Guida M, Cramarossa A, Gentile A, Benvestito S, De Fazio M, Sanbiasi D, Crucitta E, De Lena M
Division of Medical Oncology, Istituto Oncologico, Bari, Italy.
Melanoma Res. 2002 Dec;12(6):619-25. doi: 10.1097/00008390-200212000-00012.
Both primary and metastatic melanoma of the gallbladder are rare. Involvement of the gallbladder occurs in about 15% of all gastrointestinal metastatic localizations in post-mortem case records. It is often difficult to differentiate primary from metastatic lesions on the basis of clinical, radiological and histopathological features. Melanoma involving the biliary tree seldom causes relevant symptoms during life, and this is why cases reported in the literature are few and those documented in living patients even fewer. We report a case of a young woman with a metastatic gallbladder melanoma who presented with a long and vague clinical history of symptoms that mimicked chronic cholecystitis with epigastric right hypochondrial pain without instrumental evidence of disease until the development of acute cholecystitis. We report this case to emphasize the need for awareness of the possibility of gallbladder involvement in the melanoma patient and to underline the necessity of meticulous investigation of unclear lesions of the gallbladder and biliary tree in patients with a past history of malignant melanoma. The clinical presentation, diagnosis, histopathology, prognosis and treatment of primary and metastatic melanoma of the gallbladder are also discussed and reviewed.
原发性和转移性胆囊黑色素瘤均较为罕见。在尸检病例记录中，胆囊受累约占所有胃肠道转移部位的15%。基于临床、放射学和组织病理学特征，往往难以区分原发性病变与转移性病变。累及胆道系统的黑色素瘤在生前很少引起相关症状，这就是文献报道的病例较少，而有记录的在世患者病例更少的原因。我们报告一例年轻女性转移性胆囊黑色素瘤病例，该患者有漫长且模糊的症状临床病史，症状类似慢性胆囊炎，伴有上腹部右季肋部疼痛，在急性胆囊炎发作之前一直没有疾病的影像学证据。我们报告此病例是为了强调需要意识到黑色素瘤患者胆囊受累的可能性，并强调对有恶性黑色素瘤病史患者的胆囊和胆道系统不明病变进行细致检查的必要性。同时，还对原发性和转移性胆囊黑色素瘤的临床表现、诊断、组织病理学、预后及治疗进行了讨论和综述。
