切换至 "中华医学电子期刊资源库"

中华临床医师杂志(电子版) ›› 2026, Vol. 20 ›› Issue (02) : 158 -161. doi: 10.3877/cma.j.issn.1674-0785.2026.02.011

病例报告

肛周黑色素瘤伴胆囊转移一例
马钊1, 尹义强2, 樊伟1, 霍仁涛1,()   
  1. 1 250000 济南,济南市第四人民医院肝胆外科
    2 250000 济南,济南市第四人民医院病理科
  • 收稿日期:2026-02-04 出版日期:2026-02-28
  • 通信作者: 霍仁涛

A case of perianal melanoma with gallbladder metastasis

Zhao Ma, Yiqiang Yin, Wei Fan   

  • Received:2026-02-04 Published:2026-02-28
引用本文:

马钊, 尹义强, 樊伟, 霍仁涛. 肛周黑色素瘤伴胆囊转移一例[J/OL]. 中华临床医师杂志(电子版), 2026, 20(02): 158-161.

Zhao Ma, Yiqiang Yin, Wei Fan. A case of perianal melanoma with gallbladder metastasis[J/OL]. Chinese Journal of Clinicians(Electronic Edition), 2026, 20(02): 158-161.

图1 上腹部增强CT。图a为腹部平扫:病灶位于胆囊底体部,表现为稍高密度灶,胆囊壁局限性不规则增厚为主,可见高亮密度胆囊结石;图b为动脉期:病灶表现为轻至中度均匀强化,强化程度略高于周围正常胆囊壁;图c为静脉期:病灶强化程度逐渐减退,病灶密度回落
图2 胆囊转移性黑色素瘤病理及免疫组织化学表现。图a为大体观,胆囊壁内肿物呈灰黑灰红色,与周围分界欠清,累及胆囊壁全层,浆膜外见少量肝脏组织;图b为瘤细胞呈上皮样排列,核大深染,核仁明显,可见核分裂象及散在黑色素沉积,侵犯胆囊黏膜层,HE×400;图c为肝脏静脉管腔内见异型的肿瘤细胞巢团,可见少量黑色素,周围肝脏未见异常,HE×400;图d为免疫组织化学CK染色显示胆囊黏膜上皮阳性,肿瘤组织阴性,肿瘤侵犯胆囊黏膜上皮,IHC×400;图e为免疫组织化学MelanA染色显示胆囊黏膜上皮阴性,肿瘤组织细胞质弥漫强阳性,IHC×400;图f为免疫组织化学S-100染色显示胆囊黏膜上皮阴性,肿瘤组织细胞核和细胞质阳性,IHC×400
1
邹婧. 胆囊黑色素瘤并出血1例影像征象分析并文献复习 [J]. 临床医学进展, 2024, 14(10): 348-352.
2
王纤瑶, 龙剑虹. 黑色素瘤发病机制的研究进展 [J]. 中华整形外科杂志, 2017, 33(5): 397-400.
3
Nagra R, Zaman S, Mohamedahmed A, et al. Nasopharyngeal malignant melanoma masquerading in the gallbladder: the importance of histological assessment [J]. Ann R Coll Surg Engl, 2025, 107(2): 163-166.
4
Vernadakis S, Rallis G, Danias N, Serafimidis C, et al. Metastatic melanoma of the gallbladder: an unusual clinical presentation of acute cholecystitis [J]. World J Gastroenterol, 2009, 15(27): 3434-3436.
5
Hall N, Grenier NL, Shah SA, et al. Metastatic gallbladder melanoma presenting as acute emphysematous cholecystitis [J]. Case Rep Med, 2018, 2018: 5726570.
6
Marone U, Caracò C, Losito S, et al. Laparoscopic cholecystectomy for melanoma metastatic to the gallbladder: is it an adequate surgical procedure? Report of a case and review of the literature [J]. World J Surg Oncol, 2007, 5: 141.
7
胡英男, 徐菁铭, 吴靖,等. 胆囊转移性恶性黑色素瘤伴结石误诊为息肉1例 [J]. 中国中西医结合外科杂志, 2019, 25(3): 382-385.
8
王富强, 谭改民. 5例食管原发性恶性黑色素瘤临床病理分析 [J]. 临床与病理杂志, 2017, 37(2): 245-251.
9
Heath DI, Womack C. Primary malignant melanoma of the gall bladder [J]. J Clin Pathol, 1988, 41(10): 1073-1077.
10
Henriques CQ. A case of secondary melanoma of the gall-bladder presenting as acute cholecystitis [J]. Br J Surg, 1955, 42(176): 663-665.
11
Katz SC, Bowne WB, Wolchok JD, et al. Surgical management of melanoma of the gallbladder: a report of 13 cases and review of the literature [J]. Am J Surg, 2007, 193(4): 493-497.
12
D'Urso Vilar GG, Iriarte F, Speisky D, et al. Isolated gallbladder metastasis of melanoma: Case report [J]. Int J Surg Case Rep, 2020, 71: 311-314.
13
Khan ZS, Huth J, Kapur P, et al. Indications and recommended approach for surgical intervention of metastatic disease to the gallbladder[J]. World J Surg Oncol, 2010, 8: 80.
14
Zhang ZD, Myles J, Pai RP, et al. Malignant melanoma of the biliary tract: a case report [J]. Surgery, 1991, 109(3Pt1): 323-328.
15
Gates J, Kane RA, Hartnell GG. Primary biliary tract malignant melanoma [J]. Abdom Imaging, 1996, 21(5): 453-435.
16
Medina V, Darnell A, Bejarano N, et al. Primary biliary tract malignant melanoma: US, CT, and MR findings [J]. Abdom Imaging, 2003, 28(6): 842-846.
17
Khan A, Patel S, Zaccarini DJ, et al. Metastatic melanoma of the gallbladder in an asymptomatic patient [J]. Case Rep Gastrointest Med, 2017: 1767418.
18
Christou D, Katodritis N, Decatris MP, et al. Melanoma of the gallbladder: appropriate surgical management and review of the literature [J]. Clin Case Rep, 2014, 2(6): 313-318.
19
Tuveri M, Tuveri A. Isolated metastatic melanoma to the gallbladder: is laparoscopic cholecystectomy indicated?: a case report and review of the literature [J]. Surg Laparosc Endosc Percutan Tech, 2007, 17(2): 141-144.
20
Ollila DW, Hsueh EC, Stern SL, et al. Metastasectomy for recurrent stage IV melanoma [J]. J Surg Oncol, 1999, 71(4): 209-213.
21
毛丽丽, 斯璐, 郭军. 2020版CSCO黑色素瘤指南解读 [J]. 中华转移性肿瘤杂志, 2020, 3(2): 81-82.
22
Keilholz U, Ascierto PA, Dummer R, et al. ESMO consensus conference recommendations on the management of metastatic melanoma: under the auspices of the ESMO guidelines committee [J]. Ann Oncol, 2020, 31(11): 1435-1448.
23
中华医学会病理学分会, 中华医学会病理学分会皮肤病理学组. 黑色素瘤病理诊断临床实践指南(2021版) [J]. 中华病理学杂志, 2021, 50(6): 572-582.
24
张佳冉, 齐忠慧, 斯璐. 精准医疗背景下晚期恶性黑色素瘤治疗的现状与进展 [J]. 中国肿瘤生物治疗杂志, 2021, 28(4): 317-324.
No related articles found!
阅读次数
全文


摘要


AI


AI小编
你好!我是《中华医学电子期刊资源库》AI小编,有什么可以帮您的吗?