[Gastric melanoma--clinical case].
Malignant melanomas of the gastrointestinal tract and particulary of the stomach are very rare intra-operative findings. The majority of such melanomas are metastatic from a cutaneous primary. We present the clinical case of a 69-years-old woman with malignant melanoma of the left pectoral region resected in 1988, presented with epigastric pain, weight loss and anaemia. Endoscopy and CT-scan suggested the diagnosis of malignant tumor of the large curvature of the stomach. Explorative laparotomy revealed a large ulcerated tumor of the fornix, with spleno-pancreatic invasion. We also found several pigmented satellite nodules. The surgical solution consisted in a total gastrectomy and distal spleno-pancreatectomy. Histology revealed the tumor and the satellite nodules to be composed of nests of epithelioid cells with melanin pigment. After 3 months, the evolution was favorable. There are some articles in medical literature which present cases of primary gastric melanomas. According to these scientific criterias from the literature, we discussed the nature of this melanoma - a primary or a metastatic one.
Doran
H
H
Clinica de Chirurgie Prof. I. Juvara, Spitalul Clinic Dr. I. Cantacuzino, Bucureşti. doranh2003@yahoo.com
Pătraşcu
Tr
T
Catrina
E
E
Mihalache
O
O
Degeratu
D
D
Predescu
G
G
D000368:Aged; D005260:Female; D005743:Gastrectomy; D005770:Gastrointestinal Neoplasms / Q000556:secondary; D006801:Humans; D008545:Melanoma / Q000556:secondary* / Q000601:surgery; D010180:Pancreatectomy; D012878:Skin Neoplasms / Q000473:pathology* / Q000601:surgery; D013156:Splenectomy; D013274:Stomach Neoplasms / Q000556:secondary* / Q000601:surgery; D016896:Treatment Outcome