but melanoma is the most common primary and the small bowel the commonest location. Patterns include mural nodules causing intussusception, ulcerating mural nodules, serosal deposits and larger infiltrating masses as in this case that may cause bowel obstruction and dilated luminal segments.