RARE METASTASES OF MALIGNANT MELANOMA

Marija Trenkić-Božinović,Marin Bašić,Nataša Đinđić,Vuka Katić,Milan Trenkić,Aleksandar Nagorni

doi:10.5633/amm.2014.0310

Abstract

Melanomas are malignant neoplasms that originate from melanocytes. The most common are on the skin and mucous membranes. Choroidal melanomas are quite different from cutaneous melanomas with regard to presentation, metastases, and treatment. We report two cases of metastatic gastric malignant melanoma of the eye and skin, with reference to the literature. The first patient was a woman aged 23 years, who underwent gastrectomy 22 months after enucleation of the eye due to malignant choroid melanoma. The second patient was a man, 72 years old, who underwent surgery 28 months before because of malignant melanoma of the skin of the forehead. Paraffin sections, 4 μm thick were stained using a classic method, as well as immunohistochemical DAKO APAAP method, using a specific S 100 antibody and Melan A antibodies. The stomach is considered a rare place for the development of metastases. Metastases in the stomach are often limited to the submucosal as well as the serousmuscular layer, as noted in one of our patients. Metastatic melanoma of the gastrointestinal tract should be suspected in any patient with a history of malignant melanoma and new gastrointestinal symptoms. Because of the similarity between certain common histopathological types of malignant melanoma, primarily achromatic, and types of primary cancers of the stomach, the following immunohistochemical studies are needed: Melan A and S 100 protein ( markers of malignant melanoma ), as well as mucins: MUC5AC, MUC2 and CDX2 ( markers of different types of primary gastric carcinoma). Acta Medica Medianae 2014;53(3):58-62.

Highlights

Melanomas are malignant neoplasms that originate from melanocytes
Metastatic malignant melanoma is rare in the gastrointestinal tract but most commonly affects the small intestine
We report two malignant melanomas of the eye and skin, with extremely rare metastases in the stomach

Summary

Introduction

Melanomas are malignant neoplasms that originate from melanocytes. The most common are on the skin and mucous membranes. Melanomas of the gastrointestinal tract may be primary or secondary i.e. metastases. Primary gastrointestinal melanoma is a rare, and even rarer in the stomach [6]. Metastatic malignant melanoma is rare in the gastrointestinal tract but most commonly affects the small intestine. Metastases in the gastrointestinal tract may be present at the time of establishing the primary diagnosis or years later, as the first sign of recurrence [8,9]. Malignant melanoma of the uveal tissue is the most common malignant tumor of the eye in adults. Melanomas of the conjunctiva have many similarities with the skin melanomas In both cases, the regional lymph nodes are the most common sites of metastases which may be isolated and www.medfak.ni.ac.rs/amm. Gastric metastases are more common in skin melanoma [15,16]

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Conclusion