Metastatic melanoma presenting as obstructive jaundice with hemobilia

McArthur, Michael S.; Teergarden, David K.

doi:10.1016/0002-9610(83)90153-8

Cited by 31 publications

(9 citation statements)

References 5 publications

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“…In contrast to primary liver malignancies, reports on metastatic liver disease causing hemobilia are only anecdotal, such as a necrotic colon cancer metastasis or a metastatic malignant melanoma in the distal common bile duct. 3,4 In the presented case, two serial CT scans of the abdomen excluded any primary hepatic vascular pathology or liver metastasis. Percutaneous biliary drainage involves a higher risk of hemobilia (incidence 2%-10%) than endoscopic retrograde bile duct stenting.…”

Section: Discussionmentioning

confidence: 96%

Management of a rare case of fulminant hemobilia due to arteriobiliary fistula following total pancreatectomy

et al. 2006

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Hemobilia is a rare cause of acute upper gastrointestinal bleeding and is often associated with a history of hepatic or biliary tract injury, tumor growth, hepatic artery aneurysm, cholecystitis, or hepatic abscess. We report a case of a 76-year-old patient with massive hemobilia due to intrahepatic bleeding from the segment 8 hepatic artery without evidence of a true aneurysm, abscess, or metastatic disease 4 weeks following pylorus-preserving total pancreatectomy for pancreatic cancer. Gastroduodenoscopy suggested hemorrhage from the duodenojejunostomy but failed to achieve hemostasis, and the patient underwent exploratory laparotomy. It was realized intraoperatively that the bleeding originated from the intrahepatic biliary tract. Bleeding was controlled by blocking the right hepatic bile duct with a Fogarty catheter and subsequent transarterial embolization. Computed tomography did not reveal any local liver or vascular pathology. Retrospectively, the cause of delayed profuse hemobilia was most likely a traumatic intrahepatic pseudoaneurysm following endoscopic bile duct stenting 3 weeks before the pancreatectomy. The reported case is exceptional and of particular interest because of the absence of a typical history or cause of hemobilia, preoperative misleading diagnostic results in an altered anatomic situation, and the operative management to achieve bleeding control in this emergency setting.

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Section: Discussionmentioning

confidence: 96%

Management of a rare case of fulminant hemobilia due to arteriobiliary fistula following total pancreatectomy

et al. 2006

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“…[7] Ultrasonic features may help to diagnose melanoma metastases preoperatively. Metastatic melanoma of the common bile duct (CBD) is very rare, with only 18 cases reported so far;[8] the most common presentation in these cases is of progressive painless obstructive jaundice with few rare cases presenting with hematobilia,[9] pain,[10] or cholangitis. [11] Laboratory investigations in these cases suggest cholestatic jaundice.…”

Section: Discussionmentioning

confidence: 99%

Choroidal melanoma metastatizing to the biliary system: A diagnostic dilemma

Agarwal

Bhattacharya

Patil

et al. 2009

Indian J Med Paediatr Oncol

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Metastatic melanoma to the gall bladder is extremely rare and is associated with a very poor prognosis. We report a case of choroidal melanoma metastatizing to the hepatobiliary system, with an unusual presentation. Our patient presenting with obstructive jaundice was misdiagnosed as having carcinoma of the gall-bladder, but the diagnosis of metastatic melanoma to the gallbladder was confirmed by ultrasonography guided fine needle aspiration cytology (USG-FNAC). On reviewing the past history, the patient had a history of enucleation for choroidal melanoma. Even though the liver ‘is’ a common site for metastasis of choroid melanoma, the patient presenting with a suspected gall bladder mass ‘is’ a rare presentation. Hence, gastrointestinal symptoms and a history of melanoma should be investigated for the presence of gastrointestinal or liver metastases, even if the original primary malignancy was diagnosed years before the patient‘s presentation.

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“…We believe it is paticularly indicated if resection is not too dangerous and if it is relatively easy to perform, as in the present case. A resection may be necessary in cases of serious hematobilia [10] . If there is a concurrent metastatic disease elsewhere, it is prudent to adopt a less aggressive approach in order to relieve obstructive jaundice, such as the bypass procedures [14] , or stenting [18,19] .…”

Section: Discussionmentioning

confidence: 99%

“…Patients with metastatic melanoma to the common bile duct usually present with progressive painless obstructive jaundice [4,19] . Rarely the patients have hematobilia [10] , pain [5,8] , or cholangitis [19] . Laborator y data show a cholestatic jaundice.…”

Section: Discussionmentioning

confidence: 99%