A rare case of mucosal metastases 14 years after resolution of a primary uveal melanoma (original) (raw)
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Advances in Life Science and Technology, 2017
Melanoma represents 1-3% of all malignant cancers and typically appears in sites where melanocytes are commonly found, including the skin, eyes, meninges and anal region, most commonly in the rectum and sigmoid colon(1). Most melanomas found in the stomach are metastases from cutaneous sources. According to a clinicopathologic analysis of 652 patients with disseminated disease, 58% demonstrated small bowel metastases upon autopsy, 26% were found to have gastric metastases,but only 1.5% were identified to have any gastrointestinal lesions antemortem³⁴. Primary gastric melanoma is a rare entity with 11 cases reported worldwide(2). Primary gastric melanoma is underdiagnosed, it’s symptoms and signs are nonspecific and specific staining techniques must be used to confirm the diagnosis. Therefore thorough physical examination, laboratory studies and imaging are required to rule out metastatic disease in the setting of metastatic melanoma We have a case of a man N.K 56 years old, with ...
Melanoma metastasis mimicking gastric cancer: a challenge that starts from diagnosis
Therapeutic Advances in Gastroenterology, 2021
The gastrointestinal tract is an uncommon site of metastasis in melanoma. However, when the primary melanoma cannot be found, the diagnosis of gastric melanoma by endoscopic biopsy is problematic mainly because some tumors are amelanotic and do not contain melanin granules detectable by microscopy. A 56-year-old Caucasian man with melanoma was referred to us following an initial histopathological diagnosis via gastroscopy of poorly differentiated primary gastric carcinoma. A computerized tomography (CT) scan showed metastatic disease and on the basis of this information we started palliative chemotherapy. However, the atypical presentation of the disease with subcutaneous metastases prompted us to make a more in-depth evaluation. Immunohistochemical evaluation modified the diagnosis to melanoma. After only one cycle of chemotherapy, treatment was changed to dabrafenib + trametinib, which was better tolerated and initially induced a partial response. The patient is currently in good ...
Rare Metastases of Malignant Melanoma
Acta medica medianae, 2014
Melanomas are malignant neoplasms that originate from melanocytes. The most common are on the skin and mucous membranes. Choroidal melanomas are quite different from cutaneous melanomas with regard to presentation, metastases, and treatment. We report two cases of metastatic gastric malignant melanoma of the eye and skin, with reference to the literature. The first patient was a woman aged 23 years, who underwent gastrectomy 22 months after enucleation of the eye due to malignant choroid melanoma. The second patient was a man, 72 years old, who underwent surgery 28 months before because of malignant melanoma of the skin of the forehead. Paraffin sections, 4 μm thick were stained using a classic method, as well as immunohistochemical DAKO APAAP method, using a specific S-100 antibody and Melan A antibodies. The stomach is considered a rare place for the development of metastases. Metastases in the stomach are often limited to the submucosal as well as the serousmuscular layer, as noted in one of our patients. Metastatic melanoma of the gastrointestinal tract should be suspected in any patient with a history of malignant melanoma and new gastrointestinal symptoms. Because of the similarity between certain common histopathological types of malignant melanoma, primarily achromatic, and types of primary cancers of the stomach, the following immunohistochemical studies are needed: Melan A and S-100 protein (markers of malignant melanoma), as well as mucins: MUC5AC, MUC2 and CDX2 (markers of different types of primary gastric carcinoma).
Secondary Metastatic Gastric Melanoma
Journal of Bangladesh College of Physicians and Surgeons, 2020
Gastrointestinal melanomas are commonly metastatic from a cutaneous origin. They cause significant cancer related mortality. A 47- year - old male patient presented with severe pallor and prostration due to profuse upper GI bleeding. He was urgently managed with fluid and blood transfusion. Endoscopy revealed gastric mass and CT showed gastric neoplasm with abdominal lymphadenopathy but endoscopic biopsy revealed inflammatory lesion. He had history of malignant melanoma of right third toe three years back which was managed with surgery and chemotherapy. Exploratory laparotomy was done and biopsy was taken from gastric lesion as well as enlarged lymph nodes. Histopathology revealed melanoma from both specimens. Prognosis is bad. Counseling and collaboration with different relevant disciplines are essential. Management is directed to symptom relieve as well as lengthening survival. J Bangladesh Coll Phys Surg 2021; 39(1): 68-75
The evolving landscape in the management of gastric metastases from melanoma: a case series
Clinical Practice
We report 9 cases of patients with a long and vague clinical history of gastric symptoms who presented different endoscopic, biological and clinical patterns of gastric metastases from cutaneous melanoma. Finally, we review literature data and discuss the role of palliative surgery in order to control the clinical complications and to plan further systemic therapies recently enhanced with new effective drugs. Methods We retrospectively revised clinical,
Gastrointestinal metastases from malignant melanoma
Surgical Oncology, 1995
Between 1980 and 1992, 68 patients with clinical indications of involvement of the gastrointestinal (GI) tract with metastatic melanoma were treated at Roswell Park Cancer Institute. Presenting symptoms were anaemia, abdominal pain, nausea and vomiting. Sites commonly involved were the small bowel (75%), the large intestine (25%), and the stomach (16%). Twenty-one patients were considered unsuitable for surgery; their median survival after diagnosis of GI metastases was 2.9 months. Fortyseven patients underwent abdominal surgery; effective palliation was achieved in most of them. Complete resection of GI metastases was accomplished in 47% of patients. The median survival after operation was 27.6 months for patients with complete resection of GI metastasis and no other disease, 5.1 months for patients with resection of involved GI tract and other metastases present, and 1.9 months for patients who had a bypass procedure only. The 5-year survival for patients with complete resection of GI metastases and no other evidence of disease was 28.3%. The other groups had only 1-year survivors. Surgical intervention is justified on the basis of these findings, and extended palliation can be achieved in patients with complete resection of metastatic disease.
Metastases of malignant melanoma to stomach - An unusual presentation
Indian Journal of Pathology and Oncology, 2020
Background: Malignant melanoma has been known capable of inducing metastasis in most of the human organs. It is the most common metastatic tumor of the gastrointestinal (GI) tract; most commonly involving the small and large bowels and rectum; however, the stomach is a rare site. Gastrointestinal (GI) metastases are seldom diagnosed before death. Case Presentation: Here we present a known and treated case of malignant melanoma of left foot, later on presenting with non-specific gastric symptoms .UGIE revealed a growth in the gastric antrum for which mucosal biopsy was performed. Histopathology revealed a poorly differentiated carcinoma and with the help of IHC obtained a conclusion of metastatic lesion of malignant melanoma. Conclusion: Malignant melanoma of extremities warrants a thorough endoscopic evaluation for gastrointestinal metastases as > 60% cases are found to have lesions in stomach at autopsy. Hence an early diagnosis of the metastatic lesions mandate for better survival of the patients.
An uncommon presentation and course of metastatic malignant melanoma: a case report
Journal of Medical Case Reports, 2007
Most patients with brain metastases from malignant melanoma are diagnosed after treatment for known extracranial metastases and have a poor outcome despite various local and systemic therapeutic approaches. Here we discuss an unusual case where a 45-year old patient presented with a brain metastasis as the first symptom of disease and where the presumed primary lesion later was found in the gastro-intestinal tract. Treatment consisted of sequential surgical removal of a total of 4 tumor sites (2 extracranially), whole-brain radiotherapy and two radiosurgery procedures within 13 months. Following her last treatment, the patient has now been in remission for 20 months. This case illustrates that some patients with multi-organ melanoma manifestations may benefit from the repeated use of effective local therapeutic approaches and may experience a quite favourable prognosis.