Metastatic Melanoma With Multiple Small Bowel Intussusceptions

Abstract

A 53-year-old man with a history of melanoma resected from the left ear 2 years ago that subsequently metastasized to brain, liver, and lung presented with new onset of fever, anemia, and emesis. He had a history of headaches, weakness and seizures status postradiation, and chemotherapy for brain metastasis. Abdomen and pelvis CT was obtained to further evaluate the fever, nausea, vomiting, and anemia. This revealed nonobstructive small bowel intussusceptions in the right and left lower quadrants. The patient continued to have worsening abdominal pain and FDG PET CT was obtained 1 month later to further evaluate the metastatic lesions. The PET CT revealed multiple new small bowel intussusceptions throughout the abdomen and pelvis that are intensely hypermetabolic, most consistent with small bowel metastatic lesions serving as lead points for the intussusceptions.