Department of Pathology, Hokkaido Gastroenterology Hospital, Hokkaido, Japan.
Department of Surgical Pathology, Sapporo Medical University, School of Medicine, Hokkaido, Japan.
Pathol Int. 2020 Oct;70(10):786-792. doi: 10.1111/pin.12991. Epub 2020 Aug 16.
We describe an extremely rare case of simultaneous double melanoma of the stomach with no other obvious primary source. The patient has survived for more than 12 years post-complete gastrectomy. The patient was a woman in her seventies who was referred for anemia by another clinic. Esophagogastroscopy revealed an ulcerated gastric tumor that was diagnosed as a gastrointestinal stromal tumor (GIST) by endoscopic biopsy. She was admitted to our hospital for further examination and treatment. Gastroscopy at our institution revealed two submucosal tumors in the gastric wall. Since no metastatic lesions were detected after systemic exploration, multiple GIST of the stomach was diagnosed, and a total gastrectomy was performed. Malignant melanoma was diagnosed in both lesions by a histopathological study of the resected stomach. The patient's postoperative progress was good, and thorough examination of the skin did not result in the discovery of any systemic neoplastic lesions which could be regarded as the source for the primary tumor. No anticancer treatments were used. The patient has survived, with no recurrence for over ten years postsurgery. Strong evidence is presented in this case for the diagnosis and treatment of gastric malignant melanoma.
我们描述了一例极罕见的无其他明显原发病灶的胃同时性双发性黑色素瘤病例。患者在完全性胃切除术后已存活超过 12 年。该患者为 70 多岁女性，因贫血在另一家诊所就诊。食管胃十二指肠镜检查发现胃内一溃疡性肿瘤，经内镜活检诊断为胃肠道间质瘤（GIST）。她被收入我院进一步检查和治疗。我院的胃镜检查发现胃壁有两个黏膜下肿瘤。由于全身探查后未发现转移病灶，诊断为胃多发 GIST，并进行了全胃切除术。切除胃的组织病理学研究诊断两个病变均为恶性黑色素瘤。患者术后恢复良好，彻底检查皮肤后未发现任何全身肿瘤病变，可视为原发性肿瘤的来源。未使用任何抗癌治疗。患者术后已存活超过十年，无复发。该病例为胃恶性黑色素瘤的诊断和治疗提供了有力证据。
