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机器人辅助腹腔镜手术治疗酷似胃肠道间质瘤的腹部转移性黑色素瘤:一例报告并文献复习

Robot-assisted laparoscopic surgery for abdominal metastatic melanoma mimicking a gastrointestinal stromal tumor: A case report and review of the literature.

作者信息

Ye Zhou, Yang Zhe, Zheng Shusen, Wang Weilin

机构信息

Department of Hepatobiliary and Pancreatic Surgery, First Affiliated Hospital, Zhejiang University School of Medicine Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Zhejiang University, Hangzhou, Zhejiang Province, PR China.

出版信息

Medicine (Baltimore). 2018 Jun;97(26):e11207. doi: 10.1097/MD.0000000000011207.

Abstract

RATIONALE

Uveal melanoma is the most common primary intraocular malignancy, which could metastasize at an early stage of the disease and associated with poor prognoses. Liver, small bowel, stomach, and colon are the most common locations for metastatic visceral melanoma, however, solitary abdominal metastasis from uveal melanoma is extremely rare.

PATIENT CONCERNS

The current study reports the case of a 33-year-old man with history of treated choroidal melanoma of the left eye that developed metastasis to the abdomen, preoperative endoscopic ultrasonography and computed tomography strongly suggested as a gastrointestinal stromal tumor (GIST).

DIAGNOSES

The patient was diagnosed with abdominal metastatic melanoma according to his medical history and histopathological results.

INTERVENTIONS

The young adult underwent robot-assisted laparoscopic surgery.

OUTCOMES

The patient finally got the definite diagnosis with his medical history and histopathological results and he has been living disease free for nearly 3 years after the surgery.

LESSONS

Although rare, the possibility of abdominal metastatic melanoma presenting with the clinical picture of gastrointestinal stromal tumor must be always considered by the surgeon especially the patients with a history of primary malignant melanoma.

摘要

理论依据

葡萄膜黑色素瘤是最常见的原发性眼内恶性肿瘤,该病在疾病早期即可发生转移,且预后较差。肝脏、小肠、胃和结肠是转移性内脏黑色素瘤最常见的转移部位,然而,葡萄膜黑色素瘤的孤立性腹部转移极为罕见。

患者情况

本研究报告了一名33岁男性病例,该患者有左眼脉络膜黑色素瘤治疗史,现发生腹部转移,术前内镜超声和计算机断层扫描强烈提示为胃肠道间质瘤(GIST)。

诊断

根据患者病史和组织病理学结果,诊断为腹部转移性黑色素瘤。

干预措施

该青年患者接受了机器人辅助腹腔镜手术。

结果

患者最终根据病史和组织病理学结果得到明确诊断,术后近3年一直无病生存。

经验教训

外科医生,尤其是有原发性恶性黑色素瘤病史的患者,必须始终考虑到腹部转移性黑色素瘤表现为胃肠道间质瘤临床症状的可能性,尽管这种情况很罕见。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f306/6039597/2c3f94cd78ac/medi-97-e11207-g001.jpg

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