Prolonged Survival after the Surgical Management of a Solitary Malignant Melanoma Lesion within the Pancreas: a Case Report of Curative Resection

Solitary involvement of the pancreas in patients with malignant melanoma is rare and the role of surgery in these patients is not defined. We present a patient with prolonged survival following aggressive surgical management for a solitary metastatic lesion within the pancreas. A 69-year-old male presented with a 10-day history of painless jaundice. His past medical history included a wide local excision for a superficial spreading melanoma, and subsequent loco-regional recurrence requiring lymph node dissection. Imaging on presentation showed a solitary mass in the head of the pancreas, with no signs of metastases. The patient underwent a pancreato-duodenectomy. Histology reported a metastatic malignant melanoma with clear excision margins. There was no nodal involvement and he remained disease-free eight years later. The survival of patients seems to be affected by the ability to perform a curative resection, and by a long disease free interval between the treatment of the initial lesion and disease recurrence. Curative surgical resection should be offered to selected patients with a solitary pancreatic malignant melanoma metastasis. Such aggressive management may lead to prolonged, and disease-free survival.