title: Prolonged survival after the surgical management of a solitary malignant melanoma lesion within the pancreas: A case report of curative resection.
abstract: Solitary involvement of the pancreas in patients with malignant melanoma is rare and the role of surgery in these patients is not defined. We present a patient with prolonged survival following aggressive surgical management for a solitary metastatic lesion within the pancreas. A 69-year-old male presented with a 10-day history of painless jaundice. His past medical history included a wide local excision for a superficial spreading melanoma, and subsequent loco-regional recurrence requiring lymph node dissection. Imaging on presentation showed a solitary mass in the head of the pancreas, with no signs of metastases. The patient underwent a pancreato-duodenectomy. Histology reported a metastatic malignant melanoma with clear excision margins. There was no nodal involvement and he remained disease-free eight years later. The survival of patients seems to be affected by the ability to perform a curative resection, and by a long disease-free interval between the treatment of the initial lesion and disease recurrence. Curative surgical resection should be offered to selected patients with a solitary pancreatic malignant melanoma metastasis. Such aggressive management may lead to prolonged, and disease-free survival.
authors.affiliation: General Surgery Unit, Imperial College Healthcare NHS Trust, St Mary's Hospital, Mary Stanford Wing, London, United Kingdom.
authors.forename: Sophocles
authors.initials: S
authors.lastname: Lanitis
authors.forename: Nikos
authors.initials: N
authors.lastname: Papaioannou
authors.forename: George
authors.initials: G
authors.lastname: Sgourakis
authors.forename: Adrienne
authors.initials: A
authors.lastname: Seitz
authors.forename: Emmanouil
authors.initials: E
authors.lastname: Zacharakis
authors.forename: Constantine
authors.initials: C
authors.lastname: Karaliotas
mesh_terms: D000368:Aged; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008545:Melanoma / Q000556:secondary / Q000601:surgery*; D009361:Neoplasm Invasiveness; D010190:Pancreatic Neoplasms / Q000556:secondary / Q000601:surgery*; D016577:Pancreaticoduodenectomy; D012878:Skin Neoplasms / Q000473:pathology / Q000601:surgery*; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome