Multiple Metastatic Malignant Melanoma Presenting Intraluminal Gallbladder Bleeding

We report a case of malignant melanoma of unknown primary origin presenting metastasis in various organs as well as intraluminal gallbladder bleeding due to gallbladder metastasis. A 58-year-old woman was diagnosed with stage IV metastatic malignant melanoma. Because she exhibited acute cholecystitis and hemobilia due to malignant melanoma of the gallbladder, laparoscopic cholecystectomy was performed to relieve the symptoms. The resected gallbladder specimen showed a pedunculated black mass indicating malignant melanoma. Pathologic examination and immunohistochemical analysis revealed malignant melanoma of the gallbladder. Only a few cases of gallbladder malignant melanoma presenting hemobilia have been reported; here we present our case, including the experience of multidisciplinary treatment.Key words: Gallbladder malignant melanoma, Hemobilia, Laparoscopic cholecystectomyMalignant melanoma can metastasize to various organs. Metastasis often occurs in the lungs, liver, brain, and gastrointestinal tract; however, reported cases of metastatic melanoma of the gallbladder are rare. Though gallbladder melanoma is usually asymptomatic, acute cholecystitis is the most common presentation among symptomatic cases. Other symptoms, such as obstructive jaundice, external biliary fistula, and hemobilia, are rare and found in very few reports. Here, we report a case of multiple metastases of malignant melanoma of unknown primary origin, for which we performed laparoscopic cholecystectomy to treat continuous bleeding from the gallbladder. We conclude that cholecystectomy is indicated for symptomatic stage IV gallbladder of melanoma cases, because the patient who underwent cholecystectomy not only experiences resolved symptoms but also maintained a survival benefit with improved quality of life.