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J Surg Oncol. 2019 Jun;119(7):897-902. doi: 10.1002/jso.25393. Epub 2019 Feb 7.

Management of intussusception in patients with melanoma.

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Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, Florida.
Division of Surgical Oncology, Emory University, Atlanta, Georgia.
Division of Surgical Oncology, Department of Surgery, Oregon Health and Science University, Portland, Oregon.
Department of Plastic and Reconstructive Surgery, Johns Hopkins University, Baltimore, Maryland.
Division of Plastic Surgery, Department of Surgery, Yale University, New Haven, Connecticut.



Increased cross-sectional imaging for surveillance of metastatic melanoma has led to more diagnoses of asymptomatic intussusception.


We performed a multi-institutional retrospective review of patient records with a history of metastatic melanoma and a diagnosis of intussusception. Patients were divided into three groups: 1) asymptomatic patients without current evidence of melanoma (no evidence of disease [NED]); 2) asymptomatic intussusception and known active metastatic melanoma; 3) symptomatic intussusception and known active metastatic melanoma; the number of patients requiring surgery and intraoperative findings were recorded.


We reviewed 73 patients diagnosed with intussusception from 2004 to 2017. Among asymptomatic patients with NED (n = 16), 14 spontaneously resolved and 2 underwent pre-emptive surgery without abnormal intraoperative findings. Of asymptomatic patients with active metastatic disease (n = 32), 25 were initially observed and 7 underwent pre-emptive surgery and 9 of the 25 initially observed patients required surgery for development of symptoms. In this group, all 16 patients undergoing surgery (50% of the group) had intraoperative findings of intussusception and/or metastatic intestinal melanoma.. All symptomatic patients with metastatic melanoma (n = 25) underwent surgery; all had intraoperative findings of intussusception and/or metastatic melanoma except 1 (Meckel's diverticulum).


Asymptomatic patients with NED do not require surgery and intussusception will likely resolve spontaneously. Asymptomatic patients with known metastatic melanoma may be initially observed, but a low threshold for surgery should be maintained. Symptomatic patients with known metastases should undergo surgery.


bowel resection; intussusception; melanoma; metastatic melanoma, surgery

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