Abstract
Malignant melanoma is an unpredictable disease, known to metastasize early even in thin melanomas. Historically the presence of intraabdominal metastasis meant poor prognosis with a 5-year survival of less than 20%. That has significantly changed with effective systemic therapy (EST), with most recent studies reporting 5-year survival of up to 50%. Metastasecectomy for resistant disease has been considered in Stage IV disease, however there is very little literature on the combination of EST and metastasectomy. This report describes a case of Stage IV malignant melanoma patient who developed resistant disease within her gallbladder fundic wall. She underwent open cholecystectomy, with complete metabolic response at 1-year follow up PET.
Highlights
Malignant melanoma is an unpredictable disease, known to metastasize early even in thin melanomas
Metastasecectomy for resistant disease has been considered in Stage IV disease, there is very little literature on the combination of effective systemic therapy (EST) and metastasectomy
A 78-year-old patient with metastatic melanoma from an unknown primary was referred by her oncologist to a General Surgeon for assessment of rapidly growing FDG avid gallbladder lesion seen on PET scan
Summary
PET images A) Initial PET with diffuse gallbladder uptake B) Second PET with localized uptake to gallbladder C) Follow-up PET showing complete metabolic response at 1-year post cholecystectomy. Decision was made to undergo operative assessment with diagnostic laparoscopy followed by open cholecystectomy provided there was no gross intraperitoneal metastatic spread. Laparoscopy confirmed no macroscopic peritoneal disease, with a fairly normal looking gallbladder on inspection. An open cholecystectomy was done via right subcostal incision, macroscopic inspection of the specimen showed a 3cm black sessile mass protruding from the gallbladder fundus. The operation was uneventful, with the patient discharged from hospital day 3.
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
