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Multifocal gastric metastasis of malignant melanoma: An ominous endoscopic appearance

Gastric metastasis of malignant melanoma
      A 59-year-old man presented with complaints of nodular skin lesions for 10 months, associated with significant weight loss and recurrent episodes of melena for 3 months. Physical examination revealed multiple cutaneous nodular lesions (Fig. 1) which were firm to hard in consistency. Esophagogastroduodenoscopy revealed multiple variable sized black colored ulcero-nodular lesions in the fundus, body and antrum of stomach (arrows) (Fig. 2A). Biopsy from the lesion showed sheets of malignant cells with melanin deposits (arrows) (Fig. 2B) suggestive of malignant melanoma. CT scan of chest revealed bilateral lung metastasis. Patient was referred to oncology care in view of advanced stage. Melanoma has been reported to metastasize to the gastrointestinal tract and bears poor prognosis [
      • Liang KV1
      • Sanderson SO
      • Nowakowski GS
      • Arora AS
      Metastatic malignant melanoma of the gastrointestinal tract.
      ].
      Fig 1
      Fig. 1Multiple cutaneous lesions.
      Fig 2
      Fig. 2(A) Endoscopy showing multiple black colored ulcero-nodular lesions in the stomach (arrows), (B) Biopsy showing sheets of malignant cells with melanin deposits (arrows).
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      Reference

        • Liang KV1
        • Sanderson SO
        • Nowakowski GS
        • Arora AS
        Metastatic malignant melanoma of the gastrointestinal tract.
        Mayo Clin Proc. Apr 2006; 81: 511-516