1
|
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.
Collapse
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
| |
Collapse
|
2
|
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.
Collapse
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
| | | |
Collapse
|
3
|
Mellnick VM, Menias CO, Sandrasegaran K, Hara AK, Kielar AZ, Brunt EM, Doyle MBM, Dahiya N, Elsayes KM. Polypoid lesions of the gallbladder: disease spectrum with pathologic correlation. Radiographics 2016; 35:387-99. [PMID: 25763724 DOI: 10.1148/rg.352140095] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Gallbladder polyps are seen on as many as 7% of gallbladder ultrasonographic images. The differential diagnosis for a polypoid gallbladder mass is wide and includes pseudotumors, as well as benign and malignant tumors. Tumefactive sludge may be mistaken for a gallbladder polyp. Pseudotumors include cholesterol polyps, adenomyomatosis, and inflammatory polyps, and they occur in that order of frequency. The most common benign and malignant tumors are adenomas and primary adenocarcinoma, respectively. Polyp size, shape, and other ancillary imaging findings, such as a wide base, wall thickening, and coexistent gallstones, are pertinent items to report when gallbladder polyps are discovered. These findings, as well as patient age and risk factors for gallbladder cancer, guide clinical decision making. Symptomatic polyps without other cause for symptoms, an age over 50 years, and the presence of gallstones are generally considered indications for cholecystectomy. Incidentally noted pedunculated polyps smaller than 5 mm generally do not require follow-up. Polyps that are 6-10 mm require follow-up, although neither the frequency nor the length of follow-up has been established. Polyps that are larger than 10 mm are typically excised, although lower size thresholds for cholecystectomy may be considered for patients with increased risk for gallbladder carcinoma, such as patients with primary sclerosing cholangitis.
Collapse
Affiliation(s)
- Vincent M Mellnick
- From the Mallinckrodt Institute of Radiology (V.M.M.), Department of Pathology (E.M.B.), and Department of Surgery (M.B.M.D.),Washington University School of Medicine, 510 S Kingshighway Blvd, Box 8131, St Louis, MO 63110; Department of Radiology, Mayo Clinic, Scottsdale, Ariz (C.O.M., A.K.H., N.D.); Department of Radiology, Indiana University School of Medicine, Indianapolis, Ind (K.S.); Department of Radiology, University of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada (A.Z.K.); and Department of Radiology, University of Texas MD Anderson Cancer Center, Houston, Tex (K.M.E.)
| | | | | | | | | | | | | | | | | |
Collapse
|
4
|
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.
Collapse
Affiliation(s)
- Zarrish S Khan
- Department of Surgery, UT Southwestern Medical Center, Harry Hines Blvd, Dallas, 75219, USA
| | | | | | | |
Collapse
|
5
|
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.
Collapse
|
6
|
Alimova E, Gorin I, Gressier L, Hugol D, Bouillot JL, Cavalcanti A, Terrier-Lacombe MJ, Blondet C, Franck N, Morini JP, Dupin N, Avril MF. [Metastatic melanoma of the gallbladder: two cases]. Ann Dermatol Venereol 2009; 136:368-70. [PMID: 19361709 DOI: 10.1016/j.annder.2008.11.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2008] [Accepted: 11/21/2008] [Indexed: 11/26/2022]
|
7
|
Lesur G, Bourgault I, Longvert C, El Hajjam M, Dubreuil O, Julié C, Saiag P, Clerici T. [Rectosigmoid junction metastasis from melanoma: a case report]. ACTA ACUST UNITED AC 2008; 33:93-6. [PMID: 18678451 DOI: 10.1016/j.gcb.2008.05.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2008] [Accepted: 05/23/2008] [Indexed: 11/25/2022]
|