4 The authors declare that no experiments were performed on human

4 The authors declare that no experiments were performed on humans or animals for this study. The

authors declare that they have followed the protocols of their work center on the publication of patient data and that all the patients included in the study received sufficient information and gave their written informed consent to participate in the study. The authors have obtained the written informed consent of the patients or subjects mentioned in the article. The corresponding author is in possession of this document. The authors have no conflicts of interest to declare. “
“Malignant melanoma that involves the gastrointestinal (GI) tract may be either primary or metastatic.1 Gastric metastases are rare and represent advanced disease.2 The incidence of metastases to the stomach is difficult to assess; however, the number of cases of gastric metastases from melanomas is significant. A GDC-0980 solubility dmso series of necropsies in individuals with melanoma revealed gastric metastases rates of more than 22%.2 Symptoms, when present, are nonspecific and similar to those caused by other GI tumours: abdominal pain, dysphagia, altered bowel habits, tenesmus, small bowel obstruction or perforation, hematemesis, melena and anemia.3 Special immunohistochemical stains that include HMB-45 and S100 are important in confirming the diagnosis of metastatic

melanoma.3 Management may include surgical resection, chemotherapy, immunotherapy, observation or engaging in clinical trials. Prognosis is poor, with a this website median survival of 6–9 months.4 A 54-year-old male patient presented to the emergency room with asthenia and a history of dark vomiting in the previous 24 h. He was pale with stable vital signs and haemoglobin of 8.6 g/dL (medium corpuscular volume 80.8 fl; medium corpuscular haemoglobin concentration 26.8 pg). He denied

other gastrointestinal symptoms such as abdominal pain, previous vomiting and bleeding or altered bowel habits. Two weeks before, he had been submitted to surgical excision of a ulcerated dark nodular lesion of the left leg, with approximately 6 cm, diagnosed as malignant melanoma (Breslow’ depth >4 mm; T4b),4 for which he first sought medical attention one week before due to local pain. Upper endoscopy showed several nodular polypoid lesions, between 15 Oxymatrine and 25 mm with central ulceration and dark pigmentation (Fig. 1), along the proximal gastric body, with no major bleeding stigmata. The biopsy specimen confirmed metastatic malignant melanoma with immunohistochemistry stains positive for S-100 protein and HMB45 (Fig. 2). A computer tomography (CT) revealed metastases to the liver, lungs, small bowel and the gastric metastasis (Fig. 3). Although palliative surgery and chemotherapy were initially considered as therapeutic options, the multidisciplinary decision was to manage the patient, in stage IV disease and with fast clinical deterioration, with symptomatic therapy only, and he died two weeks later.

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