皮肤黑色素瘤可以转移到几乎任何器官,包括在途转移,淋巴结,肝脏,肺,大脑,和骨头。传播到胃肠道不太常见,通常涉及小肠,结肠,和胃。胆囊受累更罕见,只有少数病例将其描述为诊断后唯一的转移部位。通常在分期或监视成像中检测到胆囊的黑色素瘤转移,因为患者通常很少或没有症状。在可切除的IV期黑色素瘤患者中,完整的手术切除似乎可以改善预后。然而,由于罕见的孤立的黑色素瘤胆囊转移,目前尚无关于最佳手术入路(内镜或开腹胆囊切除术)的指南.这里,我们报道了一例46岁女性患者在腹腔镜胆囊切除术后发现的孤立性胆囊黑色素瘤转移病例,该患者无已知的癌症史,有急性胆囊炎症状.手术后六周,患者出现套管针部位复发.此病例强调了计划和开放手术治疗可切除的黑色素瘤转移的重要性,而不是腹腔镜手术。
Cutaneous melanoma can metastasize to almost any organ, including in-transit metastases, lymph nodes, liver, lungs, brain, and bones. Spread to the gastrointestinal tract is less common and generally concerns the small bowel, colon, and stomach. Gallbladder involvement is rarer, and only few cases describe it as the sole site of metastasis upon diagnosis. Melanoma metastases to the gallbladder are usually detected on staging or surveillance imaging, as patients usually show few or no symptoms. In resectable stage IV melanoma patients, complete surgical resection appears to improve the prognosis. However, due to the rarity of isolated gallbladder metastasis of melanoma, there are no guidelines regarding the optimal surgical approach (endoscopic or open cholecystectomy). Here, we report the case of isolated gallbladder melanoma metastasis found after laparoscopic cholecystectomy performed in a 46-year-old female patient with no known history of cancer presenting with acute cholecystitis symptoms. Six weeks after surgery, the patient developed trocar site recurrence. This case highlights the importance of a planned and open surgery for resectable melanoma metastases rather than a laparoscopic approach.