Metastaza malignog melanoma u ileum

  • Mirjana Živojinov Clinical Center of Vojvodina, Center for Pathology and Histology, Novi Sad, Serbia
  • Tanja Lakić Clinical Center of Vojvodina, Center for Pathology and Histology, Novi Sad, Serbia
  • Jelena Ilić-Sabo Clinical Center of Vojvodina, Center for Pathology and Histology, Novi Sad, Serbia
  • Sandra Trivunić Dajko Clinical Center of Vojvodina, Center for Pathology and Histology, Novi Sad, Serbia
  • Dejan Ivanov University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia
  • Srdjan Živojinov University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia
DOI: https://doi.org/10.2298/VSP180224073Z
Ključne reči: dijagnoza, imunohistohemija, creva, opstrukcija, melanom, neoplazme, metastaze, hirurgija, operativne procedure, lečenje, ishod

Sažetak


Uvod. Maligni melanom je tumor koji se razvija od melanocita, ćelija koje proizvode pigment melanin, te se ovaj tip tumora može razviti u bilo kom delu tela koji sadrži ove ćelije. Melanom je ređi od drugih tumora kože, ali predstavlja uzuzetno agresivan tip tumora kože koji vrlo rano daje metastaze i pripisuje mu se oko 75% slučajeva smrtnog ishoda zbog tumora kože. U početnoj fazi tumor ima horizontalan rast, te je vrlo značajno što ranije dijagnostikovanje promene. Vremenom tumor dobija i vertikalnu fazu rasta, te upravo od dubine invazije (Breslow) zavisi pojava metastaza. Tumor metastazira ne samo u regionalne limfne čvorove, već i u jetru, pluća, mozak i skoro svako mesto koje može biti naseljeno hematogenim putem. Prikaz bolesnika. U radu su prikazana dva bolesnika koja su hitno hirurški zbrinuta u Urgentnom centru Vojvodine zbog kliničkih simptoma i znakova ileusa. U oba slučaja urađene su resekcije ileuma sa terminalnom ileostomijom. Učinjena je patohistološka analiza i na osnovu imunohistohemije i morfološke slike u oba slučaja je postavljena dijagnoza metastaze malignog melanoma u ileum. Zaključak. Kod bolesnika kojima je dijagnostikovan maligni melanom kože sa simptomima bolova u stomaku i/ili anemijom, primena modernih imidžing tehnika je imperativ u cilju postavljanja rane dijagnoze gastrointestinalnih metastaza tog tumora. Brza detekcija i radikalna resekcija mogu doprineti dužini preživljavanja ovih bolesnika.

Reference

Fallah M, Pukkala E, Sundquist K, Tretli S, Olsen JH, Tryggvadot-tir L, et al. Familial melanoma by histology and age: joint data from five Nordic countries. Eur J Cancer 2014; 50(6): 1176–83.

Begg CB, Hummer A, Mujumdar U, Armstrong BK, Kricker A, Marrett LD, et al. Familial aggregation of melanoma risks in a large population-based sample of melanoma cases. Cancer Causes Control 2004; 15(9): 957–65.

Jerant AF, Johnson JT, Sheridan CD, Caffrey TJ. Early detection and treatment of skin cancer. Am Fam Physician 2000; 62(2): 357–68, 375–6, 381–2.

Kanavy HE, Gerstenblith MR. Ultraviolet radiation and mel-anoma. Semin Cutan Med Surg 2011; 30(4): 222–8.

Kumar V, Abbas AK, Fausto N, Mitchell RN. Robbins basic pa-hology. 8th ed. New York: Elsevier Inc; 2007.

Atanackovic M. Patologija. Beograd: Medicinski fakultet Uni-verziteta u Beogradu; 2003.

Wat H, Salopek TG. Revisiting vertical growth phase and re-gression for thin melanoma. J Am Acad Dermatol 2017; 76(1): e27.

Betti R, Agape E, Vergani R, Moneghini L, Cerri A. An observa-tional study regarding the rate of growth in vertical and radial growth phase superficial spreading melanomas. Oncol Lett 2016; 12(3): 2099–102.

Breslow A. Thickness, cross-sectional areas and depth of inva-sion in the prognosis of cutaneous melanoma. Ann Surg 1970; 172(5): 902–8.

Gassenmaier M, Eigentler TK, Keim U, Goebeler M, Fiedler E, Schuler G. Serial or Parallel Metastasis of Cutaneous Melano-ma? A Study of the German Central Malignant Melanoma Registry. J Invest Dermatol 2017; 137(12): 2570–7.

Faries MB, Thompson JF, Cochran AJ, Andtbacka RH, Mozzillo N, Zager JS, et al. Completion dissection or observation for sentinel-node metastasis in melanoma. N Engl J Med 2017; 376(23): 2211–22.

Leiter U, Stadler R, Mauch C, Hohenberger W, Brockmeyer N, Berking C, et al. Complete lymph node dissection versus no dissection in patients with sentinel lymph node biopsy positive melanoma (DeCOG-SLT): a multicentre, randomised, phase 3 trial. Lancet Oncol 2016; 17(6): 757-67.

Morton DL, Thompson JF, Cochran AJ, Mozzillo N, Elashoff R, Essner R, et al. Sentinel-node biopsy or nodal observation in melanoma. N Engl J Med 2006; 355(13): 1307–17.

Morton DL, Thompson JF, Cochran AJ, Mozzillo N, Nieweg OE, Roses DF, et al. Final trial report of sentinel-node biopsy ver-sus nodal observation in melanoma. N Engl J Med 2014; 370(7): 599–609.

Kruse J, Heath R. Melanoma metastatic to the gastrointestinal tract. Am Fam Physician 1990; 41(1): 165–8.

Blecker D, Abraham S, Furth EE, Kochman ML. Melanoma in the gastrointestinal tract. Am J Gastroenterol 1999; 94(12): 3427–33.

Atmatzidis KS, Pavlidis TE, Papaziogas BT, Papaziogas TB. Pri-mary malignant melanoma of the small intestine: report of a case. Surg Today 2002; 32(9):831– 3.

Wysocki WM, Komorowski AL, Darasz Z. Gastrointestinal me-tastases from malignant melanoma: report of a case. Surg To-day 2004; 34(6): 542–6.

Tsilimparis N, Menenakos C, Rogalla P, Braumann C, Hartmann J. Malignant melanoma metastases as a cause of small bowel per-foration. Onkoligie 2009; 32(6): 356–8.

Alwhouhayb M, Mathur P, Al Bayaty M. Metastatic melanoma presenting as a perforated small bowel. Turk J Gastroenterol 2006; 17(3): 223–5.

Brummel N, Awad Z, Frazier S, Liu J, Rangnekar N. Perforation of metastatic melanoma of small bowel with simultaneous gas-trointestinal stromal tumor. World J Gastroenterol 2005; 11(17): 2687–9.

Cholakov O, Tsekov KH, Beliaev O, Stefanov P, Cherveniakov A. Disseminated malignant melanoma, complicated with upper-digestive hemorrhage. Khirurgiia (Sofiia) 2003; 59(3): 52–3.( Bulgarian)

Klausner JM, Skornick Y, Lelcuk S, Baratz M, Merhav A. Acute complications of metastatic melanoma to the gastrointestinal tract. Br J Surg 1982; 69(4): 195–6.

Mucci T, Long W, Witkiewicz A, Mastrangelo MJ, Rosato EJ, Ber-ger AC. Metastatic melanoma causing jejunal intussusception. Journal of Gastrointestinal Surgery 2007; 11(12): 1755–7.

Baniukiewicz A, Zaremba-Woroniecka A, Wróblewski E, Łaszewicz W. Przerzutowy czerniak złośliwy żołądka jako przyczyna krwawienia z przewodu pokarmowego. Opis przypadku. Gas-troenterologia Polska 2000; 7: 61–3. (Polish)

Gutman H, Ben-Ami E, Shapira-Frommer R, Schachter J. Multi-disciplinary management of very advanced stage III and IV melanoma: Proof-of-principle. Oncol Lett 2012; 4(2): 307–10.

Ollila DW, Essner R, Wanek LA, Morton DL. Surgical resec-tion for melanoma metastatic to the gastrointestinal tract. Arch Surg 1996; 131(9): 975–9; 979–80.

Godlewski J, Kuciel-Lisieska G, Tenderenda M, Troska P, Widawski T. Przerzuty czerniaka do narządów przewodu pokarmowego. Nowotwory 2009; 59: 96–8. (Polish)

Kycler W, Łaski P, Porzegowski M, Teresiak M. Chirurgiczne lec-zenie przerzutów do odległych narządów wprzebiegu czer-niaka – opis przypadku. Wspolczesna Onkologia 2006; 4: 175–8. (Polish)

Essner R, Lee JH, Wanek LA, Itakura H, Morton DL. Contem-porary surgical treatment of advanced-stage melanoma. Arch Surg 2004; 139(9): 961–6; discussion 966–7.

Pirisi M, Leutner M, Grazioli S, Bartoli EG. A woman with anemia and a small-bowel obstruction. CMAJ 2004; 170(5): 788.

Kadakia CS, Parker A, Canales L. Metastatic tumors to the upper gastrointestinal tract: endoscopic experience. Am J Gas-troenterol 1992; 87(10): 1418–23.

Bender GN, Maglinte DD, McLarney JH, Rex D, Kelvin FM. Ma-lignant melanoma: Patterns of metastasis to the small bowel, reliability of imaging studies, and clinical relevance. Am J Gas-troenterol 2001; 96(8): 2392–400.

Objavljeno
2021/08/04
Broj časopisa
Vol. 77 Br. 3 (2020): Vojnosanitetski pregled
Rubrika
Prikaz bolesnika