Gastric Metastasis of Malignant Melanoma

Abstract

Melanoma is the most aggressive and most fatal form of skin cancer. In the presence of metastasis the median survival is only six to nine months. Melanoma metastasis to the gastrointestinal tract is a common finding at the time of autopsy but is not often seen prior to death. This case report is of a 55-year-old man with known cutaneous melanoma of the left scapular region with metastasis to the left axillary, supraclavicular and infraclavicular lymph nodes, infraspinatus muscle and multiple bones. The patient presented with hematemesis in the setting of a supratherapeutic INR. At the time of endoscopy, he was found to have numerous pigmented macules in the stomach. Pathologic examination revealed collections of atypical pigmented cells. HMB45 and Melan A immunohistochemical stains identified melanoma cells. Following discharge from the hospital, the patient decided to pursue Hospice care during an appointment with his oncologist.Figure 1Figure 2Figure 3