Case report of an omental metastasis of melanoma in a patient with abdominal pain.

Abstract

Introduction: Choroidal melanoma primarily metastasizes to the liver, but rare sites like the omentum can also be affected, making this case educational due to its uncommon presentation. The decision to pursue surgical treatment for metastatic melanoma remains controversial.

Case presentation: A woman in her 60s, with a history of a stable choroidal nevus, experienced rapid lesion growth, leading to enucleation and radiotherapy. Two years later, she developed severe epigastric pain. Imaging revealed peritoneal nodules, and histopathology confirmed metastatic choroidal melanoma. Molecular analysis identified a GNAQ G48L mutation.

Discussion: Omental metastasis in choroidal melanoma is rare, and while surgery is uncommon for metastatic melanoma, it was performed to alleviate symptoms and improve functionality. Following omentectomy and immunotherapy, her condition remained stable for two years.

Conclusion: This case emphasizes the importance of recognizing atypical metastatic sites in melanoma. Surgical intervention, though rare, can be beneficial for symptom relief in selected cases, improving outcomes when combined with targeted treatments.