McDermott V G, Low V H, Keogan M T, Lawrence J A, Paulson E K
Department of Diagnostic Radiology, Duke University Medical Center, Durham, NC 27705, USA.
AJR Am J Roentgenol. 1996 Apr;166(4):809-13. doi: 10.2214/ajr.166.4.8610555.
Malignant melanoma, a common malignancy whose prevalence is increasing, represents 1-3% of cancers in the United States [1]. At autopsy, metastatic deposits to the gut are frequently found, but less than 9% of melanoma patients are diagnosed with gastrointestinal metastases while living [2]. Modern management includes aggressive surgical therapy to prolong survival and to palliate the disease [3]. Therefore, imaging of metastatic melanoma is clinically important to detect extent and determine whether the patient would benefit by surgery. Gastrointestinal metastases may manifest as mucosal or submucosal masses, serosal implants, or carcinomatosis [4]. They arise more commonly in the mesentery or distal small bowel than the proximal gastrointestinal tract or colon. The purpose of this essay is to illustrate the appearance of melanoma metastatic to the gastrointestinal tract on luminal contrast studies and on CT and to emphasize the importance of early investigation of gastrointestinal symptoms in a patient with a history of malignant melanoma.
恶性黑色素瘤是一种常见且发病率不断上升的恶性肿瘤，在美国占癌症的1%至3%[1]。尸检时经常发现肠道有转移灶，但不到9%的黑色素瘤患者在生前被诊断为胃肠道转移[2]。现代治疗方法包括积极的手术治疗，以延长生存期并缓解病情[3]。因此，转移性黑色素瘤的影像学检查对于检测病变范围以及确定患者是否能从手术中获益具有重要临床意义。胃肠道转移可能表现为黏膜或黏膜下肿块、浆膜种植或癌性腹膜炎[4]。它们更常见于肠系膜或远端小肠，而非近端胃肠道或结肠。本文旨在阐述腔内对比研究及CT上胃肠道转移性黑色素瘤的表现，并强调有恶性黑色素瘤病史的患者早期排查胃肠道症状的重要性。
