Case Report
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 26, 2020; 8(24): 6425-6431
Published online Dec 26, 2020. doi: 10.12998/wjcc.v8.i24.6425
Primary gastric melanoma in a young woman: A case report
Guo-Jie Long, Wen-Ting Ou, Lin Lin, Cai-Jin Zhou
Guo-Jie Long, Department of Gastrointestinal Surgery, Affiliated Hospital of Guangdong Medical University, Zhanjiang 524002, Guangdong Province, China
Wen-Ting Ou, Department of Oncology, Affiliated Hospital of Guangdong Medical University, Zhanjiang 524002, Guangdong Province, China
Lin Lin, Cai-Jin Zhou, Department of Gastrointestinal Surgery, Affiliated Hospital of Guangdong Medical University, , Zhanjiang 524002, Guangdong Province, China
Author contributions: Long GJ analyzed the relevant literature and wrote the manuscript; Lin L collected the patient's data; Zhou CJ led the entire treatment process, including the operation, and guided the writing of the manuscript; Ou WT performed the patient's chemotherapy.
Informed consent statement: Written informed consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Cai-Jin Zhou, Professor, Department of Gastrointestinal Surgery, Affiliated Hospital of Guangdong Medical University, No. 57 South Renmin Avenue, Xiashan District, Zhanjiang 524002, Guangdong Province, China. zhoucaipingren@163.com
Received: August 2, 2020
Peer-review started: August 2, 2020
First decision: September 30, 2020
Revised: October 10, 2020
Accepted: October 26, 2020
Article in press: October 26, 2020
Published online: December 26, 2020
Processing time: 139 Days and 13.2 Hours
Abstract
BACKGROUND

Most melanomas identified in the stomach are metastatic. The primary gastric melanoma (PGM) is extremely rare. As such, clinical reports of PGM are scarce in the literature, lending to the challenge of diagnosis and treatment.

CASE SUMMARY

A 31-year-old woman presented with a 1-mo history of dysphagia but no symptoms of abdominal pain, abdominal distension, nausea, vomiting, hematemesis, or melena. The patient reported an unintentional weight loss of 6 kg within that time. History-taking revealed no previous medical conditions or surgical events. Abdominal computed tomography at a local hospital had suggested gastric tumor. Endoscopic examination in our hospital found a large, irregular, black mass. Subsequent laparoscopic exploration found the tumor on the side of the stomach fundus penetrating through the serosa, and enlarged lymph nodes (groups 1, 3, 7, and 9) fused into a mass, surrounding the peripheral artery and inseparable. Postoperative immunohistochemistry suggested gastric malignant melanoma. Positron emission tomography-computed tomography confirmed PGM. Treatment with programmed cell death protein 1 antagonist (toripalimab) plus chemotherapy (paclitaxel) was initiated but discontinued upon tumor bleeding. At the last telephone follow-up, the patient reported poor general condition but was alive.

CONCLUSION

Although unresolved and ongoing, this rare case of PGM expands the overall knowledge about this rare tumor’s diagnosis and management.

Keywords: Primary gastric melanoma; Pathogenesis; Diagnosis; Treatment; Prognosis; Case report

Core Tip: Primary gastric melanoma (PGM) is a rare malignant tumor, and there is a lack of clinical data in the literature. We describe a case of PGM presenting with dysphagia and unintentional weight loss, which was confirmed by immunohisto-chemistry and positron emission tomography-computed tomography. We also review the literature, summarizing and discussing the limited knowledge on PGM pathogenesis, clinical manifestations, diagnosis, treatment and prognosis.