Malignant metastatic melanoma to the gallbladder: Report of a peculiar case

Abstract

Highlights Melanoma is one of the most aggressive and one of the fastest growing types of cancer. The gallbladder envolvement from a metastatic cutaneous malignant melanoma is a highly uncommon finding, usually associated with diffuse metastatic disease and observed during autopsy. We report a case of a 35-years old Caucasian woman with isolated metastasis of gallbladder form cutaneous primary malignant melanoma underwent to laparoscopic cholecystectomy. Malignant cutaneous melanoma is a skin cancer characterized by the highest mortality. Isolated metastasis of gallbladder are barely described and mostly present in a widespread metastatic disease. Surgical treatment is indicated considering the extension of the disease and the clinical status of the patient.

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

“…Regarding sex, 67.2% of the patients were male (39 patients), whereas 32.8% were female (19 patients). The ratio between men and women was 3:1, suggesting a male predominance in the reported MMG population 6–43 …”

Trocar Site Recurrence after Laparoscopic Cholecystectomy for Unsuspected Isolated Gallbladder Metastasis of Melanoma: A Case Report and Review of the Literature

“…Cutaneous melanoma has a high propensity to metastasize. Most frequent sites include lymph nodes, skin, lungs, brain, and liver, whereas spread to the GI tract occurs at a frequency of less than 5% [ 2 , 3 ]. In 15% of those cases only, the gallbladder is found to be a metastatic site [ 2 ].…”

“…The most likely metastatic pathway of melanoma to the gallbladder is hematologic spread [ 3 , 7 ], but another theory supports the migration of microscopic liver foci to the gallbladder through bile flow [ 3 , 13 , 14 ], which could explain the common synchronous dissemination to the small intestine [ 13 ]. When found, gallbladder metastasis is usually seen in the context of a widespread metastatic disease [ 5 , 6 ].…”

“…Even if malignant melanoma is one of the most common malignancies associated with metastatic disease of the gastrointestinal (GI) tract [ 1 ], GI involvement represents less than 5% of metastatic melanomas. The majority of the latter are found in the small intestine [ 2 , 3 ]. The gallbladder as the sole metastatic site is rarely described.…”

“…Fast recovery after a minimally invasive procedure (endoscopic approach) could allow the patient to rapidly initiate adjuvant immunotherapy [ 7 ]. However, laparoscopic techniques may be at risk of peritoneal or port-site metastases [ 2 , 3 , 11 ].…”