Metastatic melanoma can be managed with a variety of therapies, including surgery for isolated disease. Gastric metastases from uveal melanoma are rare and their management is not well-defined.
We present a case of a 69 yo female who underwent Total Gastrectomy for metastatic melanoma spread to the Stomach (as the only site of metastasis).
The patient presented 15 months post Enucleation for Uveal Melanoma with reflux symptoms and was found on Endoscopy to have multiple deposits of black spots, confirmed to be melanoma on biopsies. After MDT discussion following a positive PET scan for the Stomach, and absence of other metastases, patient underwent a Total Gastrectomy. Histopathology showed three metastatic melanoma deposits within lamina propria (0.5 mm / 1 mm / 2 mm) with no positive Lymph nodes. The patient had an uneventful recovery.
Uveal melanoma can metastasize rapidly, but its more well known to spread to Liver and Small Bowel. Gastric involvement is rare, and if present, should prompt investigations like PET to rule out other sites of disease. Surgery maybe required if it’s the solitary site of metastases.
Surveillance for Gastric involvement maybe required in patients with metastatic melanoma. And surgery maybe required if it’s a solitary metastasis.