Laparoscopic-assisted distal gastrectomy and central pancreatectomy for gastric and perigastric lymph node metastases and pancreatic invasion from melanoma : a case report

Okawa Yuki; Ebihara Yuma; Tanaka Kimitaka; Nakanishi Yoshitsugu; Asano Toshimichi; Noji Takehiro; Kurashima Yo; Murakami Soichi; Nakamura Toru; Tsuchikawa Takahiro; Okamura Keisuke; Shichinohe Toshiaki; Hirano Satoshi

Title	en Laparoscopic-assisted distal gastrectomy and central pancreatectomy for gastric and perigastric lymph node metastases and pancreatic invasion from melanoma : a case report
Creator	en Okawa, Yuki en Ebihara, Yuma NRID 1000050632981 en Tanaka, Kimitaka NRID 1000010758642 en Nakanishi, Yoshitsugu NRID 1000040447058 en Asano, Toshimichi NRID 1000010756688 en Noji, Takehiro NRID 1000010739296 en Kurashima, Yo NRID 1000040374350 en Murakami, Soichi NRID 1000080706573 en Nakamura, Toru NRID 1000070645796 en Tsuchikawa, Takahiro NRID 1000050507572 en Okamura, Keisuke NRID 1000090724401 en Shichinohe, Toshiaki NRID 1000070374353 en Hirano, Satoshi NRID 1000050322813
Accessrights	metadata only access
Rights	http://creativecommons.org/licenses/by/4.0/ en Creative Commons Attribution 4.0 International
Subject	Other en Malignant melanoma Other en Central pancreatectomy Other en Laparoscopic distal gastrectomy NDC 490
Description	Abstract en Background In melanoma, completely resectable metastases are surgically resected to expect to prolong relapse-free survival and overall survival. However, distant metastases of melanoma are rarely indicated for surgery because multiple metastases are often observed at diagnosis. We report a case of a man in his 50s who underwent laparoscopic-assisted distal gastrectomy and central pancreatectomy for gastric metastases, lymph node metastases, and pancreatic invasion that could be completely resected. Case presentation A 50-year-old man was diagnosed with malignant melanoma of the left parietal region. After diagnosis, tumor resection and left cervical lymph node dissection were performed, and interferon-beta treatment was added as adjuvant therapy. Seventeen months after adjuvant therapy, metastasis of stomach and abdominal lymph nodes from melanoma was diagnosed. And the pancreatic invasion of lymph nodes was suspected. Laparoscopic-assisted distal gastrectomy and the central pancreatectomy were performed because pancreatic invasion of melanoma was intraoperatively found. After 9 months of relapse-free survival, abdominal recurrence was observed. Nivolumab and ipilimumab were administered, and recurrent lesions are currently controlled. The patient has survived more than 3 years since metastasis resection. Conclusion In conclusion, laparoscopic-assisted distal gastrectomy and the central pancreatectomy were performed for gastric and perigastric lymph node metastases and pancreatic invasion due to malignant melanoma, and the negative surgical margin was achieved. Although patient selection is required, the central pancreatectomy was a good indication for maintaining exocrine and endocrine function. The development of immune checkpoint inhibitors and molecular-targeted agents may increase gastrointestinal surgery for metastatic melanoma in the future.
Publisher	en Springer
Date	Issued2020-09-29
Language	eng
Resource Type	journal article
Version Type	NA
Identifier	HDL http://hdl.handle.net/2115/79759
Relation	isIdenticalTo DOI https://doi.org/10.1186/s40792-020-01027-0
Journal	PISSN 2198-7793 en Surgical case reports Volume Number6 Issue Number1 Page Start239
Oaidate	2023-07-26