Official websites use. Share sensitive information only on official, secure websites. Correspondence to: Raffaele Longo. Email: r. Primary gastric melanoma GM is a very uncommon tumor with a poor prognosis.
Until now, only a few cases have been reported in the literature. A year-old, Caucasian, ex-smoker man, presented with asthenia, anorexia, and weight loss of 5 kg during the last 2 months. Biological test showed high levels of transaminases and a microcytic, hypochromic anemia. Whole body CT-scan documented a gastric tumor lesion with concomitant loco-regional lymph node and hepatic metastases.
Histology was consisted with the diagnosis of a primary GM. A double immunotherapy with nivolumab and ipilimumab was started but, 2 weeks later, the patient presented an acute hepatic failure quickly leading to his death despite a high dose corticotherapy. The particularity of this case relies on the rarity of GM, its difficult diagnosis representing a clinical challenge, and the complexity of its management that is not validated by large clinical trials, data being extrapolated from the treatment protocols routinely used in cutaneous melanoma.
Gastric melanoma GM is an uncommon tumor with a poor prognosis 1. Only a few cases have reported in the literature to date 1 - 6. The diagnosis is often a clinical challenge as the symptoms are aspecific 1 - 7. Its rarity and the lack of large clinical trials make difficult the management of GM as no validated treatments are available, data being extrapolated from cutaneous melanoma 1 - 6. In our case, we diagnosed a metastatic primary GM in a patient presenting with asthenia, anorexia, and weight loss of 5 kg during the last two months.
He received a cycle of a double immunotherapy with nivolumab and ipilimumab, this later at a reduced dose because of his comorbidities and altered performance status PS. Two weeks after, the patient was hospitalized for an acute, fatal hepatic failure that could be related to a treatment toxicity or a tumor hyperprogression. In November , a year-old, Caucasian, ex-smoker man consulted for asthenia, anorexia, and weight loss of 5 kg during the last 2 months.
