Isolated rectus abdominis metastasis from melanoma—An extremely rare case

Portilla, Alberto Gómez; Cruz, Anais; Juan, Nuria; Malo, Palmira; Heredia, Eduardo López de; Larrañaga, Maitane

doi:10.1016/j.ijscr.2016.07.017

Cited by 6 publications

(6 citation statements)

References 5 publications

(5 reference statements)

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“…Herring et al 18 reported on a series of 15 patients with skeletal muscle metastasis, of which only two of the primary tumors were melanoma. Gomez Portilla et al 19 reported an isolated rectus abdominis metastasis from melanoma. Calvert and Pigg 20 and Goforth 21 reported metastatic melanoma in skeletal muscle in postmortem reports on patients with disseminated melanoma.…”

Section: Discussionmentioning

confidence: 99%

Skeletal muscle and solitary bone metastases from malignant melanoma: multimodality imaging and oncological outcome

Gómez-León¹,

Pacheco-Barcía

Ballesteros

et al. 2018

Melanoma Research

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Malignant melanoma solitary metastases to bone or skeletal muscle occur in 0.8% of patients. The aim of this study was to evaluate features of skeleton and muscle metastases with multimodality imaging and review the oncological outcome. Thirteen patients with melanoma metastases from January 2006 to February 2016 were included. Histologic confirmation was obtained. Imaging studies included computed tomography (CT), MRI, and/or positron emission tomography/CT. Treatment received and BRAF status were recorded. Differences in BRAF status and overall survival (OS) were analyzed using the χ2-test. Associations between OS and metastases were analyzed using Cox proportional models. Nine (69%) patients showed osseous involvement. Lower extremity bones were affected in three (23%) patients: first toe, right calcaneal spurs, and knee. The spine was involved in three (23%) patients. In two (15%) patients, the pelvic bones were involved. In one (8%) patient, the temporal bone was affected. Nine (70%) patients had a history of malignant melanoma, with a median time to progression of 28 months. The median OS was 18 months: 24 months in patients with a history of melanoma and 3 months in patients with metastases at first diagnosis. The median follow-up duration was 28 months. BRAF mutant versus wild-type tumors showed significant differences in OS (P=0.03). The hazard ratio for death in the metastatic group at diagnosis was 6.83, 95% confidence interval: 1.060–144.072 (P=0.04). Solitary metastases from melanoma to the skeleton and muscle are rare. CT, MRI, and positron emission tomography/CT are useful for the evaluation of musculoskeletal findings. Image findings are not definitive for diagnosing a malignant solitary lesion; thus, a pathologic confirmation with a biopsy is recommended.

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Section: Discussionmentioning

confidence: 99%

Skeletal muscle and solitary bone metastases from malignant melanoma: multimodality imaging and oncological outcome

Gómez-León¹,

Pacheco-Barcía

Ballesteros

et al. 2018

Melanoma Research

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“…The rarity of our patient́s scenario, with a postoperative periprosthetic seroma, multiple omental nodes, and an hilar mediastinal soft hypermetabolic foci, could be an argument against the malignant nature of these findings. But, since our patient had been previously treated of an isolated metastasis to the rectus abdominis [9] , and the values detected on the FDG PET/CT were borderline, it was erroneously assumed that she was suffering an abdominal and mediastinal progression of the disease. The presence of these bicompartimental metastases contraindicated any aggressive surgical excision at that time, and accordingly, she was mistreated with new adjuvant chemotherapy again.…”

Section: Discussionmentioning

confidence: 95%

“…Although, melanoma is a tumor with a behavior that is not always predictable, there have been very few reports published of melanoma metastasizing to rectus abdominis muscle [7] , [8] , [9] , and fewer publications of melanoma metastasizing to the omentum, which is an extremely rare site for metastasis [10] , [11] , [12] . As the condition is so rare, there is no consensus on the best treatment and proper chemotherapy [13] .…”

Section: Introductionmentioning

confidence: 99%

Periprosthetic seroma with false-positive FDG PET-CT reactive nodes mistaken for metastases in a patient previously treated of metastasic melanoma. Potential source of diagnostic errors

Portilla

Onaindia

Larrañaga

et al. 2017

International Journal of Surgery Case Reports

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“…[3] However, melanoma skeletal muscle metastases (MSMM) are exceptional, and only a few cases of MSMM to rectus abdominis muscles have been previously reported, and our case maybe the first reported case in Asia region. [4]…”

Section: Introductionmentioning

confidence: 99%

Scalp melanoma with rectus abdominis metastasis

Hsu

Chen²,

Chu³

et al. 2019

Medicine

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Rationale: The main cause of death in melanoma patients is widespread metastases as it can metastasize to almost every organ. However, melanoma skeletal muscle metastases (MSMM) are exceptional, and only a few cases of MSMM to the rectus abdominis muscles have been previously described. And our case maybe the first reported case in Asia region. Patient concerns: A 45-year-old man with history of right scalp melanoma, pT3aN0M0, stage IIA status post wide excision with 2 cm safe margin and right neck lymph node dissection at 5 years before. He had an almost 5 years disease-free period but presented to our clinic due to intermittent abdominal sharp pain for 1 to 2 months, with a palpable soft tissue mass over his right abdomen. Metastatic melanoma to rectus abdominis muscles was highly suspected. Interventions: The patient subsequently underwent radical en-block extraperitoneal 15 cm segmental resection of the right rectus abdominis muscle including tumor mass. The resected tumor was a black-gray colored solid mass, and the final histologic study showed a metastasis of melanoma. Outcomes: Postoperative course of the patient was uneventful, and the right abdominal pain was improved. The patient was referred for further target therapy, but passed away half a year later due to multiple metastasis. Lessons: Scalp melanoma with isolated rectus muscle metastasis is extremely rare especially for a young aged patient who had an almost 5-year disease-free period. Surgery is a potentially curative therapy for patients with isolated metastatic melanoma. The goal is negative resection margins, in order to avoid local recurrences. Radical compartmental surgery should be considered for selected stage IV melanoma patients with sole rectus abdominis MSMM, whose disease could be amenable to complete resection, in preliminary procedure to prolong disease-free survival time. For oligometastatic disease, surgical resection is sometimes useful in carefully selected patients after systemic therapy; also, it could be performed as symptomatic treatment.

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Isolated rectus abdominis metastasis from melanoma—An extremely rare case

Cited by 6 publications

References 5 publications

Skeletal muscle and solitary bone metastases from malignant melanoma: multimodality imaging and oncological outcome

Skeletal muscle and solitary bone metastases from malignant melanoma: multimodality imaging and oncological outcome

Periprosthetic seroma with false-positive FDG PET-CT reactive nodes mistaken for metastases in a patient previously treated of metastasic melanoma. Potential source of diagnostic errors

Scalp melanoma with rectus abdominis metastasis

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