Pancreatic resection for isolated metastasis from melanoma of unknown primary

A 55-year-old female patient presented with a three- week history of upper abdominal pain and itching. She had no past medical history. Examination revealed fever and jaundice. Laboratory tests showed cholestasis. Tumor markers including CEA and CA 19.9 were normal. Computed tomography (CT) and magnetic resonance imaging (MRI) showed a 6x5 cm mass located in the head of the pancreas with peripheral enhancement, leading to intra and extrahepatic biliary tract dilatation (Fig. 1). The patient underwent surgery and a pancreaticoduodenectomy was performed. She had an uneventful postoperative course and was discharged 10 days later. The macroscopic examination of the pancreatectomy found a pigmented mass measuring 5,5×4 cm in the head of the pancreas (Figure 1). Histological examination confirmed melanoma with epithelioid and polygonal cells (Fig. 2). All resection margins were free and there was no lymph node involvement.