Luis Ferreira, Mar Achalandabaso, Henrique Alexandrino, Justin Geoghegan, Kevin Conlon
Introduction Solitary malignant melanoma metastasis to the pancreas is rare and occurs in approximately 1% of patients with metastatic malignant melanoma. Historically, most patients are considered unresectable. However, resection of isolated metastasis could enable disease-free survival benefit, particularly in the absence of effective systemic therapies. Methods We present our department experience of pancreatic resection for isolated MM metastasis along with a review of the English published literature. Patients with extra-pancreatic disease and patients who did not undergo surgery were excluded. Results and Discussion A 46 year old woman, with a right arm MM excised nine years ago, presented to our unit with an isolated tail of the pancreas mass on routine follow-up computed tomography. Laparoscopic distal pancreatectomy and splenectomy were preformed and revealed a 28 mm metastatic MM, with negative resection margins. The patient is asymptomatic with no recurrence two years after the resection. No adjuvant treatment was given. The literature review revealed three case series and 22 case reports with a total of 38 patients. The follow-up ranged from 1-264 months with a 5 year survival of 37.5% reported. Conclusions In carefully selected patients surgery may offer an overall survival benefit. Resection of isolated pancreatic metastases should be considered as it may provide a significant survival benefit for a disease with high mortality and lack of effective systemic therapies. Multidisciplinary decision and treatment in high volume centres is mandatory.
