眼球摘出11年後に腹腔鏡下に確認された転移性肝悪性黒色腫の1例

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  • A CASE OF METASTATIC MALIGNANT MELANOMA OF THE LIVER CONFIRMED LAPAROSCOPICALLY 11 YEARS AFTER ENUCLEATION OF MALIGNANT MELANOMA OF THE RIGHT EYE

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A 61-year-old male patient was admitted to the authors' clinic because of marked hepatomegaly. He had past history of enucleation of right eye because of malignant melanoma 11 years ago. Physical examination revealed remarkable hepatomegaly with nodular surface without any sign suggestive of liver cirrhosis. Blood biochemical analysis suggested the recurrence of malignant tumor. Based on the past history, physical examina-tion and blood biochemical analysis, hepatic metastasis of malignant melanoma could be supposed. Scintigraphy, sonography and computed tomography of the liver revealed multiple space occupying lesions in various form and size of the liver, which were sugges-tive of hepatic metastatic neoplasma. For the purpose of clarifying a diagnosis of metastatic malignant melanoma of the liver, laparoscopy is a very reliable diagnostic tool, although in about 25% of the patients with malignant melanoma, amelanotic melanoma occurred. In this patient, laparoscopical examination revealed multiple melanomas in various form and size with black brown hue of the liver. In a few melanomas, central umbilication could be found in the tumor, which characterized malignant tumor of the liver. Macroscopical appearance of a hepatic specimen due to laparoscopy-guided needle biopsy showed black brown hue and histological findings of it revealed metastatic malignant melanoma of the liver. The authors stress the usefulness of laparoscopy to make diagnosis of metastatic malignant melanoma of the liver.

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