జీర్ణకోశ & జీర్ణ వ్యవస్థ

నైరూప్య

Choroidal Metastatic Melanoma of Liver

Raheela Khalid

Malignant melanoma is one of the skin tumors, which also arises from uveal tract of eyes. It metastasizes to lymph nodes, lungs and gastrointestinal tract and liver is most common location for metastasis in GI tract.

The case is of 53 years old male presented with upper abdominal pain without alarming symptoms for 6 months duration. Past history positive of right eye enucleation 5 years previously due to biopsy proven choroidal melanoma. Physical examination was unremarkable apart from mild tenderness on right hypochondriac region. On ultrasound abdomen two hypo echoic mass lesions seen at the junction of right and left lobe of liver. The largest one measures 6.9 x 5.6 cm and the other one measures 2.7 x 1.8 cm lesion suggestive of metastatic deposits. CT scan abdomen triphasic showing heterogeneously enhancing lesion given the impression of hepatoma with no background of chronic liver disease. MRI was also done which has shown T2 Iso to hyperintense lesion giving differentials of focal nodular hyperplasia, hepatic adenoma and fibro lamellar carcinoma. Due to discrepancy in imaging reports, diagnosis remained grey, so liver biopsy done showing melanin containing tumor cells with S-100 and MART-1 positive suggestive of melanoma. He was then referred to oncologist for further management.