title: Surgical resection of malignant melanoma metastatic to the pancreas: case series and review of literature.
abstract: BACKGROUND
  Malignant melanoma only rarely metastasizes to the pancreas. As such, there is limited medical literature on the clinical course and outcomes for patients who have undergone surgical management of these tumors. The aim of our study was to review our experience with the surgical resection of melanoma metastatic to the pancreas.
  
  
  METHODS
  The records of five patients (four females, one male) with surgically resected melanoma metastatic to the pancreas were retrospectively reviewed. Tumor characteristics, patient presentation, operative details, and follow-up data were evaluated.
  
  
  RESULTS
  The primary site of melanoma was known in three cases and unknown in two cases. Four patients were symptomatic at presentation, including abdominal pain (n = 3), jaundice (n = 2), abdominal distension (n = 1), bleeding metastases (n = 1), and fatigue (n = 1). In one patient, the metastasis was an incidental discovery. Surgical resection was accomplished by pylorus-preserving pancreaticoduodenectomy in four patients and distal pancreatectomy in one patient. Single-site resection was done in two patients while the other three underwent synchronous multiple-site resections. Complications developed post-operatively in three patients. Two patients had progression of disease in the form of new metastatic lesions and received subsequent chemotherapy. The median survival was 11.4 months (range, 3-26 months).
  
  
  CONCLUSIONS
  Aggressive surgical management of pancreatic metastases provides palliative relief of symptoms and may be considered in appropriately selected candidates.
authors.affiliation: Brady Urological Institute, The Johns Hopkins University School of Medicine, Baltimore, MD 21287-2101, USA. jatinaiims@gmail.com
authors.forename: Jatinder
authors.initials: J
authors.lastname: Goyal
authors.forename: Evan J
authors.initials: EJ
authors.lastname: Lipson
authors.forename: Neda
authors.initials: N
authors.lastname: Rezaee
authors.forename: Barish H
authors.initials: BH
authors.lastname: Edil
authors.forename: Rich
authors.initials: R
authors.lastname: Schulick
authors.forename: Christopher L
authors.initials: CL
authors.lastname: Wolfgang
authors.forename: Ralph H
authors.initials: RH
authors.lastname: Hruban
authors.forename: Emmanuel S
authors.initials: ES
authors.lastname: Antonarakis
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008545:Melanoma / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D010180:Pancreatectomy / Q000401:mortality*; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D016577:Pancreaticoduodenectomy / Q000401:mortality*; D011379:Prognosis; D012189:Retrospective Studies; D012196:Review Literature as Topic; D015996:Survival Rate