Gajda Maksymilian, Kohut Maciej, Wydmański Jerzy, Kamińska-Winciorek Grazyna
Pol Merkur Lekarski. 2014 Oct;37(220):235-6.
7% of gastrointestinal tract (GIT) involvements with metastatic cutaneous melanoma concerns the stomach. The aim of the study was to describe a rare case of the cutaneous melanoma metastazing to the stomach.
. Bearing in mind the rarity of such cases, we present our experiences based on the history of 42-year-old woman, who underwent surgical excision of skin tumour located on the trunk.
Histopathological examination of the skin tumor led to the diagnosis of melanoma (Clark IV, Breslow 5mm) with ulceration and a number of mitoses 40/10 HPF. PET-CT demonstrated multiple organ dissemination. Patient was admitted to the hospital due to severe, symptomatic anaemia. RBC and FFP transfusions were necessary. Gastroscopy revealed multiple gastric and duodenal ulcers and histopathology confirmed metastatic melanoma. Attempts to achieve endoscopic hemostasis were ineffective due to the extent of lesions.
In the presence of any alarming GIT symptoms or unclear anaemia, any physician treating patient with a history of melanoma should exclude metastatic tumour. Endoscopy may be useful both for the diagnosis and local treatment of gastric metastases and should be routinely and cautiously conducted.
转移性皮肤黑色素瘤累及胃肠道（GIT）的病例中，有7%涉及胃部。本研究的目的是描述一例罕见的皮肤黑色素瘤转移至胃部的病例。
鉴于此类病例罕见，我们基于一名42岁女性的病史介绍我们的经验，该女性接受了躯干皮肤肿瘤的手术切除。
皮肤肿瘤的组织病理学检查确诊为黑色素瘤（克拉克四级，布雷斯洛5毫米），伴有溃疡，每10个高倍视野有40个核分裂象。PET-CT显示多器官转移。患者因严重的症状性贫血入院。需要输注红细胞和新鲜冰冻血浆。胃镜检查发现多处胃和十二指肠溃疡，组织病理学证实为转移性黑色素瘤。由于病变范围，内镜止血尝试无效。
在出现任何令人担忧的胃肠道症状或不明原因的贫血时，任何治疗有黑色素瘤病史患者的医生都应排除转移性肿瘤。内镜检查对于胃转移瘤的诊断和局部治疗可能有用，应常规且谨慎地进行。
