title: Laparoscopic cholecystectomy for melanoma metastatic to the gallbladder: is it an adequate surgical procedure? Report of a case and review of the literature.
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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors: Department of Surgical Oncology "B", National Cancer Institute of Naples, Italy. dott.marone@virgilio.it
authors: Ugo
authors: U
authors: Marone
authors: Corrado
authors: C
authors: Caracò
authors: Simona
authors: S
authors: Losito
authors: Antonio
authors: A
authors: Daponte
authors: Maria Grazia
authors: MG
authors: Chiofalo
authors: Stefano
authors: S
authors: Mori
authors: Rocco
authors: R
authors: Cerra
authors: Luciano
authors: L
authors: Pezzullo
authors: Nicola
authors: N
authors: Mozzillo
mesh_terms: D017081:Cholecystectomy, Laparoscopic; D005706:Gallbladder Neoplasms / Q000556:secondary / Q000601:surgery*; D006801:Humans; D008297:Male; D008545:Melanoma / Q000556:secondary / Q000601:surgery*; D008875:Middle Aged; D012878:Skin Neoplasms / Q000473:pathology / Q000601:surgery*