Compiled analysis on primary hepatic melanoma

doi:10.3877/cma.j.issn.2095-3232.2021.06.017

Abstract

Abstract:

Objective

To investigate the clinical manifestations, diagnosis and treatment experience of primary hepatic melanoma (PHM).

Methods

Literature related to PHM published before August 31, 2020 was searched using Chinese search terms "liver" and "melanoma" and English terms "(primary) and (hepatic or liver) and (melanoma)" in PubMed, Wanfang data, CNKI and Chongqing VIP databases.

Results

30 articles, 31 PHM patients were included. 19 cases were male and 12 female witha male-to-female ratio of 1.58∶1, and 30 cases were adults and 1 child. The average age was (47±15) years. The main symptoms were abdominal pain or swelling pain and discomfort in the right upper abdomen or hepatic region. The preoperative misdiagnosis rate was 74%(23/31). High-signal on T1WI and low-signal on T2WI were observed by the upper abdomen MRI scan in 12 cases, and the density of lesions were manifested with varying degree of enhancement. Pathological examination found that the tumor cells were in round, polygonal or spindle shape, with a large quantity of gray-black particles in the cytoplasm, round or oval nucleus, clear nucleoli, eosinophilic or weakly-basophilic nature and obvious caryokinesis. The positive rates of HMB45, Melan-A and Vimentin were 20/20, 8/8 and 6/6, respectively, reported by immunohistochemical staining. The therapeutic scheme included surgery, chemotherapy, interventional therapy and immunotherapy, etc. 18 cases were followed up. The 1-year survival rate was 30% and the median survival time was 5 months. 2 patients survived without recurrence during the follow-up, including 1 case receiving surgery alone, and the other receiving surgery combined with postoperative IL-2 therapy.

Conclusions

PHM is a rare disease, which is characterized with high-degree malignancy, high misdiagnosis rate, poor prognosis and without specific clinical manifestations. Contrast-enhanced MRI of the upper abdomen, pathological examination and immunohistochemical staining contribute to confirm the diagnosis. Early surgery combined with postoperative IL-2 treatment may prolong the survival time.

Key words: Liver neoplasms, Melanoma, Primary

Zhihong Pan, Jiaxi Mao, Yuan Xue, Hong Fu, Guoshan Ding, Wenyuan Guo, Fei Teng. Compiled analysis on primary hepatic melanoma[J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2021, 10(06): 612-617.

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