A case of primary malignant melanoma in the cardiac region of the stomach requiring emergency resection due to hemorrhagic shock

Abstract

The case was a 76-year-old woman who had noticed stomach discomfort for 2 months and black stools for 1 week. She was referred to our hospital by a neighborhood doctor as she was suffering from hemorrhagic shock. Upper gastrointestinal endoscopy revealed a hemorrhagic, blackish tumor that appeared as a large hematoma in the cardiac region of the stomach. Endoscopic hemostasis was difficult. Computed tomography revealed multiple metastases to the liver and lungs. Proximal gastrectomy was performed as palliative surgery. Malignant melanoma was diagnosed by pathological findings ; she was then transferred to the department of dermatology at another hospital. Dacarbazine treatment was minimally effective and she died on the 153^rd postoperative day. Malignant melanoma of the stomach is often metastatic, and primary cases are extremely rare. Only 2 such cases have been reported in Japan. We describe our case with a brief literature review.