Gallbladder Metastasis From Conjunctival Melanoma

Abstract

Malignant conjunctival melanoma is a rare tumor. A 46-year-old woman with a history of locally recurrent left conjunctival melanoma was followed by 18F-FDG PET/CT. Four years after the local recurrence treated by orbital exenteration, the follow-up PET/CT scan showed an incidental intense FDG uptake mass infiltrating the gallbladder associated with a low uptake of an infracentimetric pulmonary nodule. The patient was completely asymptomatic with no sign of local recurrence. Laparoscopic cholecystectomy was performed, and histopathologic findings were consistent with gallbladder metastasis of melanoma. After almost 2 years of immunotherapy, the patient is still in complete response.

Role of minimally invasive surgery in the treatment of gallbladder metastatic melanoma. A review of the literature and a case report

“…MMGs have been discovered in post‐mortem examinations in 15% of melanoma patients 45,46 . However, there are only 58 reported cases of patients, and the silent nature of the disease may contribute to this phenomenon 2,45–47 …”

“…When symptomatology is present, the clinical features are variable, mimicking acute cholecystitis with sudden right upper quadrant abdominal pain. Secondary symptoms may include hemobilia, melena, nausea, and jaundice, mostly due to obstruction of the common bile duct 1,5,47,48 …”

“…45,46 However, there are only 58 reported cases of patients, and the silent nature of the disease may contribute to this phenomenon. 2,[45][46][47] From an epidemiological standpoint, based on available data, the male-to-female ratio was 3:1 (39 males vs. 19 females), and the median patient age was 54 ± 14.82 years.…”

“…Secondary symptoms may include hemobilia, melena, nausea, and jaundice, mostly due to obstruction of the common bile duct. 1,5,47,48 The predominant symptoms of symptomatic tumors are epigastric pain after eating and fever. Physical examination revealed severe tenderness in the right upper quadrant of the abdomen with a nonpalpable gallbladder.…”

PET-CT in Clinical Adult Oncology—VI. Primary Cutaneous Cancer, Sarcomas and Neuroendocrine Tumors

“…T-cell-directed therapy has met with some success [ 36 ]. The value of FDG PET-CT in the management of conjunctival melanoma is not established, but several case reports suggest that metastatic lesions are hypermetabolic [ 39 , 40 , 41 ].…”