Lee Jeong Seok, Kim Su Jin, Kang Dae Hwan, Kim Hyung Wook, Choi Cheol Woong, Park Su Bum, Yeo Chang Woo, Kim Hyeong Jin
Division of Gastroenterology, Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea.
Korean J Gastroenterol. 2017 Aug 25;70(2):103-106. doi: 10.4166/kjg.2017.70.2.103.
Malignant melanoma is one of the most common malignant diseases of the gastrointestinal tract. It has been reported that the malignant melanoma metastasizes not only to the small intestine due to the abundant blood supply, but also to the stomach, colon, and esophagus. Gastrointestinal metastasis is usually suspected depending on the clinical symptoms, as well as based on radiological or endoscopic findings. Imunohistochemical stains, such as Melan-A/Melanoma antigen recognized by T cell-1 or human melanoma black-45, are useful for confirming the diagnosis of malignant melanoma. A 44-year-old male received an operation due to a malignant melanoma at the left thumb two years ago. On the national health screening endoscopy, a submucosal tumor with hyperemic change on the top was found. The final diagnosis was a metastatic malignant melanoma in the stomach, pancreas, and pelvic bone. We recommend that endoscopists should consider the potential malignancy of subepithelial tumor with mucosa change, despite the tumor size being less than 1 cm.
恶性黑色素瘤是胃肠道最常见的恶性疾病之一。据报道,恶性黑色素瘤不仅会因血液供应丰富而转移至小肠,还会转移至胃、结肠和食管。胃肠道转移通常根据临床症状以及影像学或内镜检查结果来怀疑。免疫组织化学染色,如Melan-A/T细胞识别的黑色素瘤抗原-1或人黑色素瘤黑色-45,有助于确诊恶性黑色素瘤。一名44岁男性两年前因左手拇指恶性黑色素瘤接受了手术。在国家健康筛查内镜检查中,发现一个顶部有充血改变的黏膜下肿瘤。最终诊断为胃、胰腺和骨盆骨转移性恶性黑色素瘤。我们建议内镜医师应考虑黏膜有改变的上皮下肿瘤的潜在恶性,尽管肿瘤大小小于1厘米。