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| UDK 616-006.81-033.2 ; 616.411-006.6-089 |
ISSN 0350-2899, 36(2011) br.2 p.115-119 |
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Case report Surgical treatment of isolated metastasis of melanoma in the spleen (Hirurško lečenje izolovanih metastaza melanoma u slezini) Saša Micković , Mihailo Bezmarević, Miroslav Mitrović, Darko Mirković, Marijan Novaković, Nebojša Stanković , Irena Nikolić-Micković, Biserka Vukomanović-Đurđević Vojnomedicinska akademija, (1) Klinika za abdominalnu i endokrinu hirurgiju, (2) Uprava, (3) Univerzitetska dečja klinika, Beograd, (4) Institut za patologiju i sudsku medicinu, Beograd |
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| Summary: INTRODUCTION. Melanoma represents only 1% of all malignant tumours and has a distinct potential for metastasis. Localized or solitary metastasis of melanoma in the spleen is rare, but the spleen takes an important place for haematogenous dissemination in patients with advanced stage of melanoma. Isolated metastases of melanoma in the gut are rare, but they can be described. The organs that are the most commonly affected are colon, stomach, small intestine. Surgical treatment of metastatic malignant melanoma has been known for ages. CASE REPORT. A female aging 48 had an excision of a suspicious pigmented mole on the back left base of the neck that was histopathologically confirmed as melanoma. Within the primary surgery, functional dissection of the lymph glands in the left lateral side of the neck was performed. After 18 months from the operation, due to fatigue and abdominal pain under the left rib arch, the patient underwent ultrasonography (US) of the abdomen and computed tomography (CT) scans of the abdomen and the endocranium whereby the existence of multiple metastases in the spleen was found. The findings on the organs in the abdomen and the endocranium were normal, without metastasis. After preoperative preparation we made splenectomy and definitive histopathological examination confirmed the enlarged and metastatic modified spleen. The postoperative course was uneventful, without any complications. On the council’s decision, the patient was monitored, and after a follow-up of 6 months, the control endocranial and abdominal CT scans showed normal findings. CONCLUSION. Surgical treatment of metastatic melanoma in the abdomen is often palliative, but in some isolated cases, surgery provides good survival. In advanced stages of melanoma, especially when metastases are localized only in one organ, as shown in this case, surgery is the treatment of choice. Metastases are surgically removed with a hope that it will provide a longer survival. Key words: melanoma, metastasis, spleen, digestive tract, splenomegaly. Napomena: kompletan tekst rada na srpskom jeziku Note: full text in Serbian |
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Corresponding Address: Saša Micković Vojnomedicinska akademija, Beograd Klinika za abdominalnu i endokrinu hirurgiju, tel. 011-216-40-30; mob. tel. 064-401-65-93 e-mail: mcsachanet@yahoo.com |
Paper
received: 07.04.2011 Paper aaccepted: 11.07.2011 Paper Internet issues: 21.10.2011 |
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