Thompson J F, Mathur M N, Coates A S
Sydney Melanoma Unit, Royal Prince Alfred Hospital, New South Wales, Australia.
Aust N Z J Surg. 1993 Jun;63(6):502-4. doi: 10.1111/j.1445-2197.1993.tb00438.x.
Although metastatic melanoma is renowned for its propensity to spread to a wide range of sites, symptomatic metastases within the biliary tree are very rare. A patient with a past history of melanoma who presented with obstructive jaundice and in whom computerized tomography (CT) scanning revealed a spherical filling defect 1 cm in diameter at the lower end of the common bile duct is reported. The obstructing lesion was thought likely to be a gallstone. However, on surgical exploration it was found to be a polypoid melanoma metastasis, freely mobile within the lumen of the lower duct but attached to its wall by a thin stalk. There was no evidence of metastatic melanoma elsewhere in the abdomen. The tumour was removed without difficulty, completely relieving the obstructive jaundice. The patient remains well 14 months later, with no evidence of recurrent visceral melanoma.
尽管转移性黑色素瘤以易于扩散至广泛部位而闻名，但胆道系统出现有症状的转移却极为罕见。本文报道了一名有黑色素瘤病史的患者，该患者出现梗阻性黄疸，计算机断层扫描（CT）显示胆总管下端有一个直径1厘米的球形充盈缺损。起初认为梗阻性病变可能是胆结石。然而，手术探查发现是一个息肉样黑色素瘤转移灶，在胆总管下端管腔内可自由移动，但通过细蒂附着于胆管壁。腹部其他部位未发现转移性黑色素瘤的证据。肿瘤顺利切除，梗阻性黄疸完全缓解。14个月后患者情况良好，无内脏黑色素瘤复发迹象。
