Metastatic Melanoma of the Gallbladder in an Asymptomatic Patient

Trocar Site Recurrence after Laparoscopic Cholecystectomy for Unsuspected Isolated Gallbladder Metastasis of Melanoma: A Case Report and Review of the Literature

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.

A rare case of solitary gallbladder metastasis from an early cutaneous melanoma

Solitary gallbladder metastasis from melanoma is a rare phenomenon, in this case manifesting as biliary symptoms during and following pregnancy. It is important to consider uncommon causes of biliary symptoms to aid in prompt diagnosis and treatment. This patient was successfully treated with laparoscopic cholecystectomy and adjuvant immunotherapy.

Malignant metastatic melanoma to the gallbladder: Report of a peculiar case

INTRODUCTION

Melanoma is one of the most aggressive and one of the fastest growing types of cancer. The occurrence of a malignant melanoma in the gastrointestinal tract, either primary or metastatic, is a rare event. Metastatis from cutaneous malignant melanoma to the gallbladder are a highly uncommon finding, usually associated with diffuse metastatic disease and observed during autopsy. The event of a solitary metastasis of malignant melanoma to gallbladder is barely reported.

CASE REPORT

We report a case of a 35-year old Caucasian woman with isolated metastasis of gallbladder from cutaneous primary malignant melanoma managed with laparoscopic cholecystectomy.

DISCUSSION

Gallbladder metastasis as a first site of recurrence represents a rare condition for all cancers. Since the occurrence of an isolated gallbladder metastasis of cutaneous melanoma is an uncommon circumstance, no therapeutic guidelines have yet been proposed. Nevertheless cholecystectomy appears to be the standard of care for the treatment of this unusual condition, especially when symptomatic and for palliative purpose. The surgical approach is still debated, with no unanimous consent between mini-invasive surgery and open technique.

CONCLUSION

In our case, we decided to carry out a three-port laparoscopic cholecystectomy, preferring a mini-invasive approach considering the good performance status of our patient and her young age.

Metastatic melanoma of the gallbladder: an uncommon finding

Melanoma metastasizes to the gastrointestinal tract in 2-4% of cases. In addition, it is the tumor that most frequently metastasizes to the gallbladder (50-67% of metastasis at this level). Even so, these metastases are infrequent. The indication of cholecystectomy will be provided by the patient performance status, extension and prognosis of disease. Although open surgery is preferred to treat melanoma metastasis at this level, laparoscopic surgery could be a safe technique that allows a fast recovery of the patient. We present the case of a 48-year-old man with melanoma metastases in the gallbladder treated by laparoscopic cholecystectomy.