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Geng Z, Tang C, Chen J, Luo R, Yu Q, Yuan H. Metastatic melanoma of the gallbladder: A case report and systematic review. JOURNAL OF CLINICAL ULTRASOUND : JCU 2024; 52:1113-1120. [PMID: 39011759 DOI: 10.1002/jcu.23755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 06/10/2024] [Accepted: 06/13/2024] [Indexed: 07/17/2024]
Abstract
We report a case of metastatic melanoma of the gallbladder diagnosed by contrast-enhanced ultrasound and systematically review the characteristics of transabdominal ultrasound, clinical manifestations, and treatment methods of gallbladder metastatic melanoma in order to provide reference ideas for the diagnosis and treatment of metastatic melanoma of gallbladder.
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Affiliation(s)
- Zhidan Geng
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Congyu Tang
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Jianfei Chen
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Rongkui Luo
- Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Qing Yu
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Haixia Yuan
- Department of Ultrasound, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
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2
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Sergeant C, Kerger J, Drowart A, Sales F, Langouo M. Trocar Site Recurrence after Laparoscopic Cholecystectomy for Unsuspected Isolated Gallbladder Metastasis of Melanoma: A Case Report and Review of the Literature. Case Rep Oncol 2023; 16:1183-1195. [PMID: 37900831 PMCID: PMC10601805 DOI: 10.1159/000534147] [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: 09/04/2023] [Accepted: 09/11/2023] [Indexed: 10/31/2023] Open
Abstract
Cutaneous melanoma can metastasize to almost any organ, including in-transit metastases, lymph nodes, liver, lungs, brain, and bones. Spread to the gastrointestinal tract is less common and generally concerns the small bowel, colon, and stomach. Gallbladder involvement is rarer, and only few cases describe it as the sole site of metastasis upon diagnosis. Melanoma metastases to the gallbladder are usually detected on staging or surveillance imaging, as patients usually show few or no symptoms. In resectable stage IV melanoma patients, complete surgical resection appears to improve the prognosis. However, due to the rarity of isolated gallbladder metastasis of melanoma, there are no guidelines regarding the optimal surgical approach (endoscopic or open cholecystectomy). Here, we report the case of isolated gallbladder melanoma metastasis found after laparoscopic cholecystectomy performed in a 46-year-old female patient with no known history of cancer presenting with acute cholecystitis symptoms. Six weeks after surgery, the patient developed trocar site recurrence. This case highlights the importance of a planned and open surgery for resectable melanoma metastases rather than a laparoscopic approach.
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Affiliation(s)
- Céline Sergeant
- Department of Medical Oncology, Institut Jules Bordet, Brussels, Belgium
- Department of Medical Oncology, Université Libre de Bruxelles, Brussels, Belgium
| | - Joseph Kerger
- Department of Medical Oncology, Institut Jules Bordet, Brussels, Belgium
| | - Annie Drowart
- Department of Medical Oncology, Institut Jules Bordet, Brussels, Belgium
| | - François Sales
- Department of Surgical Oncology, Institut Jules Bordet, Brussels, Belgium
| | - Mireille Langouo
- Department of Medical Oncology, Institut Jules Bordet, Brussels, Belgium
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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: 2] [Impact Index Per Article: 1.0] [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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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: 3] [Impact Index Per Article: 1.0] [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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D'Urso Vilar GG, Iriarte F, Speisky D, Bregante ML, Quildrian SD. Isolated gallbladder metastasis of melanoma: Case report. Int J Surg Case Rep 2020; 71:311-314. [PMID: 32485637 PMCID: PMC7264460 DOI: 10.1016/j.ijscr.2020.04.086] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 03/13/2020] [Accepted: 04/27/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Although metastatic melanoma is most frequently found in liver, lungs, and brain, most metastases found in the gallbladder are from melanoma. Here, we present a case of isolated metastatic melanoma found during cholecystectomy. PRESENTATION OF CASE 74-year-old male with a personal history of hypertension, diabetes mellitus, obesity, and arrhythmia. A skin lesion was found on the right malar region. An excisional biopsy was performed and histopathological examination showed an ulcerated nodular-type malignant melanoma, Breslow 7.6 mm, Clark IV. Surgical excision with margins of 2 cm and sentinel lymph-node biopsy was carried and were negative. Abdominal sonography at 6 months showed an 18 mm solid mass adhered to the wall of the gallbladder that was suggestive of a polyp. Thorax-abdomen-pelvis CT showed no abnormalities. The gallbladder lesion had increased in volume on the following sonography and therefore, cholecystectomy was performed. Histopathological study revealed melanoma infiltrating the mucosa and muscular layer. Written informed consent was previously obtained, and Institutional Review Board approval was not needed. DISCUSSION Isolated metastatic melanoma in the gallbladder is uncommon. Follow-up controls with images are important in the diagnosis. As most metastatic melanoma to the gallbladder are asymptomatic, surgeons should have high level of suspicion. Cholecystectomy could prolong survival in these patients. CONCLUSION Isolated gallbladder metastasis of melanoma is an uncommon presentation of this disease. Laparoscopic cholecystectomy is an adequate procedure in this particular situation and may improve patient survival. The presentation of this case may help surgeons to maintain a high level of suspicion regarding the condition.
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Affiliation(s)
| | - Facundo Iriarte
- General Surgery Department, British Hospital of Buenos Aires, Perdriel 74, CABA, 1280, Argentina.
| | - Daniela Speisky
- Pathology Department, British Hospital of Buenos Aires, Perdriel 74, CABA, 1280, Argentina
| | - Mariano Luis Bregante
- General Surgery Department, British Hospital of Buenos Aires, Perdriel 74, CABA, 1280, Argentina
| | - Sergio Damian Quildrian
- General Surgery Department, British Hospital of Buenos Aires, Perdriel 74, CABA, 1280, Argentina
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7
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Giannini I, Cutrignelli DA, Resta L, Gentile A, Vincenti L. Metastatic melanoma of the gallbladder: report of two cases and a review of the literature. Clin Exp Med 2015; 16:295-300. [PMID: 25929736 DOI: 10.1007/s10238-015-0353-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Accepted: 04/20/2015] [Indexed: 12/14/2022]
Abstract
Melanoma is one of the most aggressive and highly metastatic cancers. The most common sites of distant metastases are soft tissues, lung, liver, skin and brain, whereas only few patients develop gastrointestinal metastases. Metastatic involvement of the gallbladder is rare and more often part of a widespread disease than a solitary lesion. The "gold-standard" treatment of metastatic melanoma of the gallbladder remains unclear. We report two cases of patients with past history of cutaneous melanoma who developed visceral metastases. The first patient was asymptomatic and had a widespread disease with metastatic involvement of both the spleen and the gallbladder. The second patient had an isolated metastasis of the gallbladder and complained of upper abdominal pain. The chosen treatment was open cholecystectomy (and splenectomy) in the first case and laparoscopic cholecystectomy in the second. A review of the literature is provided.
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Affiliation(s)
- I Giannini
- General Surgery and Liver Transplantation Unit, Department of Emergency and Organ Transplantation, University "A. Moro" of Bari, Policlinico. Piazza G. Cesare, 11, 70124, Bari, Italy.
| | - D A Cutrignelli
- Complex Operating Unit of Plastic Aesthetic and Reconstructive Surgery, Department of Emergency and Organ Transplantation, University "A. Moro" of Bari, Bari, Italy
| | - L Resta
- Department of Emergence and Organ Transplantation, Institute of Pathological Anatomy, University "A. Moro" of Bari, Bari, Italy
| | - A Gentile
- Department of Emergence and Organ Transplantation, Institute of Pathological Anatomy, University "A. Moro" of Bari, Bari, Italy
| | - L Vincenti
- General Surgery Unit, Policlinico of Bari, Bari, Italy
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Christou D, Katodritis N, Decatris MP, Katodritou A, Michaelides I, Nicolaou N, Kounoushis M, Hadjicostas P. Melanoma of the gallbladder: appropriate surgical management and review of the literature. Clin Case Rep 2014; 2:313-8. [PMID: 25548636 PMCID: PMC4270716 DOI: 10.1002/ccr3.121] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2014] [Accepted: 06/28/2014] [Indexed: 12/23/2022] Open
Abstract
KEY CLINICAL MESSAGE Melanomas of the gallbladder (GB) are extremely rare with a very poor prognosis. They feature in the literature as a few case reports and the method of their management is not clear. We report a case of patient with metastatic cutaneous melanoma to the GB, and our treatment suggestion.
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Affiliation(s)
- Demetris Christou
- Department of General Surgery, Larnaca General HospitalLarnaca, Cyprus
| | - Nicos Katodritis
- Department of Radiation Oncology, Bank of Cyprus Oncology CentreNicosia, Cyprus
| | - Marios P Decatris
- Department of Medical Oncology, Bank of Cyprus Oncology CentreNicosia, Cyprus
| | | | | | - Nicolaos Nicolaou
- Department of General Surgery, Larnaca General HospitalLarnaca, Cyprus
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Abstract
We report a case of malignant melanoma of unknown primary origin presenting metastasis in various organs as well as intraluminal gallbladder bleeding due to gallbladder metastasis. A 58-year-old woman was diagnosed with stage IV metastatic malignant melanoma. Because she exhibited acute cholecystitis and hemobilia due to malignant melanoma of the gallbladder, laparoscopic cholecystectomy was performed to relieve the symptoms. The resected gallbladder specimen showed a pedunculated black mass indicating malignant melanoma. Pathologic examination and immunohistochemical analysis revealed malignant melanoma of the gallbladder. Only a few cases of gallbladder malignant melanoma presenting hemobilia have been reported; here we present our case, including the experience of multidisciplinary treatment.
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Khan ZS, Huth J, Kapur P, Huerta S. Indications and recommended approach for surgical intervention of metastatic disease to the gallbladder. World J Surg Oncol 2010; 8:80. [PMID: 20828420 PMCID: PMC2944133 DOI: 10.1186/1477-7819-8-80] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2010] [Accepted: 09/10/2010] [Indexed: 12/26/2022] Open
Abstract
Metastatic disease to the gallbladder is unusual. The most common malignancy metastatic to the gallbladder is melanoma, followed by renal cell carcinoma (RCC) and breast cancer. Due to the unusual nature of the disease, there are no trials available for review. Thus, the management for these patients has been based on institutional experience and review of case series. The indications for surgical intervention for melanoma are metastatic disease discrete to the gallbladder and biliary symptoms, which are uncommon for melanoma, but might occur due to cystic duct obstruction culminating in cholecystitis. Laparoscopic cholecystectomy without a lymphadenectomy is emerging as the preferred approach for this metastatic deposit. The vast majority of patients with metastases to the gallbladder from RCC carry a good prognosis and a laparoscopic cholecystectomy should be considered. Patients with metastases to the gallbladder from the breast classically present with biliary symptoms and commonly undergo a laparoscopic cholecystectomy, which invariably demonstrates a deposit in the gallbladder from lobular breast cancer. In the present report, we review the indications for surgical intervention from various malignancies metastatic to the gallbladder and the current consensus for the laparoscopic approach from the diverse metastatic deposits to the gallbladder.
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Affiliation(s)
- Zarrish S Khan
- Department of Surgery, UT Southwestern Medical Center, Harry Hines Blvd, Dallas, 75219, USA
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Yoon WJ, Yoon YB, Kim YJ, Ryu JK, Kim YT. Metastasis to the gallbladder: A single-center experience of 20 cases in South Korea. World J Gastroenterol 2009; 15:4806-9. [PMID: 19824115 PMCID: PMC2761559 DOI: 10.3748/wjg.15.4806] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To evaluate the clinicopathologic characteristics of patients with metastases to the gallbladder (MGBs).
METHODS: We performed a single-center retrospective study of 20 patients with MGBs diagnosed pathologically from 1999 to 2007.
RESULTS: Among 417 gallbladder (GB) malignancies, 20 (4.8%) were MGBs. The primary malignancies originated from the stomach (n = 8), colorectum (n = 3), liver (n = 2), kidney (n = 2), skin (n = 2), extrahepatic bile duct (n = 1), uterine cervix (n = 1), and appendix (n = 1). Twelve patients were diagnosed metachronously, presenting with cholecystitis (n = 4), abdominal pain (n = 2), jaundice (n = 1), weight loss (n = 1), and serum CA 19-9 elevation (n = 1); five patients were asymptomatic. The median survival after the diagnosis of MGB was 8.7 mo. On Cox regression analysis, R0 resection was the only factor associated with a prolonged survival [hazard ratio (HR): 0.01, P = 0.002]; presentation with cholecystitis was associated with poor survival (HR: 463.27, P = 0.006).
CONCLUSION: MGBs accounted for 4.8% of all pathologically diagnosed GB malignancies. The most common origin was the stomach. The median survival of MGB was 8.7 mo.
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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: 27] [Impact Index Per Article: 1.6] [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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