PMC3670551_01
Transverse (a) and coronal (b) images of contrast enhanced CT showing upper abdominal mass located at liver hilum, containing heterogenous lymphadenopathy (arrows).
CRIM.SURGERY2013-534730.001.jpg
PMC3670551_01_CRIM.SURGERY2013-534730.001.jpg
fig1
Computerized tomographic (CT) scan demonstrated a 5 cm abdominal mass located at the liver hilum, and displacing the body of the pancreas (Figures 1(a) and 1(b)).
Axial and coronary images of 18F-FDG CT-PET. Upper and low left pictures represent plane CT and PET fusion image, respectively. Metabolically active lesion (yellow-red) located in the upper abdomen below the liver with high avidity to 18F-FDG on CT-PET fusion image (lower left).
CRIM.SURGERY2013-534730.002.jpg
PMC3670551_01_CRIM.SURGERY2013-534730.002.jpg
fig2
Positron emission tomography (PET-CT) showed marked 18-FDG avidity in the area of concern (Figure 2).
Low magnification (a) and high magnification (b) sections from the core needle biopsy showed connective tissue and a small amount of lymphoid tissue massively infiltrated by a malignant process composed of large, atypical cells with eosinophilic cytoplasm, vesicular nuclei with prominent nucleoli (hematoxylin and eosin). MART-1 immunostain confirmed the diagnosis of metastatic melanoma (c). In the resected specimen, lymph nodes matted together were almost completely replaced by metastatic melanoma with extensive areas of necrosis (arrows) ((d), low magnification, hematoxylin and eosin; (e), confirmatory MART-1 immunostain).
CRIM.SURGERY2013-534730.003.jpg
PMC3670551_01_CRIM.SURGERY2013-534730.003.jpg
fig3
Histopathological examination proved it to be metastatic melanoma (Figures 3(a) and 3(b)). Histopathologic examination of the resected specimen showed lymph nodes replaced by metastatic melanoma (Figures 3(c), 3(d), and 3(e)).