Published online Nov 28, 2019. doi: 10.3748/wjg.v25.i44.6571
Peer-review started: September 19, 2019
First decision: November 4, 2019
Revised: November 6, 2019
Accepted: November 13, 2019
Article in press: November 13, 2019
Published online: November 28, 2019
Most melanomas identified in the stomach are metastatic; primary gastric melanoma (PGM) is extremely rare, and the relevant studies are relatively scarce. PGM may be incorrectly diagnosed as other gastric malignant tumor types.
We describe a rare case of PGM confirmed through long-term clinical observation and pathological diagnosis. A 67-year-old woman presented to our hospital with recurrent chest tightness and chest pain. Digital gastrointestinal radiography revealed a circular shadow in the gastric cardia. Computed tomography (CT) revealed a heterogeneous tumor with uneven enhancement. Enlarged lymph nodes were noted in the lesser curvature of the stomach. On magnetic resonance imaging (MRI), T1- and T2-weighted imaging revealed hyperintensity in and hypointensity in the tumor, respectively, both of which increased substantially after uneven enhancement. Near total gastrectomy was performed, and the tumor was pathologically confirmed to be a gastric melanoma. Because no other possible primary site of malignant melanoma was suspected, a clinical diagnosis of PGM was made. The patient was followed for nearly 5 years, during which she received CT reexamination, but no recurrence or metastasis was observed.
Certain imaging characteristics could be revealed in PGM. Imaging examination can be of great value in preoperative diagnosis, differential diagnosis, and follow-up of patients with PGM.
Core tip: Primary gastric melanoma (PGM) is extremely rare and has rarely been discussed. This report presents a rare case of PGM, along with the relevant digital gastrointestinal radiography, computed tomography, and magnetic resonance imaging findings of PGM, which have been rarely reported thus far. In this case report, the related literature was reviewed so as to explore the imaging features of PGM.