Clinical Endoscopy

Acute Liver Failure Secondary to Hepatic Infiltration of Malignant Melanoma: Yujin Lee, Jaekwang Lee, Hyunsoo Kim, Changkeun Park, Jaekwon Jung, Daejin Kim, Yun Jin Chung, Hanjun Ryu; Clin Endosc 2022;55(2):287-291. Published online April 1, 2021; DOI: https://doi.org/10.5946/ce.2020.272

Acute liver failure due to malignant melanoma is uncommon. We presents a case of acute liver failure secondary to hepatic infiltration of a malignant melanoma. An 86-year-old man was admitted with elevated liver enzymes and an increased lactate dehydrogenase level. His condition progressed to acute liver failure, but the etiology of liver failure was unclear. Esophagogastroduodenoscopy was performed to evaluate dyspepsia, which showed signs indicative of malignant melanoma. Based on the endoscopy findings and elevated liver enzyme levels, liver biopsy was performed to confirm the presence of malignant melanoma. Hepatic infiltration of malignant melanoma was observed histologically. However, massive and diffuse liver metastasis is very rare and difficult to identify on imaging studies. If the etiology of liver failure is unclear, diffuse metastatic melanoma infiltration should be considered as differential diagnosis. Early liver biopsy can help to clarify the diagnosis.

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HEPATOPATHY SECONDARY TO INFILTRATION BY MALIGNANT MELANOMA: DIAGNOSTIC VALUE OF LIVER BIOPSY
Alejandro García Martínez, Álvaro Morales Prado, Jorge Martínez-Echevarría Gil-Delgado, Daniel Mateos Millán
Revista Española de Enfermedades Digestivas.2024;[Epub] CrossRef
Tumor lysis syndrome with hepatic failure- A rare presentation of undiagnosed metastatic melanoma
Nicholas Cochran-Caggiano, Brandon Zaffuto, Ryan Dean
JEM Reports.2023; 2(1): 100009. CrossRef
Acute liver failure secondary to malignant infiltration: A single center experience
Rocío González Grande, Ana Bravo Aranda, Inmaculada Santaella Leiva, Susana López Ortega, Miguel Jiménez Pérez
Seminars in Oncology.2023; 50(3-5): 71. CrossRef

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A Case of Whole Body Metastatic Malignant Melanoma: Kook Hyun Kim, M.D.; Korean J Gastrointest Endosc 2011;42(6):388-391. Published online June 6, 2011

Abstract PDF: Malignant melanomas have the potential to metastasize to any site in the body. They commonly invade the gastrointestinal tract. The small bowel is most commonly involved, followed by the stomach, large bowel, and esophagus. The vast majority of gastrointestinal melanomas are metastatic from a cutaneous lesion. An abdominal CT scan revealed multiple and variable sized low density lesions throughout the whole liver. Endoscopy revealed multiple black pigmentations at the distal esophagus, stomach, duodenum and rectum. The brain CT showed multiple hemorrhagic metastases in the brain. This 72-year-old man had malignant melanoma in his right thumb one year ago. It had metastasized to the liver, lung, gastrointestinal tract and brain. Here we report this case of whole body metastatic malignant melanoma and review the literature.

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A Case of Primary Malignant Melanoma of the Esophagus: Sang Hee Kim, M.D., Jae Kwang Kim, M.D., Jin Il Kim, M.D., Yong Jai Park, M.D., Seong Yong Woo, M.D., Seung Chul Yu, M.D., Hyeon Seong Kim, M.D. and Chang Young Yoo, M.D.*; Korean J Gastrointest Endosc 2009;38(3):133-136. Published online March 30, 2009

Abstract PDF: Primary malignant melanoma of the esophagus is a rare, but aggressive tumor with a fatal prognosis. Hematogenous and lymphatic metastasis are common. The tumor has multiple black and pigmented lesions. Resection of the tumor with an anastomotic procedure is the treatment of choice. Despite this operation, the prognosis is quite poor with the mean life expectancy being less than 1 year. We describe here a case of a 54-year-old man with esophageal malignant melanoma, and we also include a review of the relevant literature. (Korean J Gastrointest Endosc 2009;38:133-136)

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A Case of Primary Melanoma of the Anus that Spread to the Submucosa of the Rectum: Sung Whan Cho, M.D., Won Il Park, M.D., Hyung Yook Kim, M.D., Kwang Jin Kim, M.D. and Ung Suk Yang, M.D.; Korean J Gastrointest Endosc 2008;37(4):299-302. Published online October 30, 2008

Abstract PDF: Primary malignant melanoma of the anorectum is rare, representing about 1% of all colorectal carcinoma and less than 1% of all melanomas. The most common symptom of malignant melanoma of the anorectum is anal bleeding and this is often misdiagnosed as hemorrhoids. A 72-year-old female patient was admitted due to intermittent anal bleeding for 6 months. Colonoscopic examination showed a large exophytic mass with an irregularly ulcerated and greenish-brown pigmentation on the anus and the examination also simultaneously showed a submucosal tumor-like lesion in the rectum that was located 5 cm from the anal verge. Light microscopy of the tumor revealed malignant melanocytes and the tumor cells reacted positively for immunohistochemical staining with S-100 protein and HMB-45. Distant metastasis to the brain was detected on brain MRI. (Korean J Gastrointest Endosc 2008;37:299-302)

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A Case of Primary Malignant Melanoma of the Esophagus Treated by Esophagectomy: Jin Sun Park, M.D., Sang Jo Choi, M.D., Choong Keun Cha, M.D., Sung Jae Shin, M.D., Ki Myung Lee, M.D., Ki-Baik Hahm, M.D., Ph.D., Jin Hong Kim, M.D., ungsoo Lee, M.D.* and Jae Ho Han, M.D.^†; Korean J Gastrointest Endosc 2006;33(4):220-225. Published online October 30, 2006

Abstract PDF: A primary malignant melanoma of the esophagus is a very rare disease representing approximately 0.1∼.02% of all esophageal neoplasms and 0.5% of all mucosal melanomas. Despite a surgical resection, a primary malignant melanoma of the esophagus has a poor prognosis, mainly due to the fast development of hematogenous and lymphatic metastases. However, a resection of the tumor appears to be the treatment of choice. Local excision does not prolong the survival of patients. After a radical excision, the mean survival time is 7∼12 months and the estimated 5 year survival is 4.2%. However, after a local excision, the average survival time is 9 months and there is no report of a patient who survived more than 1year. We encountered a 55-year-old woman with a primary malignant melanoma of the esophagus, who underwent a radical esophageal resection with a lymph node dissection. We report this case with a review of the relevant literature. (Korean J Gastrointest Endosc 2006;33:220⁣225)

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Two Cases of Endoscopically Diagnosed Gastric Metastatic Malignant Melanoma of: Jae Seong Ryu, M.D.^†, Hyae Ju Oh, M.D.^†, Jin Wuk Hur, M.D., Jee Yeon Kim, M.D., Jee; Korean J Gastrointest Endosc 2004;28(2):71-75. Published online March 1, 2004

Abstract PDF: Although malignant melanoma involving the stomach is commonly mentioned in association with autopsies, endoscopic experience in this gastric malignancy is still limited, and few cases have been illustrated in the literature. This clinical condition is even rarer in Asians who are much less vulnerable to malignant melanoma than Caucasians. We experienced two cases of gastric metastases of malignant melanoma which presented as indigestion and epigastric pain. In the first case, a 75-year-old man visited because of indigestion persisting for 2 months. He had a history of multiple gastric ulcer and was treated at a local medical center, but symptoms did not improved. Endoscopic finding revealed multiple and elevated lesions with central black pigmented bases. In the second case, a 47-year-old man visited because of epigastric soreness and intermittent pain for 1 month. Metastatic melanoma in the stomach was noticed by endoscopic examination. Both patients had multiple metastatic lesions in the liver, thyroid, and brain. These two cases were diagnosed as having metastatic malignant melanoma in the stomach of unknown origin. Therefore, we report these cases with a brief review of the related literature. (Korean J Gastrointest Endosc 2004;28:71⁣75)

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구연 / 포스터 : 직장에 원발한 악성 흑생종 , 간전이: Korean J Gastrointest Endosc 2001;22(5):367-367. Published online November 30, 2000

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증례 : 위장관 내 전이성 악성 흑색종 ( A Case of Metastatic Malignant Melanoma in Stomach ): Korean J Gastrointest Endosc 2000;20(6):472-476. Published online November 30, 1999

Abstract PDF: Malignant melanomas are common metastatic lesions in the gastrointestinal tract. There are some descriptions for endoscopic findings but few reports on the endoscopic ultrasonographic findings of metastatic malignant melanomas in the stomach. A 67-year-old woman was admitted due to indigestion persisting for 1 month. She had a 3×4 cm sized black pigmented skin lesion on her left foot. An abdominal ultrasonography and CT scan revealed multiple variable sized round lesions in the liver, suggesting metastatic lesions. An endoscopy revealed multiple, elevated lesions with central ulcerations and a star shaped black pigmentation around the ulcer mound on the antrum of the stomach, as well as huge ulcers with black pigmented bases on the upper body. An endoscopic ultrasonography determined that the depths of the elevated lesions on the antrum were 1imited to the mucosal layer and that huge ulcers on the upper body were invading the serosa simultaneously. The skin lesion was diagnosed as a malignant melanoma and the stomach lesion were also confirmed to be metastatic malignant melanomas. The case of malignant melanomas that metastased to the stomach and had unusual endoscopic ultrasonographic findings is herein reported. (Korean J Gastrointest Endose 2000;20:472 476)

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증례 : 식도 위장관 ; 식도에 발생한 원발성 악성 흑색종 1예 ( Case Reports : Esophagus , Stomach & Intestine ; A Case of Primary Malignant Melanoma of the Esophagus ): Korean J Gastrointest Endosc 1997;17(2):163-166. Published online November 30, 1996

Abstract PDF: Primary malignant melanoma of tbe esophagus is extremely rare and its incidence is below 0.1%. The tumor is polypoid and tend to be large, which is covered with false membrane, friable, hemorrhagic, and necrotic. Hematogenous and lymphogenic metastasis are common. Resection of the tumor with an anastomotic procedure seems to be the treatment of choice, and postoperative irradiation may be useful. But, despite these measures, prognosis is poor, with a 5-year survival of 4.2%. We report a case of 58-year-old man with primary malig- nant melanoma of the epophagus, and review of the literature in presented related studies. (Korean J Gastrointest Endosc 17: 163-166, 1997)

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증례 : 식도 위장관 ; 소장에 다발성 장중첩증을 유발한 전이성 악성 피부 흑색종 1예 ( Case Reports : Esophagus , Stomach & Intestine ; A Case of the Multiple Intussusceptions of Small Bowel by Metastatic Malignant Melanoma ): Korean J Gastrointest Endosc 1996;16(6):1008-1015. Published online November 30, 1995

Abstract PDF: We present herein the case of 31-year-old man with disseminated malignant melanoma in whom a multiple metastasis into jejunum causing multiple intussusceptian. At laparotomy, multiple variable sized metastatic melanoma were noted on proximal and distal jejunum. To our knowledge, there was no report about multiple intussusceptions by malignant melanoma in Korea. (Korean J Gastrointeat Endosc 16: 1008-1013, 1996)

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직장으로 전이된 악성 흑색종 1예 ( A Case of Metastatic Melanoma of the Rectum ): Korean J Gastrointest Endosc 1993;13(2):411-413. Published online November 30, 1992

Abstract PDF: A 42-year-old woman preseated with intermittent rectal bleeding of a week's duration. A large polypoid mass with pigmented, ulcerated, nodular surface was seen in the rectum at 3cm from the anal verge during flexible sigmoidoscopy. A histologic diagnosis of metastatic melanoma wae made on light microscopic examination of biopsies obtained at sigmoidoscopy. The presence of metastatic melanoma at sites other than the rectum was found at the skin, pleura and lung. We report a case of metastatic malignant melanoma of the rectum with the review of the literature.

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내시경으로 진단된 위의 전이성 맥락막 악성흑색종 1예 ( A Case of Gastric Metastasis of Malignant Melanoma Diagnosed by Gastroscopy ): Korean J Gastrointest Endosc 1993;13(1):65-67. Published online November 30, 1992

Abstract PDF: Gastric metastasis occurs in about 0.7% to 1.7%, of patients dying of solid tumors of extragastrointestinal origin. Metastatic disease involving the stomach is an unusual and difficult clinical problem and presenting symptoms include nonspecific epigastric pain and melena. In most cases of gastric metastasis, the histologic finding of the gastroscopic biopsy suggests the correct diagnosis. There are only a few reports of gastric metastasis from malignant melanoma. We report a case of malignat melanoma of gastric metastasis, which was diagnosed by gastroscopy.

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위로 전이된 악성 흑색종 1예 ( A Case of Metastatic Melanoma of the Stomach ): Korean J Gastrointest Endosc 1991;11(2):299-302. Published online November 30, 1990

Abstract PDF: The potential of malignant melanoma to metastasize to all parts of the body is well known. Metastatic melanoma of the stomach may present with vague gastrointestinal symptoms, abdominai pain, or gastrointestinal bleeding. When gastrointestinal symptoms occur in a patient with known melanoma, gastric metastases should be considered. Melanoma metastatic to the stomach develops multiple small ulcerating masses. These sharply delineated submucosal lesions have been described as having a "bull's eye" or "target" configuration. Barium X-ray study, endoscopy, cytology study, and biopsy may yield the diagnosis. The prognosis is poor. We report a case of metastatic melanoma of the stomach with the review of the literature.

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