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. 2003;5(3):174-9.
doi: 10.1080/13651820310015284.

Pancreatic resection for metastatic melanoma

M Nikfarjam  1 , P Evans, C Christophi
Affiliations

Pancreatic resection for metastatic melanoma

M Nikfarjam et al. HPB (Oxford). 2003.

Abstract

Background: The pancreas is an occasional site of metastases from melanoma. It may be the only location of metastatic disease, but more often the melanoma metastasis to other organs as well. Treatment options are somewhat limited, and the role of operative treatment is poorly defined.

Case outlines: Two patients presenting with abdominal pain were found to have pancreatic lesions. A 45-year-old woman had a pylorus-preserving pancreatoduodenectomy for a mass in the head of pancreas; concurrent liver nodules were treated by segmental liver resection. A 55-year-old man had a total pancreatectomy for multiple pancreatic tumours. Both patients gave a history of ocular melanoma, diagnosed >10 years previously. They had no evidence of malignancy elsewhere. Histology of resected specimens confirmed metastatic melanoma with features consistent with an ocular primary. All resection margins were clear of malignancy, and no lymph node metastases were detected. At 6 months follow-up there were no signs of tumour recurrence.

Discussion: Complete surgical resection offers potential cure in selected patients with metastatic melanoma involving the pancreas, when there is no evidence of widespread disease.

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Figures

Figure 1.
Figure 1.
(a) MRI scan showing a mass in the head of the pancreas (arrow). PET scan showing focal uptake in the region of the pancreatic head. (b) H&E section of the melanoma demonstrating mixed spindle and epithelioid cell types with minimal melanin production within fibrous connective tissue (×800). (c) Immunoperoxidase study showing strong immunoreactivity of cells with Melon A (×800).
Figure 2.
Figure 2.
(a) CT scan of the abdomen identifying an ill-defined mass in the pancreatic head (arrow). (b) PET scan demonstrating significant uptake in the region of the pancreatic head. (c) Resected pancreas and duodenum with multiple foci of highly pigmented melanoma (*) with the greatest number in the uncinate process. (d) H&E section of melanoma cells with a spindle cell appearance with melanin pigment production (×800).
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