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Diagnosis of primary biliary melanoma with distinct imaging features: a case report and literature review

Authors :
Xinhong Wang
Xiaofei Deng
Zheng Shu
Juan Wu
Source :
Journal of International Medical Research, Vol 51 (2023)
Publication Year :
2023
Publisher :
SAGE Publishing, 2023.

Abstract

Primary biliary melanoma arises from proliferating melanocytes in the mucosal surface of the bile duct and is extremely rare. Since the vast majority of biliary melanomas represent metastases of cutaneous origin, accurate preoperative diagnosis of melanoma and exclusion of other primary sources are vital in cases involving primary lesions. Although melanomas with pigmented cells have typical signal characteristics, obtaining a non-invasive pre-treatment diagnosis remains difficult, due to their low incidence. Here, the case of a 61-year-old male Asian patient who presented with upper quadrant abdominal pain, swelling and jaundice for 2 weeks, and who was diagnosed with primary biliary melanoma following extensive preoperative blood analyses, computed tomography (CT) and magnetic resonance imaging (MRI), is described. Post-resection immunohistochemistry confirmed the diagnosis and the patient received six chemotherapy cycles of temozolomide and cisplatin, however, progression of multiple liver metastases was observed at the 18-month follow-up CT. The patient continued with pembrolizumab and died 17 months later. The present case of primary biliary melanoma is the first reported diagnosis based on typical MRI features and the exhaustive exclusion of a separate primary origin.

Subjects

Subjects :
Medicine (General)
R5-920

Details

Language :
English
ISSN :
14732300 and 03000605
Volume :
51
Database :
Directory of Open Access Journals
Journal :
Journal of International Medical Research
Publication Type :
Academic Journal
Accession number :
edsdoj.8048e22669894c95858d6ce9172e6482
Document Type :
article
Full Text :
https://doi.org/10.1177/03000605231164005