Year: 2025
Type: article
Abstract: Revisiting melanoma of unknown primary: do not overlook the uveal tractTo the Editor, I read with great interest the article by Küçükdemirci et al. [1] and would like to thank the authors for presenting this intriguing case.At the end of the case presentation, the authors note that the multiple foci of melanoma in the duodenum may represent either primary lesions or metastases.As is well known, melanocytes are derived from the neural crest and are located in the basal layer of the epidermis, primarily in the skin, but also in the uveal tract of the eye, mucosal epithelia, hair follicles, and the meninges [2].Contrary to the suggestion in the article, malignant melanoma is among the most common tumors to metastasize to the gastrointestinal (GI) tract.The top three malignancies associated with GI metastases are lung cancer, breast cancer, and melanoma.These cancers have been reported to disproportionately frequently affect the gastrointestinal tract [3].Approximately 50% of melanoma-related GI metastases are multifocal.Due to the hematogenous route of spread and the vascular anatomy of the intestinal wall, the submucosal layer is often involved, with the overlying mucosa appearing intact.The small intestine is the most commonly affected region of the GI tract in such cases [3].The case under discussion shows many of these typical features, suggesting that the duodenal lesions are more likely metastatic rather than primary.As mentioned, one of the primary sites of malignant melanoma is the eye -specifically the uvea, which accounts for approximately 85% of ocular melanomas.Among these patients, around 50% will develop metastases during the disease course [4].Although the most common presenting symptoms include blurry vision, photopsia, visual field defects, ocular pain, and metamorphopsia, up to one-third of patients may remain asymptomatic [5].A case similar to that presented by Küçükdemirci et al.[1] reported uncountable liver metastases from uveal melanoma
DOI: 10.15403/jgld-6450
Authors: Mehmet Engin Ozekin, Idris Kurt
Institution: Trakya University
Language: English
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7117293587
FWCI:
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