Addepally Naga S, Klair Jagpal S, Lai Keith, Aduli Farshad, Girotra Mohit
Department of Internal Medicine, University of Arkansas for Medical Sciences, Little Rock, AR.
Division of Gastroenterology and Hepatology, University of Arkansas for Medical Sciences, Little Rock, AR.
ACG Case Rep J. 2016 Sep 14;3(4):e128. doi: 10.14309/crj.2016.101. eCollection 2016 Aug.
Malignant melanoma is one of the few malignancies that are well known for unusual behavior. Primary malignant melanoma usually originates from squamous epithelium of skin, mucous membranes, retina, and uvea. Although melanoma can metastasize to any part of the body, including biliary tract, primary malignant melanoma of bile ducts is an extremely rare entity. We present a 52-year-old man who presented with 5-month epigastric pain and 15-pound weight loss, with 1-week duration of jaundice, nausea/vomiting, pale stools, and dark urine, blood work suggested cholestatic jaundice. Imaging revealed a large perihilar/peripancreatic mass involving the portal vein and hepatic artery, and intrahepatic biliary dilation. Biliary brushings revealed neoplastic cells strongly suggestive of malignant melanoma.
恶性黑色素瘤是少数几种以异常行为而闻名的恶性肿瘤之一。原发性恶性黑色素瘤通常起源于皮肤、黏膜、视网膜和葡萄膜的鳞状上皮。尽管黑色素瘤可转移至身体的任何部位，包括胆道，但胆管原发性恶性黑色素瘤是一种极其罕见的疾病。我们报告一名52岁男性，他出现上腹部疼痛5个月，体重减轻15磅，伴有黄疸、恶心/呕吐、大便苍白和尿液深色1周，血液检查提示胆汁淤积性黄疸。影像学检查显示肝门周围/胰周有一个大肿块，累及门静脉和肝动脉，肝内胆管扩张。胆道刷检发现肿瘤细胞，强烈提示为恶性黑色素瘤。
