Primary biliary tract melanoma: Report of a case and review of the literature

Nathaniel E. Smith, Janis M Taube, Tam M. Warczynski, Kevin D. Collier, Timothy M. Pawlik

Research output: Contribution to journalArticle

Abstract

INTRODUCTION: Primary melanoma of the bile duct is extremely rare with only nine cases of primary melanoma of the bile duct reported in the literature. PRESENTATION OF CASE: A 55-year-old previously healthy gentleman developed increasing jaundice over several months and subsequently underwent an ERCP with stone extraction. Cytology brushings in an area of a distal stricture in the bile duct were concerning for cholangiocarcinoma. The patient was referred to our institution and underwent a pancreaticoduodenectomy. The surgical specimen showed a single 4.5 cm polypoid lesion located in the bile duct. A diagnosis of melanoma was rendered after immunohistochemical studies on the tumor demonstrated positivity for melanoma markers. Follow-up of the patient with skin, ocular, and lymph node exams showed no evidence of melanoma. A PET scan 4 and 10 months post-surgery failed to reveal either a primary skin lesion or other sites of metastases. DISCUSSION: The vast majority of melanomas of the bile duct represent metastases from a cutaneous source and tend to present as multiple flat pigmented lesions. Conversely, cases of primary bile duct melanoma are characterized by a distinct gross morphology consisting of a solitary intraluminal polypoid lesion attached by a pedicle with no other identifiable primary lesion. Other supporting criteria include absence of other involved sites and presence of an in situ junctional component. CONCLUSION: Given the clinical history, gross findings, and lack of a primary cutaneous site or other demonstrable metastases, this patient likely represents the tenth reported case of primary biliary tract melanoma.

Original languageEnglish (US)
Pages (from-to)441-444
Number of pages4
JournalInternational Journal of Surgery Case Reports
Volume3
Issue number9
DOIs
StatePublished - 2012

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Keywords

  • Bile duct
  • Gastrointestinal tumors
  • Melanoma

ASJC Scopus subject areas

  • Surgery

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