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Gallbladder Pathology Online

Pathology of Melanoma of the Gallbladder

Dr Sampurna Roy  MD    

 

The first case of primary melanoma of the gallbladder mucosa was described by Wieting and Hambi, in 1907.

Both primary and metastatic melanoma of the gallbladder are rare.

Both primary melanoma and metastatic melanomas of the gallbladder have similar presentations. Most patients are asymptomatic and lesions are identified incidentally. Other presentations are those which, mimic acute cholecystitis such as right upper quadrant or epigastric pain and nausea or vomiting. Obstruction of the cystic duct by the tumor in the absence of cholelithiasis can lead to obstructive jaundice.

A primary malignant melanoma of the gall bladder is difficult or impossible to distinguish from secondary melanoma.

Mac Fadden et al, compared primary and metastatic biliary melanomas. To help in the differentiation between primary and secondary malignant melanoma in the gall bladder, it was suggested that certain criteria should be fulfilled before primary melanoma is diagnosed. 

(i) Tumours must be solitary and arise from the mucosal surface of the gall bladder;

(ii) they must either be papillary or polypoid;

(iii) they must either display junctional activity or have any other primary sites excluded by history taking, examination, and investigation.

Microscopic examination reveal mostly spindle cells with vesicular nuclei and large nucleoli.

Many cells stained positively for S 100 protein and HMB 45 using immunohistochemistry and they contained dark brown pigment that stained as melanin pigment with Fontana-Masson.

The tumour may metastasize to the common bile duct, stomach, the duodenum, the jejunum, the lung, the brain and a bronchopulmonary lymph node.

In case of metastic melanoma of gallbladder, potential primary sites include skin, oral cavity, anorectal region, uveal tract, and meninges.

Because of its rarity, melanoma of the gallbladder should always be suspected in a patient with a past history of cutaneous malignant melanoma who presents with hepatobiliary symptoms. The prognosis of both primary and metastatic disease is very poor.

 

Further reading:

Melanoma of the gallbladder: appropriate surgical management and review of the literature

Melanoma of the gallbladder: a review of cases

Metastatic malignant melanoma of the gallbladder: a case report and review of literature

Primary Malignant Melanoma of the Gallbladder:

Primary melanoma of the gallbladder: does it exist?

Malignant melanoma of the gallbladder: a report of two cases and review of the literature.

Primary malignant melanoma of the gallbladder in dysplastic naevus syndrome.

Gallbladder melanoma mimicking acute acalculous cholecystitis.  

Primary gallbladder melanoma in dysplastic nevus syndrome.

Metastatic malignant melanoma of the gallbladder presenting as biliary colic: a case report and review of literature.

Secondary malignant melanoma of the gallbladder. A contribution to the differential diagnosis of pigmented lesions of the gallbladder.

Malignant melanoma of the gallbladder

 

 

 

Dr  Sampurna Roy  MD

Consultant  Histopathologist (Kolkata - India)

 

 

 

 

          

 

 

 

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