Сlinical case of visceral metastasis of cutaneous melanoma

Abstract

Cutaneous melanoma is the most common tumor that metastasizes to the gastrointestinal tract, however, the diagnosis of visceral metastases remains difficult due to its low symptoms. Lifetime verification of melanoma metastases in the digestive tract is only 1–4%. Additional difficulties in verifying visceral melanoma metastases arise due to spontaneous regression of the primary tumor. The presented rare clinical case illustrates a variant of the course of disseminated melanoma of the skin with metastatic lesions of the gastrointestinal tract, while the dissemination was preceded by spontaneous regression of melanoma of the skin. Despite the lifetime endoscopic verification of multiple visceral metastases of cutaneous myeloma, the patient’s prognosis is unfavorable. The fact of spontaneous regression of cutaneous melanoma influenced the late diagnosis of melanoma dissemination, also due to the rarity of melanoma metastasis in the mucosa of the upper digestive tract, endoscopists are not sufficiently aware of endoscopic variants of melanoma metastases. It should be noted that endoscopic diagnostic methods must necessarily be included in the examination plan of a patient with melanoma, and when dynamically monitoring patients with melanoma after treatment, it is necessary to pay attention to non-specific signs of gastrointestinal tract damage (abdominal pain, anemia). In addition, in a patient with a history of melanoma, with endoscopic detection of an unpigmented neoplasm, it should be differentiated with a possible metastatic lesion, histological and immunohistochemical examination of the biopsy should be performed.