| Abstract:
Melanoma of the
gallbladder: a review of cases seen at Duke University Medical Center.Cancer.
1999 Jan 1;85(1):32-9.
BACKGROUND: Both
primary and metastatic melanoma of the gallbladder are rare. In cases
involving isolated tumors of the gallbladder, there continues to be
controversy regarding the establishment of primary status. Despite
appropriate therapy, the diagnosis of either condition portends a poor
prognosis, with few patients surviving more than 2 years. METHODS: A
review of all patients seen at Duke University Medical Center since
1970 generated 1 case of primary and 19 cases of secondary melanoma of
the gallbladder. These were analyzed with respect to presentation,
clinical and pathologic diagnosis, treatment, and prognosis. RESULTS:
The sole patient with a primary lesion presented with acute
cholecystitis. Ultrasound demonstrated a mass in the lumen of the
gallbladder. Cholecystectomy revealed melanoma, and the patient
eventually died of disseminated disease 13.5 months later. Survival
was poor for patients who presented with metastases to the gallbladder
in the setting of widespread disease, with 0% survival at 1 year
(n=11). Those with isolated, resectable lesions fared better overall,
with 100% survival (n=6) at 1 year. One patient remains alive and free
of disease 13.8 years later, which, to our knowledge, represents the
longest documented survival for a patient with melanoma that has
metastasized to the gallbladder. CONCLUSIONS: Surgery remains the
mainstay of therapy for patients with gallbladder melanoma and appears
to improve patient outcome in the setting of resectable disease.
Hopefully, further investigations will lead to standardized protocols
for the treatment of these lesions.
Primary melanoma of the gallbladder: does it exist? Report of a case
and review of the literature.World
J Gastroenterol. 2006 Jul 14;12(26):4259-61.
With the occasion
of a case of malignant melanoma of the gallbladder, which appeared to
be primary, we have reviewed the literature and the result of this
research was that primary melanoma of the gallbladder remains a
questionable medical entity. Only few cases of both primary and
metastatic gallbladder melanoma have been reported so far, and the
only agreement is that surgery is the mainstay treatment. The role of
adjuvant chemotherapy, hormonotherapy or immunotherapy for both
primary and metastatic disease remains undefined.
Malignant melanoma of the gallbladder: a report of two cases and
review of the literature.
J Gastrointest Surg. 2008 Jun;12(6):1123-6.
Melanoma
metastatic to the gallbladder is rare. When present, it is often part
of a widespread complex of metastases. Primary gallbladder melanomas
are also extremely rare and can sometimes be difficult to distinguish
from metastatic lesions. The optimal treatment for malignant melanoma
of the gallbladder remains unclear, and prognosis is generally poor.
We present here two cases of patients with metastatic lesions to the
gallbladder. One patient presented with symptomatic cholelithiasis and
was found incidentally to have a metastasis. Another patient had known
a metastasis, but underwent curative resection of the only site of
disease. We review the published literature for gallbladder melanoma,
both primary and metastatic to determine the role of surgery in this
disease.
Gallbladder melanoma mimicking acute acalculous cholecystitis.Surg
Endosc. 2000 Jun;14(6):593. Epub 2000 May 8.
Gallbladder (GB)
melanoma is a rare entity with a dismal prognosis. Its primary or
secondary status is difficult to establish in the absence of an overt
cutaneous localization. We report herein the case of a misdiagnosed GB
melanoma mimicking acute acalculous cholecystitis that was treated by
means of laparoscopic cholecystectomy (LC). A 54-year-old man was
referred to our institution for acute cholecystitis. Apart from the
ablation of some nevocytic nevi 7 years before admission, the
patient's medical history was unremarkable. The ultrasound (US)
examination showed a slightly enlarged acalculous gallbladder with
thickened walls and a well-circumscribed polypoid mass in the fundus.
The patient was treated medically and referred to LC. At surgery, some
satellite nodules were visualized in the GB hepatic bed. The GB was
removed, and two hepatic nodules were excised. Histology showed a pT3
melanoma. The patient underwent an open hepatic wedge resection 3
weeks after laparoscopy. No recurrence was observed at 6-month
follow-up. To date, only one case of melanoma of the gallbladder
treated with LC has been reported. GB melanoma is a diagnostic
challenge when there is no evidence of a primary lesion. However, the
occurrence of acalculous cholecystitis and a GB polyp in patients with
a positive history of mole ablation should alert surgeons to the
possibility of a melanoma.
Primary malignant melanoma of the gallbladder in dysplastic naevus
syndrome.Virchows
Arch. 2001 Feb;438(2):159-65.
A case of
gallbladder involvement by malignant melanoma in a 57-year-old woman
is reported. The gallbladder, resected for cholelithiasis, harboured a
pedunculated polypoid dark mass, which histologically revealed sheets
and nests of epithelioid cells with hyperchromatic nuclei in the
lamina propria and at the junctional level. These cells were pigmented
(with positive reaction with Schmorl's stain and bleaching with
peroxide) and showed immunohistochemical positivity for S-100, gp 100
antigen (HMB-45 antibody) and vimentin. The patient, affected by
dysplastic naevus syndrome, had a melanoma in situ excised from the
scalp 8 years earlier. The features of the investigated lesion address
towards a diagnosis of primary gallbladder melanoma. Furthermore, this
is the first time that the existence of such a controversial entity is
sustained by the ultrastructural investigation of melanosomes,
demonstrating the presence of two melanocitary populations, a typical
one exclusively junctional and an atypical one both at the junctional
level and in the lamina propria.
Metastatic malignant melanoma of the gallbladder presenting as biliary
colic: a case report and review of literature.Am
Surg.2007 Aug;73(8):833-5.
Malignant
melanoma (MM) is the most common cancer to metastasize to the
gastrointestinal tract. Autopsy reports estimate that up to 15 per
cent of these patients also have gallbladder metastases, and MM
accounts for up to 60 per cent of metastatic lesions to the
gallbladder. However, despite its prevalence, MM to the gallbladder is
reported only sparingly in the literature. This discordance may be
explained by the fact that these lesions are seldom symptomatic.
Abdominal ultrasound remains the modality of choice in studying
gallbladder pathology and has the ability to define metastatic
lesions. The effect of screening for gallbladder metastases on
improving survival is not well defined, and thus its role remains
controversial. Cholecystectomy for melanoma metastases to the
gallbladder seems to be mostly palliative, although there have been
isolated reports of excellent long-term survival outcomes. The role
for immunotherapy and chemotherapy in this population is not well
defined, and overall prognosis is poor. Recent reports have advocated
laparoscopic cholecystectomy as the treatment of choice, though there
remains a concern for peritoneal port site seeding. We present the
case of a 48-year-old man with MM metastatic to the gallbladder and a
brief review of the literature.
Secondary malignant melanoma of the gallbladder. A contribution to
the differential diagnosis of pigmented lesions of the gallbladder.Pathologe.
2004 Mar;25(2):155-9.
The history of
gallbladder involvement by a malignant melanoma in a 65-year-old woman
is reported. The gallbladder, clinically resected for cholecystitis,
harboured a polypoid dark pigmented tumour. The tumour was identified
as a malignant melanoma immunohistochemically by positive reactions
for gp100 (HMB45), melan A, and MiTF. Clinically, the patient was
treated for cutaneous malignant melanoma by local excision 10 years
earlier. The literature of pigmented lesions of the gallbladder is
reviewed. In conclusion, the most important differential diagnosis of
pigmented lesions of the gallbladder is the secondary gallbladder
melanoma.
Malignant melanoma of the gallbladder.Ultraschall
Med. 1996 Aug;17(4):195-8.
A 75 year woman
developed a primary malignant melanoma of the gallbladder. The patient
presented with abdominal pain in the upper right quadrant typically
seen in acute cholecystitis. Neither intravesical concretions nor
cholestasis was seen. Ultrasound demonstrated hyperechogenic
intraluminal "school of fish" reflections, which are typical for
metastatic melanoma to the gallbladder. Intravesical fluid collection
was not present. The tumor did not expand past the wall of the
gallbladder. The main sonographic features are hyperdense intraluminal
strands of tumor and the lack of fluid. Computed tomography showed
solid intraluminal masses with hypodensive and partially hyperdensive
reticular structure.
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