INDICATIONS FOR SURGICAL RESECTION OF METASTATIC OCULAR MELANOMA - A CASE-REPORT AND REVIEW OF THE LITERATURE

Conclusions. Ocular melanoma can metastasize to the gallbladder and po rta hepatic nodes and mimic pancreatic carcinoma, If one suspects meta static disease, a complete metatstatic work-up must be done prior to s urgery to prevent unnecessary surgery. If no distant disease is presen t or the patient is symptomatic, metastatic disease should be resected . Purpose. To review the literature pertaining to the spread of ocular melanoma and to determine if distant disease should be resected. Pati ents and Methods. A 44-yr-old Egyptian male presented to an outside in stitution with mid-epigastric and right upper quadrant abdominal pain. His past medical history was significant for a left orbital enucleati on for uveal melanoma in 1982. On physical examination, there was no s upraclavicular adenopathy and no skin lesions were noted. There was a mass in the right upper quadrant. The total bilirubin was 4.8 mg/dL. A computed tomography showed a mass in the head of the pancreas and por tal vein involvement could not be determined. Results. The patient was taken to the operating room and a pancreatico-duodenectomy was perfor med for a cystic mass in the head of the pancreas. Final pathology rev ealed metastatic melanoma in the gallbladder and an enlarged, cystic l ymph node growing into the head of the pancreas replaced with metastat ic melanoma. The patient did well post-operatively and was discharged home on the eighth post-operative day.