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Black ulcerative colon lesions – thinking outside of the necrosis box
Black ulcerative colon lesions – thinking outside of the necrosis box
André Coimbra Trigo, Maria José Temido, David Perdigoto
Centro Hospitalar da Universidade de Coimbra
53 years-old previously healthy woman, apart from a dermal nevus excision 5 years before, presenting with episodes of involuntary ocular movements, underwent a cranial CT scan which showed 5 suspicious lesions. As part of the diagnostic workup a colonoscopy showed an ulcerative-vegetating lesion with a darkened area, next to the ileocecal valve. The histology revealed neoplastic cells with pigment in the cytoplasm and the immunohistochemical study revealed positivity for Melan A and SOX10, making the diagnosis of a metastasized melanoma. This image reinforces the importance of bearing this diagnosis in mind as it could easily be misperceived as necrosis.
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