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Pancreatic Resection for Metastatic Melanoma. Case Report and Review of the Literature

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Abstract

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.

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Acknowledgments

We thank very much Miss Tania Lazzarin for help in the preparation of the manuscript.

Conflict of interest

The authors declare that they have no conflicts of interest.

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Authors and Affiliations

  1. Department of Medical and Surgical Sciences, 4th Surgical Clinic, University of Padua, Padova, Italy

    Cosimo Sperti, Maria Laura Polizzi, Valentina Beltrame, Margherita Moro & Sergio Pedrazzoli

  2. Clinica Chirurgica IV, University of Padua, Via Giustiniani 2, 35128, Padova, Italy

    Cosimo Sperti

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  1. Cosimo Sperti
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  2. Maria Laura Polizzi
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  3. Valentina Beltrame
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Correspondence to Cosimo Sperti.

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Sperti, C., Polizzi, M.L., Beltrame, V. et al. Pancreatic Resection for Metastatic Melanoma. Case Report and Review of the Literature. J Gastrointest Canc 42, 302–306 (2011). https://doi.org/10.1007/s12029-010-9169-5

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