title: Primary malignant melanoma of the stomach.
abstract: We report a 54-year-old patient with a complaint of weakness, abdominal pain and weight loss. During the clinical examination a palpable tumor resistance in the abdomen was found as well as iron deficiency anemia. Gastroscopy showed an exulcerated, dark brown, fungiform tumor about 4 cm in diameter at the great curve of stomach. Endoscopic biopsy revealed the diagnosis of malignant melanoma by demonstrating the presence of melanin containing tumor cells in gastric mucosa. The patient underwent subtotal gastrectomy, appendectomy and splenectomy. The diagnosis of gastric melanoma with regional lymph node metastases, as well as metastases in appendix adjacent tissue was confirmed by histology and immunohistochemistry. In three years follow up period patient developed cerebral and retroauricular subcutaneous metastases that were treated by surgery, adjuvant chemotherapy and radiotherapy. Finally, an explorative laparatomy was revealed advanced intraabdominal tumor dissemination with dark pigmented ascites. Concerning that all available diagnostic procedures failed to prove other site of melanoma, presented case was considered as primary gastric melanoma as a possible rare site of tumor.
authors.affiliation: Department of Surgery, Clinical Hospital Centre Zagreb, Kispatićeva 12, Zagreb, Croatia.
authors.forename: Zeljko
authors.initials: Z
authors.lastname: Jelincic
authors.forename: Jasminka
authors.initials: J
authors.lastname: Jakic-Razumovic
authors.forename: Igor
authors.initials: I
authors.lastname: Petrovic
authors.forename: Ana Marija
authors.initials: AM
authors.lastname: Cavcic
authors.forename: Josip
authors.initials: J
authors.lastname: Unusic
authors.forename: Robert
authors.initials: R
authors.lastname: Trotic
mesh_terms: D001063:Appendiceal Neoplasms / Q000473:pathology / Q000556:secondary; D001706:Biopsy; D006801:Humans; D008297:Male; D008545:Melanoma / Q000473:pathology* / Q000601:surgery / Q000628:therapy; D008875:Middle Aged; D013274:Stomach Neoplasms / Q000473:pathology* / Q000601:surgery / Q000628:therapy