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Rehman S, Venna P, Davis S, Gopagoni R, Uttam R, Farrukh AM, Salehi M. Primary gallbladder melanoma: A systematic review of literature. Ann Diagn Pathol 2024; 68:152244. [PMID: 38103326 DOI: 10.1016/j.anndiagpath.2023.152244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 12/06/2023] [Accepted: 12/07/2023] [Indexed: 12/19/2023]
Abstract
Primary gallbladder melanoma (PGM) is a rare malignancy with only sporadic cases reported in the English literature. We performed a systematic review of the cases published in the PubMed, Science Direct and Google Scholar databases with the aim of describing the reported clinicopathologic features of PGM. Thirty-six articles reporting on 39 patients were reviewed. There was a male predominance, with 23 (64 %) of 36 patients being males. The mean age at presentation was 55 ±16 years. Pain in the right upper quadrant was reported in 20/27 (74 %). The average size of the tumor was 3.5 × 1.9 × 1.4 cm. Gallbladder calculi were reported in 7/27 (26 %). A cholecystectomy was performed in 34/38 (89.5 %). Grossly, the tumor mostly (96.5 %) had polypoid appearances and on microscopic examination, the tumor were predominantly comprised of epithelioid cells 12/17 (70.6 %). Mitotic figures and prominent nucleoli were reportedly found in 8/8 (100 %) and 3/3 (100 %) respectively. Junctional melanocytic components were present in 13/21 (61.9 %). Tumor cells were reportedly immunoreactive for S-100 and HMB-45 in all tested cases. Metastasis were reported in 25/36 (69.4 %), with lymph nodes being the most common site (n = 8), followed by brain (n = 6) and liver (n = 4) for metastasis. At a mean follow-up period of 19 +/- 3 months, 16 (48.5 %) of the 33 patients with available survival data were alive and 17/33 (51.5 %) were dead of disease. There is a lack of unified criteria for the diagnosis of PGM, and future studies should aim to resolve this.
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Affiliation(s)
| | | | | | | | - Ritika Uttam
- JJM Medical College, Davangere, Karnataka, India
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2
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Adams SH, Luo E, Lozeau D, Wen X. A Case Report of Primary Malignant Melanoma of the Gallbladder with Multiple Metastases. Case Rep Pathol 2023; 2023:4847053. [PMID: 38115990 PMCID: PMC10730246 DOI: 10.1155/2023/4847053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 11/19/2023] [Accepted: 11/29/2023] [Indexed: 12/21/2023] Open
Abstract
Primary malignant melanoma of the gallbladder is an extremely rare tumor with approximately 39 cases described in the literature so far. However, since the first case was reported in 1907, it remains controversial whether gallbladder involvement in malignant melanoma is primary or metastatic. Here, we report a case of primary malignant melanoma of the gallbladder. A 52-year-old male presented to the emergency department with right upper quadrant abdominal pain and was found to have tumefactive sludge filling the majority of the gallbladder with possible gallbladder wall thickening on ultrasonography. A laparoscopic cholecystectomy was performed for presumed acute cholecystitis. Histopathologic examination of the gallbladder revealed malignant melanoma arising from the mucosa of the gallbladder. Further clinical investigation excluded other primary sites, supporting a diagnosis of primary malignant melanoma of the gallbladder.
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Affiliation(s)
- Steven H. Adams
- Stony Brook Medicine Department of Pathology, Stony Brook, New York, USA
| | - Erinn Luo
- Ward Melville High School, East Setauket, New York, USA
| | - Daniel Lozeau
- Stony Brook Medicine Department of Pathology, Stony Brook, New York, USA
- Stony Brook Medicine Department of Surgery, Stony Brook, New York, USA
| | - Xiaoyun Wen
- Stony Brook Medicine Department of Pathology, Stony Brook, New York, USA
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3
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Bangeas PI, Bekiaridou A, Tsolakidis A, Efthymiadis KG, Drevelegkas K, Giakoustidis D, Giakoustidis A, Alexidis P, Papadopoulos VN. Role of minimally invasive surgery in the treatment of gallbladder metastatic melanoma. A review of the literature and a case report. Cancer Rep (Hoboken) 2022; 5:e1549. [PMID: 34981676 PMCID: PMC9327651 DOI: 10.1002/cnr2.1549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 08/22/2021] [Accepted: 08/24/2021] [Indexed: 11/24/2022] Open
Abstract
Background Primary and secondary gallbladder melanomas are rare, and only 58 cases have been reported in scientific literature to date. This paper aimed to explore the role of minimally invasive surgery in the management of gallbladder metastatic melanomas. Case Herein, we present the case of a 68‐year‐old man with metastatic gallbladder melanoma who was treated with laparoscopic cholecystectomy. Our case management was then compared with that of other cases reported in the literature. Conclusion Currently, metastatic melanomas can be considered as a potentially curable disease. Palliation of symptoms and fast recovery following minimally invasive procedures could be beneficial for these patients. Particularly, laparoscopic procedures appear to prolong the survival of gallbladder melanoma patients.
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Affiliation(s)
- Petros Ioannis Bangeas
- 1st University Department of Surgery, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Alexandra Bekiaridou
- 1st University Department of Surgery, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Alexandros Tsolakidis
- 1st University Department of Surgery, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | | | - Dimitris Giakoustidis
- 1st University Department of Surgery, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Alexandros Giakoustidis
- 1st University Department of Surgery, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Petros Alexidis
- Department of Radiation Oncology, Papageorgiou Hospital, Thessaloniki, Greece
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4
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Jeon HJ, Kwon HJ, Kim SG, Hwang YJ. Malignant melanoma of the gallbladder: A case report and literature review. Ann Hepatobiliary Pancreat Surg 2021; 25:445-449. [PMID: 34402451 PMCID: PMC8382871 DOI: 10.14701/ahbps.2021.25.3.445] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 01/17/2021] [Accepted: 02/01/2021] [Indexed: 11/17/2022] Open
Abstract
Metastatic melanoma of the gallbladder is extremely rare. It has a poor prognosis. Its optimal treatment remains unclear. Surgical resection is generally considered the mainstay of treatment. However, there are no standards to guide the choice between open surgery and laparoscopic surgery. Criteria for the extent of surgical dissection have not been established yet either. We report a patient diagnosed with gallbladder cancer who underwent extended cholecystectomy but had metastatic melanoma at the final biopsy. We reviewed the literature on the treatment of metastatic melanoma in the gallbladder and compared it with our case to determine a treatment strategy.
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Affiliation(s)
- Hyun-Jeong Jeon
- Department of Surgery, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Hyung-Jun Kwon
- Department of Surgery, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Sang-Geol Kim
- Department of Surgery, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Yoon-Jin Hwang
- Department of Surgery, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University, Daegu, Korea
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5
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L Chandrananth M, Cullinan M. A rare cause of hemobilia: Metastatic melanoma of the gallbladder. INTERNATIONAL JOURNAL OF HEPATOBILIARY AND PANCREATIC DISEASES 2020. [DOI: 10.5348/100091z04mc2020ci] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Introduction: Gallbladder melanoma is an extremely rare entity, even more so in living patients, as many remain asymptomatic. Patients usually present with symptoms resembling acute cholecystitis, however here we present a case of metastatic melanoma of the gallbladder presenting with hemobilia.
Case Report: An 82-year-old lady with a history of skin cancer excisions, including melanoma, many years ago, presented with anemia of unknown origin. A computed tomography (CT) scan was performed, demonstrating a gallbladder mass and hemobilia. She successfully underwent open cholecystectomy, partial liver resection, and lymph node dissection, which on histopathology, demonstrated metastatic melanoma. She remains disease free eight months later.
Conclusion: Although melanoma of the gallbladder is rare, in patients with a past history of melanoma, a high index of suspicion should be maintained if there are concerning signs, such as anemia, without a clear cause. With early identification and surgical intervention, a patient’s survival rate can be optimized.
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Affiliation(s)
- Meera L Chandrananth
- MD, Biomed, Surgical Registrar, Department of General Surgery, Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Mark Cullinan
- MBBS, FRACS, Hepato-Pancreato-Biliary and Upper Gastrointestinal Surgeon, General Surgery and Gastroenterology Clinical Institute, Epworth Health-Care, Melbourne, Victoria, Australia; Department of Surgery, Monash University, Melbourne, Victoria, Australia; Department of Surgery, Monash Medical Centre, Melbourne, Victoria, Australia
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6
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Ercolino GR, Guglielmi G, Pazienza L, Urbano F, Palladino D, Simeone A. Gallbladder and small bowel metastasis of regressive melanoma: a case report. BJR Case Rep 2018; 5:20180032. [PMID: 31131119 PMCID: PMC6519491 DOI: 10.1259/bjrcr.20180032] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Revised: 06/21/2018] [Accepted: 06/25/2018] [Indexed: 02/03/2023] Open
Abstract
Malignant melanoma development in gastrointestinal (GI) tract may be primary or secondary. Although small bowel, colon and stomach represent common GI sites affected from metastatic cutaneous malignant melanoma (cMM), more than 90% of the cases are identified only during autoptic examinations. Therefore, the diagnosis in a living patient of gallbladder metastasis from cMM is considered extremely rare. We aimed to describe a case of metastatic melanoma involving the gallbladder, the stomach and the small bowel in a 78-year-old male with diffuse abdominal pain and a history of cMM of the back, which was radically resected 4 years before. Abdominal ultrasound showed intracholecystic multiple nodulations. CT, besides confirming the gallbladder nodules, revealed multiple masses in the stomach, duodenum and ileum. Malignant melanoma lesions were confirmed by histopathological and immunohistochemical analyses of bioptic material obtained from endoscopic examination. In patients with history of melanoma, careful inspection of GI tract should be prompted adopting adequate imaging techniques and endoscopy in order to better influence treatment planning and prognosis.
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Affiliation(s)
| | | | - Luca Pazienza
- Department of Radiology, Scientific Institute Hospital "Casa Sollievo della Sofferenza", San Giovanni Rotondo, Italy
| | - Filomena Urbano
- Department of Radiology, Scientific Institute Hospital "Casa Sollievo della Sofferenza", San Giovanni Rotondo, Italy
| | - Diego Palladino
- Department of Radiology, Scientific Institute Hospital "Casa Sollievo della Sofferenza", San Giovanni Rotondo, Italy
| | - Anna Simeone
- Department of Radiology, Scientific Institute Hospital "Casa Sollievo della Sofferenza", San Giovanni Rotondo, Italy
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7
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Adrian S, Clemens C, Elisabeth SW, Sylvia S. Clinicohistopathological Characteristics of Malignant Melanoma in the Gall Bladder: A Case Report and Review of the Literature. Case Rep Pathol 2018; 2018:6471923. [PMID: 29750128 PMCID: PMC5884404 DOI: 10.1155/2018/6471923] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Revised: 01/09/2018] [Accepted: 01/16/2018] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE Primary gall bladder melanoma is a rare and controversial entity. So far, only 36 cases are documented in the literature. Metastatic melanoma targeting the gall bladder, however, has been reported to occur in about 15-20% of melanoma patients and is much more common. METHODS Based on the case of a 58-year-old woman presenting with multiple melanoma nodules in the gall bladder, we searched in the available literature in PubMed for articles describing a "primary melanoma of the gallbladder" regardless of language used. RESULTS We detected 33 papers that described 36 cases of primary gall bladder melanoma between 1907 and 2017. From different criteria distinguishing primary and secondary gall bladder melanoma, generally, the following were accepted: (1) exclusion of previous primary melanoma, (2) absence of synchronous involvement of other sites, (3) unicity of the lesion, (4) polypoid or papillary shape of the lesion, and (5) presence of junctional melanocitary component. Review of the 36 published cases revealed that only about one-fourth of them fulfilled all the five criteria. CONCLUSION Primary gall bladder melanoma is even rarer than described in the literature, and the question whether this entity really exists remains open.
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Affiliation(s)
- Schmidt Adrian
- Department of Internal Medicine, Division of Medical Oncology and Hematology, Triemli Hospital, Birmensdorferstrasse 497, 8063 Zurich, Switzerland
| | - Caspar Clemens
- Department of Internal Medicine, Division of Medical Oncology and Hematology, Cantonal Hospital Baden, Im Ergel 1, 5404 Baden, Switzerland
| | - Schmidt-Weiss Elisabeth
- Centre for Hematology and Oncology, Clinic of Medical Oncology, University Hospital Zurich, Rämistrasse 100, 8091 Zürich, Switzerland
| | - Stadlmann Sylvia
- Division of Pathology, Cantonal Hospital Baden, Im Ergel 1, 5404 Baden, Switzerland
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8
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Revzin MV, Scoutt L, Smitaman E, Israel GM. The gallbladder: uncommon gallbladder conditions and unusual presentations of the common gallbladder pathological processes. ACTA ACUST UNITED AC 2014; 40:385-99. [DOI: 10.1007/s00261-014-0203-0] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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9
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Primary malignant melanoma of the gallbladder: a case report and review of the literature. Case Rep Surg 2012; 2012:693547. [PMID: 23094182 PMCID: PMC3475298 DOI: 10.1155/2012/693547] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2012] [Accepted: 09/25/2012] [Indexed: 11/18/2022] Open
Abstract
Malignant melanoma is characterized by the ability of diffuse metastases. Since the first report of an isolated malignant melanoma case of the gallbladder, it is already controversial whether isolated cases are metastatic or primary tumors. A 49-year-old woman appealed to the emergency unit because of abdominal pain. Ultrasonography revealed increased thickness of the gallbladder wall and a lesion with surrounding fluid sized 12 mm without acoustic shadow, which arose from the gallbladder wall and was consistent with a polyp. Histopathologic evaluation of the surgical specimen after laparoscopic cholecystectomy revealed malign epithelial tumor consisting of atypical cells with large eosinophilic cytoplasm and dense melanin pigment within the cytoplasm of the tumor cells. As no other focus was identified as a result of the evaluation, the patient was diagnosed with primary malignant melanoma of the gallbladder. In this paper, we aimed to define our treatment modality for a case with isolated malignant melanoma of the gallbladder.
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10
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Smith NE, Taube JM, Warczynski TM, Collier KD, Pawlik TM. Primary biliary tract melanoma: Report of a case and review of the literature. Int J Surg Case Rep 2012; 3:441-4. [PMID: 22706296 DOI: 10.1016/j.ijscr.2012.05.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2012] [Revised: 04/26/2012] [Accepted: 05/04/2012] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION Primary melanoma of the bile duct is extremely rare with only nine cases of primary melanoma of the bile duct reported in the literature. PRESENTATION OF CASE A 55-year-old previously healthy gentleman developed increasing jaundice over several months and subsequently underwent an ERCP with stone extraction. Cytology brushings in an area of a distal stricture in the bile duct were concerning for cholangiocarcinoma. The patient was referred to our institution and underwent a pancreaticoduodenectomy. The surgical specimen showed a single 4.5cm polypoid lesion located in the bile duct. A diagnosis of melanoma was rendered after immunohistochemical studies on the tumor demonstrated positivity for melanoma markers. Follow-up of the patient with skin, ocular, and lymph node exams showed no evidence of melanoma. A PET scan 4 and 10 months post-surgery failed to reveal either a primary skin lesion or other sites of metastases. DISCUSSION The vast majority of melanomas of the bile duct represent metastases from a cutaneous source and tend to present as multiple flat pigmented lesions. Conversely, cases of primary bile duct melanoma are characterized by a distinct gross morphology consisting of a solitary intraluminal polypoid lesion attached by a pedicle with no other identifiable primary lesion. Other supporting criteria include absence of other involved sites and presence of an in situ junctional component. CONCLUSION Given the clinical history, gross findings, and lack of a primary cutaneous site or other demonstrable metastases, this patient likely represents the tenth reported case of primary biliary tract melanoma.
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Affiliation(s)
- Nathaniel E Smith
- Department of Pathology, The Johns Hopkins Hospital, 600 North Wolfe Street, Baltimore, MD 21287, United States
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11
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12
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Malignant melanoma of the gallbladder: a report of two cases and review of the literature. J Gastrointest Surg 2008; 12:1123-6. [PMID: 18060465 DOI: 10.1007/s11605-007-0432-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2007] [Accepted: 11/09/2007] [Indexed: 01/31/2023]
Abstract
Melanoma metastatic to the gallbladder is rare. When present, it is often part of a widespread complex of metastases. Primary gallbladder melanomas are also extremely rare and can sometimes be difficult to distinguish from metastatic lesions. The optimal treatment for malignant melanoma of the gallbladder remains unclear, and prognosis is generally poor. We present here two cases of patients with metastatic lesions to the gallbladder. One patient presented with symptomatic cholelithiasis and was found incidentally to have a metastasis. Another patient had known a metastasis, but underwent curative resection of the only site of disease. We review the published literature for gallbladder melanoma, both primary and metastatic to determine the role of surgery in this disease.
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13
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Marone U, Caracò C, Losito S, Daponte A, Chiofalo MG, Mori S, Cerra R, Pezzullo L, Mozzillo N. Laparoscopic cholecystectomy for melanoma metastatic to the gallbladder: is it an adequate surgical procedure? Report of a case and review of the literature. World J Surg Oncol 2007; 5:141. [PMID: 18072972 PMCID: PMC2233626 DOI: 10.1186/1477-7819-5-141] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2007] [Accepted: 12/11/2007] [Indexed: 11/15/2022] Open
Abstract
Background Only 2% to 4% of patients with melanoma will be diagnosed with gastrointestinal metastasis during the course of their disease. The most common sites of gastrointestinal metastases from melanoma include the small bowel (35%–67%), colon (9%–15%) and stomach (5%–7%), with a median survival of 6–10 months after surgery, and 18% survival at five years. Metastatic melanoma to the gallbladder is extremely rare and it is associated with a very poor prognosis. Case presentation We report a case of a 54-year old man presented to observation with diagnosis of 6.1 mm thick, Clark's level IV, ulcerated melanoma of the trunk, developing in the course of the disease metastatic involvement of the gallbladder as first site of recurrence, treated by laparoscopic cholecystectomy. To date only few cases of patients with metastatic melanoma of the gallbladder treated by this surgical procedure have been reported in literature. Conclusion Gallbladder metastasis represents a rare event as a first site of recurrence. It must be considered a possible expression of systemic disease also despite radiological absence of other metastatic lesions. Laparoscopic approach has a possible therapeutic role, but open surgery has also a concomitant diagnostic purpose because gives the possibility of manual exploration of abdominal cavity, useful particularly to reveal bowel metastatic lesions, not easily identifiable by preoperative imaging examinations.
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Affiliation(s)
- Ugo Marone
- Department of Surgical Oncology "B", National Cancer Institute of Naples, Italy.
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14
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Tuveri M, Tuveri A. Isolated metastatic melanoma to the gallbladder: is laparoscopic cholecystectomy indicated?: a case report and review of the literature. Surg Laparosc Endosc Percutan Tech 2007; 17:141-4. [PMID: 17450099 DOI: 10.1097/sle.0b013e31803c766a] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Metastatic involvement of the gallbladder in melanoma is rare, but constitutes the most common metastatic lesion involving this organ. The surgical management seems to be indicated for patients with isolated and resectable gallbladder metastases to avoid symptoms or tumor complications. We report on a case of a young woman with an isolated metastatic gallbladder melanoma who presented with symptoms of acute cholecystitis. The patient underwent laparoscopic cholecystectomy (LC) and lymphadenectomy of the hepatoduodenal ligament. Histology was characteristic for metastatic malignant melanoma. Nodes were negative for metastases. We emphasize the appropriateness of a laparoscopic approach, once ruled out a widespread metastatic disease. It can be done with a remarkably low rate of complications. Gentle manipulation, avoidance of perforation, and use of a retrieval bag for the removal of the gallbladder should be practiced to help minimize the chance of mechanical exfoliation or implantation of malignant cells during LC. In isolated metastatic localization, LC may be curative and provide adequate palliation of symptoms with a short convalescence and a fast recovery.
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Affiliation(s)
- Massimiliano Tuveri
- Dipartimento di Chirurgia Generale e Vascolare, Clinica Sant'Elena, Quartu Sant'Elena, Cagliari, Italia.
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15
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Katz SC, Bowne WB, Wolchok JD, Busam KJ, Jaques DP, Coit DG. Surgical management of melanoma of the gallbladder: a report of 13 cases and review of the literature. Am J Surg 2007; 193:493-7. [PMID: 17368297 DOI: 10.1016/j.amjsurg.2006.06.033] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2005] [Revised: 06/14/2006] [Accepted: 06/14/2006] [Indexed: 11/18/2022]
Abstract
BACKGROUND Melanoma has the potential to spread to virtually any organ, including the gallbladder. The role of intervention in this rare entity must be based on a thorough appreciation of the underlying disease biology. METHODS We present a review of all patients treated for gallbladder melanoma at Memorial Sloan-Kettering Cancer Center (MSKCC) between 1991 and 2003. RESULTS The study group consisted of 13 patients with melanoma metastatic to the gallbladder. The median survival was 12 months following the diagnosis, and only 1 patient survived more than 42 months. Factors associated with improved outcome included symptomatic metastases and metastatic disease confined to the gallbladder (P < .05). Cholecystectomy led to the resolution of right upper quadrant pain in all patients for the duration of their survival. CONCLUSIONS In patients with melanoma metastatic to the gallbladder, overall survival is determined more by the biology of the disease than treatment. In the presence of symptoms, cholecystectomy is often effective palliation in carefully selected patients.
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Affiliation(s)
- Steven C Katz
- Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
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16
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Safioleas M, Agapitos E, Kontzoglou K, Stamatakos M, Safioleas P, Mouzopoulos G, Kostakis A. Primary melanoma of the gallbladder: Does it exist? Report of a case and review of the literature. World J Gastroenterol 2006; 12:4259-61. [PMID: 16830389 PMCID: PMC4087388 DOI: 10.3748/wjg.v12.i26.4259] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
With the occasion of a case of malignant melanoma of the gallbladder, which appeared to be primary, we have reviewed the literature and the result of this research was that primary melanoma of the gallbladder remains a questionable medical entity. Only few cases of both primary and metastatic gallbladder melanoma have been reported so far, and the only agreement is that surgery is the mainstay treatment. The role of adjuvant chemotherapy, hormonotherapy or immunotherapy for both primary and metastatic disease remains undefined.
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Affiliation(s)
- Michail Safioleas
- Department of Propedeutic Surgery, School of Medicine, Athens University, Laiko Hospital, Greece.
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17
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Bejarano González N, García Moforte N, Darnell Martín A, Dinarès Fernández MC, Laporte Roselló E, Navarro Soto S. Primary malignant melanoma of the common bile duct: a case report and literature review. GASTROENTEROLOGIA Y HEPATOLOGIA 2005; 28:382-4. [PMID: 16137472 DOI: 10.1157/13077759] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Primary malignant melanoma of the common bile duct is rare. Only seven cases have been described in the literature. Diagnosis is based on failure to find another primary site, histological examination with electron microscopy, and immunohistochemical tests. We describe a new case of primary malignant melanoma of the biliary tract and present a review of previous reports.
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Affiliation(s)
- N Bejarano González
- Department of General Surgery, Hospital de Sabadell, Corporació Parc Taulí, Sabadell, Barcelona, Spain
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18
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Crippa S, Bovo G, Romano F, Mussi C, Uggeri F. Melanoma metastatic to the gallbladder and small bowel: report of a case and review of the literature. Melanoma Res 2005; 14:427-30. [PMID: 15457102 DOI: 10.1097/00008390-200410000-00016] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
From post-mortem case records, the small bowel is the most frequent site of metastatic melanoma in the gastrointestinal (GI) tract, with gallbladder involvement occurring in 15% of cases. However, few cases have been documented in living patients and, when found, are associated with a poor prognosis. We report a case of a Caucasian man with metastatic gallbladder and small bowel melanoma from an unknown primary. He presented with diffuse abdominal pain, vomiting and progressive asthenia; subsequently, intestinal obstruction occurred. He had no past history of malignant melanoma and the primary lesion was not found. The multiple lesions, together with the absence of mucosal involvement in both the gallbladder and small bowel, led us to believe that the lesions were metastatic deposits from a probably regressed primary melanoma. It should be emphasized that surgical resection for melanoma metastatic to the GI tract is recommended for palliative reasons and can be performed safely. The clinical presentation, diagnosis, treatment and prognosis of previously reported cases of melanoma metastatic to the gallbladder and small bowel are reviewed. The differences between primary and secondary GI tract melanomas are also discussed.
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Affiliation(s)
- Stefano Crippa
- Department of Surgery, University of Milan-Bicocca, San Gerardo Hospital, Via Donizetti, 106, Monza 20052 (MI), Italy.
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Abstract
This review considers pigmented melanin-containing lesions arising in extracutaneous locations. It includes reactive lesions as well as benign and malignant neoplasms. Melanocytic lesions of the mucosae, nervous system, and individual organs are discussed, and rarer pigmented tumors in unusual sites are also covered. A brief description of the histology and clinical behavior along with proposed explanations for their ectopic location are provided. Emphasis is given to the reality that detailed morphological evaluation and application of ancillary techniques can establish the melanocytic nature and biologic potential of such tumors, but cannot, by themselves, determine the primary or metastatic nature of these lesions.
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Affiliation(s)
- Adriano Piris
- Istituto Nazionale per lo Studio e la Cura dei Tumori, Milan, Italy
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20
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Gassler N, Banafsche N, Quentmeier A, Otto HF, Helmke BM. [Secondary malignant melanoma of the gallbladder. A contribution to the differential diagnosis of pigmented lesions of the gallbladder]. DER PATHOLOGE 2004; 25:155-9. [PMID: 15011002 DOI: 10.1007/s00292-004-0682-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
The history of gallbladder involvement by a malignant melanoma in a 65-year-old woman is reported. The gallbladder, clinically resected for cholecystitis, harboured a polypoid dark pigmented tumour. The tumour was identified as a malignant melanoma immunohistochemically by positive reactions for gp100 (HMB45), melan A, and MiTF. Clinically, the patient was treated for cutaneous malignant melanoma by local excision 10 years earlier. The literature of pigmented lesions of the gallbladder is reviewed. In conclusion, the most important differential diagnosis of pigmented lesions of the gallbladder is the secondary gallbladder melanoma.
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Affiliation(s)
- N Gassler
- Pathologisches Institut, Universität Heidelberg, Im Neuenheimer Feld 220/221, 69120 Heidelberg, Germany.
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21
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Swiatoniowski G, Mazur G, Hałoń A, Rozumek G, Dabrowska M, Zawisza R, Prudlak E. Malignant melanoma with gall bladder metastasis as a second neoplasm in the course of prostate cancer. Pathol Oncol Res 2004; 10:243-5. [PMID: 15619649 DOI: 10.1007/bf03033770] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2004] [Accepted: 11/17/2004] [Indexed: 10/20/2022]
Abstract
Malignant melanoma is a neoplasm with an often unpredictable course and metastases potentially affecting all organs of the human body. Metastases into the gall bladder are rare. The role of hormonal background in the development and progression of malignant melanoma has not been established. The authors present a case of a 63-year-old man who had initially undergone long-term hormone therapy for the treatment of prostate cancer, and later presented with melanoma metastatic to the gall bladder.
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Guida M, Cramarossa A, Gentile A, Benvestito S, De Fazio M, Sanbiasi D, Crucitta E, De Lena M. Metastatic malignant melanoma of the gallbladder: a case report and review of the literature. Melanoma Res 2002; 12:619-25. [PMID: 12459652 DOI: 10.1097/00008390-200212000-00012] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Both primary and metastatic melanoma of the gallbladder are rare. Involvement of the gallbladder occurs in about 15% of all gastrointestinal metastatic localizations in post-mortem case records. It is often difficult to differentiate primary from metastatic lesions on the basis of clinical, radiological and histopathological features. Melanoma involving the biliary tree seldom causes relevant symptoms during life, and this is why cases reported in the literature are few and those documented in living patients even fewer. We report a case of a young woman with a metastatic gallbladder melanoma who presented with a long and vague clinical history of symptoms that mimicked chronic cholecystitis with epigastric right hypochondrial pain without instrumental evidence of disease until the development of acute cholecystitis. We report this case to emphasize the need for awareness of the possibility of gallbladder involvement in the melanoma patient and to underline the necessity of meticulous investigation of unclear lesions of the gallbladder and biliary tree in patients with a past history of malignant melanoma. The clinical presentation, diagnosis, histopathology, prognosis and treatment of primary and metastatic melanoma of the gallbladder are also discussed and reviewed.
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Affiliation(s)
- M Guida
- Division of Medical Oncology, Istituto Oncologico, Bari, Italy.
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23
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