Author/Authors :
Kyun Kim Dong نويسنده Department of Radiology, Seoul St. Mary’s Hospital,
College of Medicine, the Catholic University of Korea, 222
Banpo-daero, Seocho-gu, Seoul, 06591, Republic of
Korea , Choi Joon-Il نويسنده Department of Radiology, Seoul St. Mary’s Hospital,
College of Medicine, the Catholic University of Korea, 222
Banpo-daero, Seocho-gu, Seoul, 06591, Republic of
Korea , Hyung Choi Moon نويسنده Department of Radiology, Seoul St. Mary’s Hospital,
College of Medicine, the Catholic University of Korea, 222
Banpo-daero, Seocho-gu, Seoul, 06591, Republic of
Korea , Lall Chandana نويسنده Department of Radiological Sciences, University of
California, Irvine, 101 The City Drive South, Orange, CA 92868, the
Unites States of America , Sun Jung Eun نويسنده Department of Hospital Pathology, Seoul St. Mary’s
Hospital, College of Medicine, the Catholic University of Korea, 222
Banpo-daero, Seocho-gu, Seoul, 06591, Republic of
Korea , Seok Lee In نويسنده Division of Gastroenterology, Department of Internal
Medicine, Seoul St. Mary’s Hospital, College of Medicine, the
Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul,
06591, Republic of Korea
Abstract :
Pancreatic metastasis of malignant melanoma is rare and
porto-splenic tumor thrombus associated with malignant melanoma is even
less frequent. We report a case of metastatic malignant melanoma
involving the pancreas, portal vein, splenic vein and superior
mesenteric vein. A 60-year-old man showed an elevated amylase level. He
had a history of sigmoid colon adenocarcinoma and malignant melanoma.
Computed tomography (CT) and magnetic resonance imaging (MRI) showed
extensive thrombosis involving the intra- and extrahepatic portal veins
extending into the superior/inferior mesenteric vein and splenic vein.
On T1 weighted images, tumor thrombi demonstrated diffusely high signal
intensity, which is a characteristic finding in malignant melanoma.
Also, thrombus showed prominent diffusion restriction on diffusion
weighted images and intense uptake of 18F-fluorodeoxyglucose (18F-FDG)
on positron emission tomography (PET). Ultrasound-guided biopsy
confirmed the metastatic, malignant melanoma involving the pancreas and
the veins. We report an unusual manifestation of metastatic, malignant
melanoma to the pancreas with extensive tumor thrombi. Specific MR
features including high signal intensity on T1 weighted images and
diffusion restriction on diffusion weighted images were helpful in
reaching a conclusion.
