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Pancreatic resection for metastatic melanoma. Case report and review of the literature.
MedLine Citation:
PMID:  20524082     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
INTRODUCTION: Pancreatic metastasis from several malignancies are increasingly encountered in clinical practice, and the usefulness of surgical resection has been suggested for certain neoplasms. Isolated pancreatic metastasis from malignant melanoma is a rare occurrence, and the role of surgery as an adjunct to systemic therapy for melanoma metastatic to a solitary or multiple sites is still debated.
CASE REPORT: We report a patient with melanoma of unknown primary site metastatic simultaneously to the lung and pancreas 3 years after axillary lymph node dissection. Distal pancreatectomy with splenectomy and video thoracoscopic assisted resection of pulmonary metastasis were performed. The postoperative course was uneventful, but 6 months after surgery, the patient experienced single pulmonary recurrence. During chemotherapy with different drugs, pulmonary lesion remained stable for 1 year, and no abdominal recurrence occurred. After then, the size of the lesion progressively increased and a second metastasis occurred in the lung. Five months later, brain metastases occurred, and the patients died 24 months after surgery. Sixteen pancreatic resections for metastatic malignant melanoma, reported with adequate clinical details, were also retrieved from the literature.
CONCLUSION: In spite of the very limited experience, it appears that surgical resection is only a palliative procedure, because long-term survival is a rare event. However, considering the lack of effective systemic therapy, surgery may be considered as a part of an aggressive multidisciplinary approach in selected cases with malignant melanoma metastatic to single or multiple visceral sites.
Authors:
Cosimo Sperti; Maria Laura Polizzi; Valentina Beltrame; Margherita Moro; Sergio Pedrazzoli
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of gastrointestinal cancer     Volume:  42     ISSN:  1941-6636     ISO Abbreviation:  J Gastrointest Cancer     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2011-11-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101479627     Medline TA:  J Gastrointest Cancer     Country:  United States    
Other Details:
Languages:  eng     Pagination:  302-6     Citation Subset:  IM    
Affiliation:
Department of Medical and Surgical Sciences, 4th Surgical Clinic, University of Padua, Padova, Italy, csperti@libero.it.
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