Presentation
Malaena and symptomatic anemia (Hb 55g/L)
Patient Data
There is an exophytic mass in the left upper quadrant contiguous with the stomach and spleen, and measuring 8.0 x 7.5 x 10.2 cm. There are multiple low density lesions in the liver concerning for metastases. The patient has previously had a right hemicolectomy and bowel wall thickening is seen at the anastamosis. There is also a right renal cyst and bilateral pleural effusions.
Case Discussion
This patient underwent gastroscopy. Biopsy of an ulcerated lesion in the antrum demonstrated features consistent with malignant melanoma.
This patient had also recently had a right hemicolectomy for adenocarcinoma of the ascending colon. At time of laparotomy a stomach mass and liver lesions concerning for metastases were seen. No biopsies were performed on the liver lesions to determine if these were metastases from the colonic adenocarcinoma or from the melanoma and they are indeterminate on imaging.
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