Bharwad Aastha, Shah Hamna, Salyers William J
University of Kansas School of Medicine - Wichita, Department of Internal Medicine, Wichita, Kansas, USA.
Eur J Case Rep Intern Med. 2022 Nov 16;9(11):003640. doi: 10.12890/2022_003640. eCollection 2022.
Malignant melanoma with metastasis to the stomach is rare and seldom diagnosed before death. The most common gastrointestinal (GI) metastatic site is the small intestine, followed by the colon, rectum and stomach. We present the case of a 55-year-old woman with a history of melanoma who presented with melena and syncope, and was found to have metastatic gastric melanoma.
It is important to consider gastric metastasis in patients with a history of melanoma who present with non-specific abdominal symptoms such as abdominal pain, nausea, vomiting, melena/haematochezia, weight loss and anaemia.It is crucial to keep gastric melanoma metastasis as a differential diagnosis in a patient with melanoma due to its aggressive nature and poor prognosis if diagnosis is delayed.Appearances can vary greatly at endoscopy, and so immunohistochemistry is vital at histological work-up for the identification of gastric melanoma.
发生胃转移的恶性黑色素瘤很罕见,在死亡前很少被诊断出来。最常见的胃肠道转移部位是小肠,其次是结肠、直肠和胃。我们报告一例55岁有黑色素瘤病史的女性病例,该患者出现黑便和晕厥,被发现患有转移性胃黑色素瘤。
对于有黑色素瘤病史且出现腹痛、恶心、呕吐、黑便/便血、体重减轻和贫血等非特异性腹部症状的患者,考虑胃转移很重要。由于胃黑色素瘤转移具有侵袭性且诊断延迟预后较差,因此在黑色素瘤患者中将其作为鉴别诊断至关重要。内镜检查时外观差异可能很大,因此免疫组化在胃黑色素瘤组织学检查以进行识别时至关重要。