Primary Malignant Melanoma of Liver–A Report of 2 Cases

Abstract

Background: Malignant melanoma is extremely aggressive cancer arising from melanocytes. 90% of all melanomas are of cutaneous origin, although liver is a frequent site of metastasis from melanoma. Primary hepatic melanoma (PHM) is rare. Case Report: In this case report, we present 2 patients of PHM, who came with jaundice, ascites, abdominal pain, for a short duration (1–2 months) and progressively worsened in a short span and finally succumbed. CT scans of both patients revealed diffusely distributed nodules of varying sizes in both the lobes of liver with no evidence of portal hypertension. Liver biopsy showed tumour cells with poor differentiation, which were in nests with prominent melanin deposits. The pigmentation distributed sinusoidally, which was heavy enough to obscure cell morphology. Pigment could be bleached with potassium permanganate. Immunohistochemical stain showed, tumour cells were positive for HMB-45, s100, melanin A. Comprehensive dermatologic, ophtholmological examination revealed no evidence of cutaneous or ocular primary lesion. Other sites like brain, respiratory tract, lung, GIT, were not involved. Our case report showed that, primary malignant melanoma of liver has a histological diversity and immunohistochemical staining may aid in differential diagnosis from other hepatic neoplasms. Both of the above patients died in a short duration after diagnosis, which confirms PHM are extremely aggressive tumours associated with short life span (months). Conclusion: The rare occurrence and aggressive nature of PHM eludes the development of optimal treatment regimen and study of natural history of tumor. The usefulness of chemotherapy, radiation, and immunotherapy in treatment of PHM has potential for further research. The authors have none to declare.