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- v.12(9); 2024 Sep
- PMC11349811
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Clin Case Rep. 2024 Sep; 12(9): e9377.
Published online 2024 Aug 27. doi:10.1002/ccr3.9377
PMCID: PMC11349811
Sofoklis Stavros,
1 Athanasios Zikopoulos,1 Anastasios Potiris,1 Dimitrios Baltogiannis,2,3 Chara Skentou,4 Ekaterini Domali,5 and Peter Drakakis1
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Associated Data
- Data Availability Statement
Key Clinical Message
Uveal melanomas represent approximately 5% of all human melanomas. Omental metastases are often diagnosed as secondary metastatic sites and only a few cases have been described as the first single manifestation of distant metastasis. In this case image, we illustrate the interesting appearance of the metastatic localization of metastatic uveal melanoma.
Keywords: metastases, omentum, pelvis, uveal melanoma
1. CASE IMAGE PRESENTATION
Uveal melanomas represent approximately 5% of all human melanomas.1 Omental metastases are often diagnosed as secondary metastatic sites and only a few cases have been described as the first single manifestation of distant metastasis.2, 3 In this case image, we illustrate the macroscopic image of distant omental metastases from uveal melanoma.
Α 40‐year‐old woman was presented to our private clinic a year ago due to multiple large cystic pelvic masses with ascites in the setting of a preexisting metastatic melanoma of the eye. In 2018, she underwent a surgery for melanoma excision combined with radiation. Two years later, she was diagnosed with liver metastasis based on an upper abdomen MRI. Excision of the solitary metastasis was performed, and the histology was compatible with metastatic uveal melanoma. A year later, multiple liver metastases were revealed via an MRI of the upper and lower abdomen. Hence, radiofrequency ablation and chemotherapy were the suggestive options. Into the following period, her condition deteriorated, based on MRI and PET scan findings.
In 2023, the patient complained of difficulty in breathing and feeding as well as diffuse abdominal pain due to the enlarged size of pelvic lesions and ascites. The patient was scheduled for an exploratory laparotomy. A median subumbilical incision was performed. While inspecting and palpating the abdominal four quadrants, multiple dark‐colored lesions characteristic of metastatic foci were observed (Figure1). Cystic adnexal formations of about 20 cm were also observed bilaterally while the uterus was free of metastases. Lesions up to 1 cm were observed in the small intestine, while the omentum had multiple diffuse metastatic foci. On the right anterior pelvic wall, a diffuse superficial metastatic lesion was observed while another one was found on the right abdominal wall. Multiple diffuse masses were palpated perihepatically and a single duodenum lymph node metastasis was identified. During the operation, a bilateral adnexectomy and partial omentectomy was performed (Figure2). Histological diagnosis was compatible with omental and ovarian metastatic uveal melanoma.
FIGURE 1
Multiple dark‐colored lesions characteristic as omental metastatic foci of uveal melanoma.
FIGURE 2
The excised omentum and both the ovaries illustrating the characteristic and interesting pattern appearance of the uveal melanoma metastases.
The patient was discharged on the fourth postoperative day in a good condition. Based on the oncological council decision, chemotherapy treatment was the preferable postoperative treatment. Through that case image, our aim is to illustrate the interesting appearance of that metastatic localization of uveal melanoma via images which show the omental appearance and the excised lesions.
AUTHOR CONTRIBUTIONS
Sofoklis Stavros: Visualization; writing – original draft. Athanasios Zikopoulos: Visualization. Anastasios Potiris: Project administration. Dimitrios Baltogiannis: Conceptualization; writing – original draft. Chara Skentou: Investigation. Ekaterini Domali: Validation. Peter Drakakis: Supervision.
FUNDING INFORMATION
There is no funding for this article.
CONFLICT OF INTEREST STATEMENT
The authors state that they have no conflict of interest.
ETHICS STATEMENT
This research was conducted ethically in accordance with the World Medical Association Declaration of Helsinki. The subject has given her written informed consent to publish the case (including the publication of images).
CONSENT
Written informed consent was obtained from the patient to publish this report in accordance with the journal's patient consent policy.
Notes
Stavros S, Zikopoulos A, Potiris A, et al. Omental metastases from uveal melanoma—An interesting intraoperative omental pattern appearance. Clin Case Rep. 2024;12:e9377. doi: 10.1002/ccr3.9377 [CrossRef] [Google Scholar]
DATA AVAILABILITY STATEMENT
The data that support the findings of this study are available from the corresponding author upon reasonable request.
REFERENCES
1. Jager MJ, Shields CL, Cebulla CM, etal. Uveal melanoma. Nat Rev Dis Primers. 2020;6(1):24. doi: 10.1038/s41572-020-0158-0 [PubMed] [CrossRef] [Google Scholar]
2. Zhao H, Yang M, Zhang X, etal. The first case of omental metastasis from primary choroidal melanoma. Jpn J Clin Oncol. 2013;43(3):314‐317. doi: 10.1093/jjco/hys229 [PubMed] [CrossRef] [Google Scholar]
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