| Popis: |
Background: Primary gastric melanoma (PGM) is a rare malignancy. Unlike skin melanoma which carries a definitive correlation to sun exposure, the pathogenesis of gastric melanoma is not well defined. It appears in the older age with median of 70 years and has no known risk factors. The diagnosis may be challenging due to non-specific symptoms, and endoscopy with tissue biopsy along with detailed physical examination ruling out skin and ocular lesions, and PET-CT, are the tools for establishing diagnosis. The prognosis for PGM is poor mainly due to late diagnosis. No detailed staging algorithm nor treatment protocols for PGM exists. Methods: A case series of all patients with PGM that were evaluated and managed by our surgical oncology service between 2011 and 2016. Data regarding diagnosis, imaging, pathologic evaluation and treatment protocols were collected and analyzed. Results: During study acquisition period, 3 cases with the diagnoses of PGM were identified. One patient was treated with aggressive surgery upfront, one patient was treated with more conservative surgical approach with delay from diagnosis to surgery, and one patient was not eligible for surgery due to age, medical and general condition. In 5 years of follow-up only the patient that had aggressive surgery survived. Conclusion: PGM carry very bad prognosis. We believe that aggressive surgery should be considered as the main component of the therapy plan without delay, for better clinical outcome and survival. |
