Clinical Endoscopy

The Korean Society of Gastrointestinal Endoscopy (대한소화기내시경학회)
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Endoscopic diagnosis of gastric metastases from malignant melanoma: systematic review

  • Helena Campoli Reggiani (School of Medical Sciences of Minas Gerais) ;
  • Ana Clara Aguiar Pongeluppi (School of Medical Sciences of Minas Gerais) ;
  • Vitoria Froes Miraglia Martins Ferreira (School of Medical Sciences of Minas Gerais) ;
  • Isadora Pinheiro Felix (School of Medical Sciences of Minas Gerais) ;
  • Paulo Moacir de Oliveira Campoli (Department of Digestive Endoscopy, Araujo Jorge Hospital)
  • Received : 2021.12.29
  • Accepted : 2022.02.28
  • Published : 2022.07.30
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Abstract

Background/Aims: Metastases of malignant melanoma (MM) are rare and associated with poor prognosis. The objective of this study was to analyze the clinical and endoscopic characteristics of gastric metastases of MM by systematically reviewing cases and case series involving patients diagnosed using upper gastrointestinal endoscopy. Methods: The PubMed and LILACS databases were searched. Reports containing individual patient data were included. Outcomes such as clinical data, endoscopic findings, treatments, and survival were analyzed. Results: A total of 88 studies with individual data from 113 patients with gastric metastases of MM were included. The primary sites of MM were the skin (62%), eyes (10%), and mucous membranes (6%). Most patients (56%) had multiple metastases in the stomach, located predominantly in the gastric body (approximately 80%). The overall survival rate at 2 years was 4%. There was a significant reduction in the survival of patients with multiple gastric metastases compared to that of patients with single metastasis (hazard ratio, 0.459; 95% confidence interval, 0.235-0.895; p=0.022). Conclusions: Gastric metastases of MM have a poor prognosis, especially in patients with multiple implants in the stomach. Additional studies are needed to verify whether ocular and mucosal melanomas are associated with a higher risk of gastric metastases than that of cutaneous melanomas.

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References

  1. Schizas D, Tomara N, Katsaros I, et al. Primary gastric melanoma in adult population: a systematic review of the literature. ANZ J Surg 2021;91:269-275. 
  2. Strippoli S, Ruggeri E, Fucci L, et al. The evolving landscape in the management of gastric metastases from melanoma: a case series. Clin Pract 2018;16:1079-1084. 
  3. Kim GH, Ahn JY, Jung HY, et al. Clinical and endoscopic features of metastatic tumors in the stomach. Gut Liver 2015;9:615-622. 
  4. Moher D, Liberati A, Tetzlaff J, et al. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med 2009;151:264-269. 
  5. Trouillet N, Robert B, Charfi S, et al. Gastric metastases: an endoscopic series of ten cases. Gastroenterol Clin Biol 2010;34:305-309. 
  6. Campoli PM, Ejima FH, Cardoso DM, et al. Metastatic cancer to the stomach. Gastric Cancer 2006;9:19-25. 
  7. Liang KV, Sanderson SO, Nowakowski GS, et al. Metastatic malignant melanoma of the gastrointestinal tract. Mayo Clin Proc 2006;81:511-516. 
  8. Panagiotou I, Brountzos EN, Bafaloukos D, et al. Malignant melanoma metastatic to the gastrointestinal tract. Melanoma Res 2002;12:169-173. 
  9. Kovcin V, Josifovski J, Opric M. Gastric metastases of melanoma: two case reports. Melanoma Res 1998;8:90-91. 
  10. Geboes K, De Jaeger E, Rutgeerts P, et al. Symptomatic gastrointestinal metastases from malignant melanoma. A clinical study. J Clin Gastroenterol 1988;10:64-70. 
  11. Monti M, Guidoboni M, Oboldi D, et al. Melanoma metastasis mimicking gastric cancer: a challenge that starts from diagnosis. Therap Adv Gastroenterol 2021;14:1756284821989559. 
  12. Chowdhury AAM, Khan MU, Hussain MM. Secondary metastatic gastric melanoma. J Bangladesh Coll Phys Surg 2021;39:68-75. 
  13. Groudan K, Ma W, Joshi K. Metastatic melanoma presenting as a gastric mass. Cureus 2020;12:e11874. 
  14. Rothschild PS, Subramaniam A, Chakrabarti R. Jaundice and haematemesis: an unusual presentation of metastatic malignant melanoma. Cureus 2020;12:e8035. 
  15. Lee MW, Lee HJ. Numerous black elevations in the stomach and duodenum. Am J Med Sci 2020;360:78. 
  16. Lim AH, Argyrides J. Gastrointestinal bleeding from metastatic melanoma. N Engl J Med 2020;382:e7. 
  17. Voudoukis E, Mpitouli A, Giannakopoulou K, et al. Disseminated metastatic cutaneous melanoma to pancreas and upper gastrointestinal tract diagnosed by endoscopic ultrasound: an unusual case. Clin J Gastroenterol 2020;13:134-138. 
  18. Okawa Y, Ebihara Y, Tanaka K, et al. Laparoscopic-assisted distal gastrectomy and central pancreatectomy for gastric and perigastric lymph node metastases and pancreatic invasion from melanoma: a case report. Surg Case Rep 2020;6:239. 
  19. Jain A, Jaju A, Iyer M, et al. Metastases of malignant melanoma to stomach: an unusual presentation. Indian J Pathol Oncol 2020;7:480-482. 
  20. Sachdeva S, Dalal A, Kumar A, et al. Multifocal gastric metastasis of malignant melanoma: an ominous endoscopic appearance: gastric metastasis of malignant melanoma. Dig Liver Dis 2020;52:1512. 
  21. Dinh B, Mossad D, Krishnamurthy P. S2953 Rare metastatic gastric melanoma causing iron deficiency anemia. Am J Gastroenterol 2020;115:S1552-S1553. 
  22. Umeda Y, Tanaka K, Tsuboi J, et al. Small gastric metastases of malignant melanoma mimicking gastric erosion (with video). Gastrointest Endosc 2020;92:423-424. 
  23. Shank CG, Mitchell N, Junga ZC, et al. A rare case of antemortem metastatic gastric and small intestine melanoma. ACG Case Rep J 2020;7:e00300. 
  24. Januszewicz W, Corrie P, Liu H, et al. A sinister black finding in the stomach. Lancet 2019;393:1149. 
  25. Santos-Seoane SM, Perez-Casado L, Helguera-Amezua C, et al. Metastatic melanoma of the stomach. Cir Esp (Engl Ed) 2019;97:51. 
  26. Hussain S. Gastric and umbilical metastasis of cutaneous malignant melanoma. Int J Innov Sci Res Technol 2019;4:819-821. 
  27. Morita S, Suda T, Terai S. Gastric metastasis from uveal melanoma. Clin Gastroenterol Hepatol 2019;17:A20. 
  28. Masuda TS, Kuiava VA, dos Santos PH, et al. Gastric metastases of a malignant melanoma. Clin Biomed Res 2019;39:179-180. 
  29. Rausei S, Pappalardo V, Boni L, et al. Laparoscopic intragastric resection of melanoma cardial lesion. Surg Oncol 2018;27:642. 
  30. Farshad S, Keeney S, Halalau A, et al. A case of gastric metastatic melanoma 15 years after the initial diagnosis of cutaneous melanoma. Case Rep Gastrointest Med 2018;2018:7684964. 
  31. Falk V, Zepeda-Gomez S, Sultanian R, et al. Acute upper gastrointestinal bleeding in a patient with malignant melanoma. BMJ Case Rep 2018;2018:bcr2018225869. 
  32. Borahma M, Essamri W, Afifi R, et al. Metastatic melanoma in the gastric body. Austin J Gastroenterol 2018;5:1093. 
  33. Queiroz CA, Soares RH, de Andrade LP, et al. Gastric metastasis of malignant melanoma. Rev Med Minas Gerais 2017;27:e-1898.
  34. Iadevaia MD, Sgambato D, Miranda A, et al. Amelanotic metastatic melanoma of the stomach presenting with iron deficiency anemia. Acta Gastroenterol Belg 2017;80:327-328. 
  35. Genova P, Sorce M, Cabibi D, et al. Gastric and rectal metastases from malignant melanoma presenting with hypochromic anemia and treated with immunotherapy. Case Rep Oncol Med 2017;2017:2079068. 
  36. Hachiya M, Satoh K, Takami S, et al. A case of metastatic uveal melanoma of the liver and digestive tract. Nihon Shokakibyo Gakkai Zasshi 2017;114:1978-1986. 
  37. Lee JS, Kim SJ, Kang DH, et al. The diagnosis of metastatic malignant melanoma incidentally found during a national health screening endoscopy: a case report. Korean J Gastroenterol 2017;70:103-106. 
  38. Shustef E, Torres-Cabala CA, Curry JL, et al. Intraepithelial melanoma in the stomach after treatment with immune checkpoint blockade therapy. Am J Dermatopathol 2017;39:e116-e118. 
  39. Grander LC, Cabral F, Lisboa AP, et al. Multiple cutaneous melanomas associated with gastric and brain metastases. An Bras Dermatol 2016;91(5 suppl 1):98-100. 
  40. Hiramoto S, Kyogoku K. A case report of gastroduodenal metastasis from skin melanoma. Nihon Shokakibyo Gakkai Zasshi 2016;113:1001-1004. 
  41. Cooper CJ, Mardini H. Gastrointestinal bleeding as the initial presentation of gastric melanoma metastasis. Am J Gastroenterol 2016;111:S1139-S1140. 
  42. Wong K, Serafi SW, Bhatia AS, et al. Melanoma with gastric metastases. J Community Hosp Intern Med Perspect 2016;6:31972. 
  43. Kuzu UB, Suna N, Gokcan H, et al. Metastases of malignant melanoma to stomach. Prz Gastroenterol 2016;11:54-55. 
  44. Ozturk O, Basar O, Koklu S, et al. An unusual presentation of malignant melanoma: amelanotic gastric metastasis. Am J Gastroenterol 2015;110:476. 
  45. Zhao L, Yan J, Li L, et al. Gastric metastasis from sphenoid sinus melanoma: a case report. Oncol Lett 2015;9:609-613. 
  46. Eivazi-Ziaei J, Esmaili H. Metastatic malignant melanoma affecting stomach. J Cancer Res Ther 2014;10:733-736. 
  47. Laskaratos FM, Gillmore R, Clark I, et al. Dark macules in the upper gastrointestinal tract: an ominous sign. Dig Liver Dis 2014;46:1133. 
  48. Ruiz-Cuesta P, Hervas-Molina AJ, Villar-Pastor CM, et al. Metastasis gastrica tardia de melanoma cutaneo Late gastric metastasis from cutaneous melanoma]. Gastroenterol Hepatol 2014;37:564-565. 
  49. Rozsa A, Mellar E, Poczik S, et al. Gastrointestinal locations of primary melanoma. Magy Seb 2014;67:9-14. 
  50. Mostafa MG, Hussein MR, El-Ghorory RM, et al. Gastric metastases from invasive primary mucosal epithelioid malignant melanoma of the hard palate: report of the first case in the English literature. Expert Rev Gastroenterol Hepatol 2014;8:15-19. 
  51. Loganathan G, Singh P. Gastric malignant melanoma. Indian J Gastroenterol 2014;33:199. 
  52. Shaaban H, Modi Y, Modi T, et al. Diffuse gastroduodenal metastasis from cutaneous malignant melanoma presenting as amelanotic "volcano-like" ulcers. J Gastrointest Cancer 2014;45:116-117. 
  53. El-Sourani N, Troja A, Raab HR, et al. Gastric metastasis of malignant melanoma: report of a case and review of available literature. Viszeralmedizin 2014;30:273-275. 
  54. Suganuma T, Fujisaki J, Hirasawa T, et al. Primary amelanotic malignant melanoma of the small intestine diagnosed by esophagogastroduodenoscopy before surgical resection. Clin J Gastroenterol 2013;6:211-216. 
  55. Kraft Rovere R, Pires de Souza ME, Fernanda Hilgert S, et al. Melanoma metastasis to the gastric mucosa preceded by guillain-barre as a paraneoplastic syndrome. Gastrointest Cancer Res 2013;6:150-151. 
  56. Crino SF, Scalisi G, Pallio S, et al. Malignant melanoma rather than malignant cutaneous melanoma? Eur J Gastroenterol Hepatol 2013;25:503-506. 
  57. Canhotoa M, Barbeiroa S, Arroja B, et al. Multiple gastric metastases of malignant melanoma. GE Port J Gastroenterol 2013;20:279-281. 
  58. Rana SS, Chaudhary V, Bhasin DK. Narrow band imaging appearance of gastric metastasis from malignant melanoma. Ann Gastroenterol 2013;26:353. 
  59. Li Z, Linghu E. One case report: endoscopic manifestation of gastric metastatic melanoma. Am J Gastroenterol. 2013;108: S603. 
  60. Das HS, Panda C, Padhi S, et al. Endoscopic diagnosis of a case of malignant melanoma. Trop Gastroenterol 2012;33:296-297. 
  61. Wu PR, Yen HH, Chen CJ. Gastrointestinal: primary esophageal melanoma with gastric metastasis. J Gastroenterol Hepatol 2011;26:1338. 
  62. Kawaguti FS, Maluf-Filho F, Medeiros RS, et al. Ocular melanoma with multiple gastrointestinal metastases. Dig Endosc 2011;23:208. 
  63. Goral V, Ucmak F, Yildirim S, et al. Malignant melanoma of the stomach presenting in a woman: a case report. J Med Case Rep 2011;5:94. 
  64. Bahat G, Saka B, Colak Y, et al. Metastatic gastric melanoma: a challenging diagnosis. Tumori 2010;96:496-497. 
  65. Kasza J, Espinel F, Khambaty F, et al. Laparoscopy for stage IV melanoma in two organs. Surg Laparosc Endosc Percutan Tech 2010;20:295-297. 
  66. Matsubayashi H, Takizawa K, Nishide N, et al. Metastatic malignant melanoma of the gastric mucosa. Intern Med 2010;49:1243-1244. 
  67. Carneiro JQ, Landim MR, Mendes JV, et al. Metastatic gastric melanoma: case report. Rev Soc Bras Clin Med 2010;8:461-463. 
  68. Slattery E, O'Donoghue D. Metastatic melanoma presenting 24 years after surgical resection: a case report and review of the literature. Cases J 2009;2:189. 
  69. Padhi S, Kar A, Behera PK, et al. Occult malignant melanoma metastasizing to the stomach in an elderly patient. Indian J Pathol Microbiol 2008;51:461-462. 
  70. Koklu S, Gultuna S, Yuksel I, et al. Diffuse gastroduodenal metastasis of conjunctival malignant melanoma. Am J Gastroenterol 2008;103:1321-1323. 
  71. Alghisi F, Crispino P, Cocco A, et al. Morphologically and immunohistochemically undifferentiated gastric neoplasia in a patient with multiple metastatic malignant melanomas: a case report. J Med Case Rep 2008;2:134. 
  72. Erzin Y, Akyuz U, Pata C. What is your diagnosis? Small black spots in the stomach and duodenum. Neth J Med 2008;66:129-131. 
  73. Bargiggia S, Parente F, Ucci G, et al. Bleeding gastric metastatic melanoma. Dig Liver Dis 2008;40:699. 
  74. Pommer B, Probst A, Messmann H. Gastric metastases from malignant melanoma. Endoscopy 2008;40 Suppl 2:E30-E31. 
  75. Parisian KR, Mcfarland JE, Shah AN. Metastatic malignant melanoma of the gastrointestinal tract. Clin Gastroenterol Hepatol 2008;6:A24-A24.e1. 
  76. Rocha ME, Rodrigues GP, Borges SA, et al. Metastatic melanoma of the stomach. ABCD Arq Bras Cir Dig 2008;21:205-207. 
  77. Cohen VM, Ahmadi-lari S, Hungerford JL. Gastric metastases from conjunctival melanoma. Melanoma Res 2007;17:255-256. 
  78. Prado AB, Vargas SF, Clemente LJ. Gastric metastasis of cutaneous melanoma. Gastroenterol Latinoam 2007;18:35-38. 
  79. Lufrano M, Storch I, Feldstein R, et al. Metastatic melanoma in a dialysis patient with vomiting diagnosed by gastric polyp biopsy. Am J Gastroenterol 2007;102:S343. 
  80. Ueno N, Yoneda M, Inamori M, et al. Metastatic malignant melanoma in the upper alimentary tract. Gastrointest Endosc 2006;64:1002;discussion 1003. 
  81. Benedeto-Stojanov DA, Nagorni AV, Zivkovic VV, et al. Metastatic melanoma of the stomach and the duodenum. Arch Oncol 2006;14:60-61. 
  82. Fink W, Zimpfer A, Ugurel S. Mucosal metastases in malignant melanoma. Onkologie 2003;26:249-251. 
  83. Mimica M, Tomic I. Endoscopic diagnosis of malignant melanoma metastatic to the stomach. Am J Gastroenterol 2002;97:1572-1573. 
  84. Hokama A, Sugama R, Kinjo F, et al. At the focal point...metastatic malignant melanoma. Gastrointest Endosc 1999;50:241. 
  85. Woollons A, Derrick EK, Price ML, et al. Gastrointestinal malignant melanoma. Int J Dermatol 1997;36:129-131. 
  86. Hsu CC, Chen JJ, Changchien CS. Endoscopic features of metastatic tumors in the upper gastrointestinal tract. Endoscopy 1996;28:249-253. 
  87. Klausner JM, Skornick Y, Lelcuk S, et al. Acute complications of metastatic melanoma to the gastrointestinal tract. Br J Surg 1982;69:195-196. 
  88. Morini S, Bassi O, Colavolpe V. Malignant melanoma metastatic to the stomach: endoscopic diagnosis and findings. Endoscopy 1980;12:86-89. 
  89. Backman H, Davidsson L. Metastases of malignant melanoma in the stomach and small intestine. Acta Med Scand 1965;178:329-335. 
  90. Reed PI, Raskin HF, Graff PW. Malignant melanoma of the stomach. JAMA 1962;182:298-299. 
  91. McLaughlin CC, Wu XC, Jemal A, et al. Incidence of noncutaneous melanomas in the U.S. Cancer 2005;103:1000-1007. 
  92. Bishop KD, Olszewski AJ. Epidemiology and survival outcomes of ocular and mucosal melanomas: a population-based analysis. Int J Cancer 2014;134:2961-2971. 
  93. Tas F, Keskin S, Karadeniz A, et al. Noncutaneous melanoma have distinct features from each other and cutaneous melanoma. Oncology 2011;81:353-358. 
  94. Pomerantz H, Margolin HN. Metastases to the gastrointestinal tract from malignant melanoma. Am J Roentgenol Radium Ther Nucl Med 1962;88:712-717. 
  95. Potchen EJ, Khung CL, Yatsuhashi M. X-ray diagnosis of gastric melanoma. N Engl J Med 1964;271:133-136. 
  96. Nelson RS, Lanza F. Malignant melanoma metastatic to the upper gastrointestinal tract: endoscopic and radiologic correlations, form and evolution of lesions, and value of directed biopsy in diagnosis. Gastrointest Endosc 1978;24:156-158. 
  97. Oda I, Kondo H, Yamao T, et al. Metastatic tumors to the stomach: analysis of 54 patients diagnosed at endoscopy and 347 autopsy cases. Endoscopy 2001;33:507-510. 
  98. Gilg MM, Grochenig HP, Schlemmer A, et al. Secondary tumors of the GI tract: origin, histology, and endoscopic findings. Gastrointest Endosc 2018;88:151-158.e1. 
  99. Booth JB. Malignant melanoma of the stomach: report of a case presenting as an acute perforation and review of the literature. Br J Surg 1965;52:262-270. 
  100. Haendchen Bento L, Kazuyoshi Minata M, Pires Batista C, et al. Clinical and endoscopic aspects of metastases to the gastrointestinal tract. Endoscopy 2019;51:646-652.