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恶性黑色素瘤转移至胆囊。一例罕见转移部位的病例报告。

Malignant melanoma metastasis in the gallbladder. A case report of an unusual metastatic site.

作者信息

Hess Gabriel Fridolin, Glatz Katharina, Rothschild Sacha I, Kollmar Otto, Soysal Savas Deniz, Boll Daniel T, Droeser Raoul André, Mechera Robert

机构信息

Clarunis University Center for Gastrointestinal and Liver Disease, St. Clara Hospital and University Hospital Basel, Spitalstrasse 21, CH-4056, Basel, Switzerland.

Institute of Pathology, University Hospital Basel, Schönbeinstrasse 40, CH-4056, Basel, Switzerland.

出版信息

Int J Surg Case Rep. 2020;75:372-375. doi: 10.1016/j.ijscr.2020.09.116. Epub 2020 Sep 19.

Abstract

INTRODUCTION

Malignant melanoma is a neoplasia with the ability to metastasize to all organs. Most frequently, metastases derives from a skin primary. A solitary metastasis in the gallbladder is rarely mentioned in current literature.

PRESENTATION OF CASE

We present the case of a 62-year-old female patient with the unusual metastatic spread of malignant melanoma into the gallbladder. The lesion was detected during routine follow up appointment six years after the initial surgical and radio-chemotherapeutic treatment of a malignant melanoma on the back. Following multidisciplinary team meeting, it was decided to perform a laparoscopic cholecystectomy to remove the gallbladder metastasis.

DISCUSSION

New occurrence of a melanoma metastasis in the gallbladder is extremely rare, especially in stable disease. The therapeutical concept must be discussed extensively in the present of this metastasized tumor.

CONCLUSION

In otherwise stable disease, palliative surgery for metastasis in the gallbladder is a possible option to prevent biliary complications. In a palliative setting always weigh up the risks and benefits while maintaining the quality of life.

摘要

引言

恶性黑色素瘤是一种能够转移至所有器官的肿瘤。最常见的情况是,转移灶源自皮肤原发肿瘤。目前文献中很少提及胆囊孤立转移瘤。

病例介绍

我们报告一例62岁女性患者,其恶性黑色素瘤出现了罕见的转移至胆囊的情况。该病变是在背部恶性黑色素瘤初次手术及放化疗治疗六年后的常规随访中发现的。经过多学科团队会诊,决定行腹腔镜胆囊切除术以切除胆囊转移瘤。

讨论

胆囊出现新的黑色素瘤转移极为罕见,尤其是在病情稳定的情况下。对于这种转移瘤,必须广泛讨论治疗方案。

结论

在其他方面病情稳定的情况下,对胆囊转移瘤进行姑息性手术是预防胆道并发症的一种可行选择。在姑息治疗中,始终要权衡风险和益处,同时维持生活质量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf85/7522582/5b27b7dcc7a5/gr1.jpg

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