Background: Malignant melanoma frequently spreads to the gastrointestinal tract, with 60%
of patients with advanced metastatic disease showing digestive involvement; however, primary MM of
the small intestine is a controversial diagnosis. In fact, whether these lesions arise as true small bowel
primary neoplasms or represent metastases from unidentified cutaneous melanomas remains debatable.
The most common complications are intestinal obstruction, massive gastrointestinal bleeding, and perforation.
Objective & Methods: We report a case of a 64-year-old patient, with an unremarkable medical history,
in which a late diagnosis of primary ileal malignant melanoma in the setting of an emergency
laparotomy due to small bowel obstruction, and where PET-scan showed costal metastasis. Therefore,
we provide a narrative review of the scientific literature about this topic.
Results: 36 cases of primary small bowel melanoma, included that in the present study, were found
through our search in the scientific literature.
Conclusion: Primary small bowel MM appears to be an extremely rare entity which clinicians should
be more aware of, in order to plan better a correct strategy of early diagnosis and appropriate treatment.