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Rehman S, Venna P, Davis S, Gopagoni R, Uttam R, Farrukh AM, Salehi M. Primary gallbladder melanoma: A systematic review of literature. Ann Diagn Pathol 2024; 68:152244. [PMID: 38103326 DOI: 10.1016/j.anndiagpath.2023.152244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 12/06/2023] [Accepted: 12/07/2023] [Indexed: 12/19/2023]
Abstract
Primary gallbladder melanoma (PGM) is a rare malignancy with only sporadic cases reported in the English literature. We performed a systematic review of the cases published in the PubMed, Science Direct and Google Scholar databases with the aim of describing the reported clinicopathologic features of PGM. Thirty-six articles reporting on 39 patients were reviewed. There was a male predominance, with 23 (64 %) of 36 patients being males. The mean age at presentation was 55 ±16 years. Pain in the right upper quadrant was reported in 20/27 (74 %). The average size of the tumor was 3.5 × 1.9 × 1.4 cm. Gallbladder calculi were reported in 7/27 (26 %). A cholecystectomy was performed in 34/38 (89.5 %). Grossly, the tumor mostly (96.5 %) had polypoid appearances and on microscopic examination, the tumor were predominantly comprised of epithelioid cells 12/17 (70.6 %). Mitotic figures and prominent nucleoli were reportedly found in 8/8 (100 %) and 3/3 (100 %) respectively. Junctional melanocytic components were present in 13/21 (61.9 %). Tumor cells were reportedly immunoreactive for S-100 and HMB-45 in all tested cases. Metastasis were reported in 25/36 (69.4 %), with lymph nodes being the most common site (n = 8), followed by brain (n = 6) and liver (n = 4) for metastasis. At a mean follow-up period of 19 +/- 3 months, 16 (48.5 %) of the 33 patients with available survival data were alive and 17/33 (51.5 %) were dead of disease. There is a lack of unified criteria for the diagnosis of PGM, and future studies should aim to resolve this.
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Affiliation(s)
| | | | | | | | - Ritika Uttam
- JJM Medical College, Davangere, Karnataka, India
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2
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Adams SH, Luo E, Lozeau D, Wen X. A Case Report of Primary Malignant Melanoma of the Gallbladder with Multiple Metastases. Case Rep Pathol 2023; 2023:4847053. [PMID: 38115990 PMCID: PMC10730246 DOI: 10.1155/2023/4847053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 11/19/2023] [Accepted: 11/29/2023] [Indexed: 12/21/2023] Open
Abstract
Primary malignant melanoma of the gallbladder is an extremely rare tumor with approximately 39 cases described in the literature so far. However, since the first case was reported in 1907, it remains controversial whether gallbladder involvement in malignant melanoma is primary or metastatic. Here, we report a case of primary malignant melanoma of the gallbladder. A 52-year-old male presented to the emergency department with right upper quadrant abdominal pain and was found to have tumefactive sludge filling the majority of the gallbladder with possible gallbladder wall thickening on ultrasonography. A laparoscopic cholecystectomy was performed for presumed acute cholecystitis. Histopathologic examination of the gallbladder revealed malignant melanoma arising from the mucosa of the gallbladder. Further clinical investigation excluded other primary sites, supporting a diagnosis of primary malignant melanoma of the gallbladder.
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Affiliation(s)
- Steven H. Adams
- Stony Brook Medicine Department of Pathology, Stony Brook, New York, USA
| | - Erinn Luo
- Ward Melville High School, East Setauket, New York, USA
| | - Daniel Lozeau
- Stony Brook Medicine Department of Pathology, Stony Brook, New York, USA
- Stony Brook Medicine Department of Surgery, Stony Brook, New York, USA
| | - Xiaoyun Wen
- Stony Brook Medicine Department of Pathology, Stony Brook, New York, USA
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3
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Kumar K, Zaidi A, Husain N, Chandra A. Primary malignant melanoma of the gall bladder masquerading as xanthogranulomatous cholecystitis. BMJ Case Rep 2023; 16:e256093. [PMID: 37734863 PMCID: PMC10514650 DOI: 10.1136/bcr-2023-256093] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/23/2023] Open
Abstract
Malignant melanoma of the gall bladder is rare. Most cases are metastatic and primary gall bladder melanoma is even more rare. We report a case of primary malignant melanoma of the gall bladder which illustrates the diagnostic challenge posed by this condition. Histopathology and immunohistochemistry play a pivotal role in making a diagnosis and ruling out conditions which mimic it such as xanthogranulomatous cholecystitis and other relatively common epithelial malignancies. We tested for prognostic and predictive markers including BRAF and PD-L1 and immunohistochemistry showed positive staining for BRAF. The tumour cells expressed HMB-45 and were negative for cytokeratin and CD68, favouring a diagnosis of malignant melanoma and excluding the possibility of xanthogranulomatous cholecystitis and carcinoma. On follow-up at 3 months there was no evidence of recurrence of metastasis.
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Affiliation(s)
- Kaushlendra Kumar
- Pathology, Dr Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Ariba Zaidi
- Pathology, Dr Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Nuzhat Husain
- Pathology, Dr Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Abhijit Chandra
- Surgical Gastroenterology, King George's Medical College, Chhatrapati Shahuji Maharaj Medical University, Lucknow, Uttar Pradesh, India
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4
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Boca A, Bletard N, Materne R. Melanoma of the gallbladder. Acta Gastroenterol Belg 2023; 86:505-506. [PMID: 37814572 DOI: 10.51821/86.3.12020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/11/2023]
Abstract
An 80-year-old man, with no medical history, was referred to the gastroenterologist due to cholestasis and altered general condition. Physical examination revealed mild abdominal tenderness in the right hypochondrium, with no other clinical signs. Laboratory examinations showed a cholestasis (gamma-glutamyl transferase: 160 U/L and alkaline phosphatase: 120 U/L) and an elevated CRP level of 25 mg/L. Abdominal MRI was performed (Fig 1, Fig 2A). Subsequently, a PET-CT and brain MRI for seizures (Fig. 2B) were realized.
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Affiliation(s)
- A Boca
- Department of Radiology, Clinique CHC MontLegia, Liege, Belgium
| | - N Bletard
- Department of Pathology, Clinique CHC MontLegia, Liege, Belgium
| | - R Materne
- Department of Radiology, Clinique CHC MontLegia, Liege, Belgium
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Bangeas PI, Bekiaridou A, Tsolakidis A, Efthymiadis KG, Drevelegkas K, Giakoustidis D, Giakoustidis A, Alexidis P, Papadopoulos VN. Role of minimally invasive surgery in the treatment of gallbladder metastatic melanoma. A review of the literature and a case report. Cancer Rep (Hoboken) 2022; 5:e1549. [PMID: 34981676 PMCID: PMC9327651 DOI: 10.1002/cnr2.1549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 08/22/2021] [Accepted: 08/24/2021] [Indexed: 11/24/2022] Open
Abstract
Background Primary and secondary gallbladder melanomas are rare, and only 58 cases have been reported in scientific literature to date. This paper aimed to explore the role of minimally invasive surgery in the management of gallbladder metastatic melanomas. Case Herein, we present the case of a 68‐year‐old man with metastatic gallbladder melanoma who was treated with laparoscopic cholecystectomy. Our case management was then compared with that of other cases reported in the literature. Conclusion Currently, metastatic melanomas can be considered as a potentially curable disease. Palliation of symptoms and fast recovery following minimally invasive procedures could be beneficial for these patients. Particularly, laparoscopic procedures appear to prolong the survival of gallbladder melanoma patients.
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Affiliation(s)
- Petros Ioannis Bangeas
- 1st University Department of Surgery, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Alexandra Bekiaridou
- 1st University Department of Surgery, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Alexandros Tsolakidis
- 1st University Department of Surgery, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | | | - Dimitris Giakoustidis
- 1st University Department of Surgery, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Alexandros Giakoustidis
- 1st University Department of Surgery, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Petros Alexidis
- Department of Radiation Oncology, Papageorgiou Hospital, Thessaloniki, Greece
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Asymptomatic malignant melanoma of the gallbladder with multiple brain metastases diagnosed with endoscopic ultrasound-guided fine-needle aspiration cytology. Clin J Gastroenterol 2019; 12:490-494. [DOI: 10.1007/s12328-019-00957-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2019] [Accepted: 02/27/2019] [Indexed: 11/25/2022]
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7
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Adrian S, Clemens C, Elisabeth SW, Sylvia S. Clinicohistopathological Characteristics of Malignant Melanoma in the Gall Bladder: A Case Report and Review of the Literature. Case Rep Pathol 2018; 2018:6471923. [PMID: 29750128 PMCID: PMC5884404 DOI: 10.1155/2018/6471923] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Revised: 01/09/2018] [Accepted: 01/16/2018] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE Primary gall bladder melanoma is a rare and controversial entity. So far, only 36 cases are documented in the literature. Metastatic melanoma targeting the gall bladder, however, has been reported to occur in about 15-20% of melanoma patients and is much more common. METHODS Based on the case of a 58-year-old woman presenting with multiple melanoma nodules in the gall bladder, we searched in the available literature in PubMed for articles describing a "primary melanoma of the gallbladder" regardless of language used. RESULTS We detected 33 papers that described 36 cases of primary gall bladder melanoma between 1907 and 2017. From different criteria distinguishing primary and secondary gall bladder melanoma, generally, the following were accepted: (1) exclusion of previous primary melanoma, (2) absence of synchronous involvement of other sites, (3) unicity of the lesion, (4) polypoid or papillary shape of the lesion, and (5) presence of junctional melanocitary component. Review of the 36 published cases revealed that only about one-fourth of them fulfilled all the five criteria. CONCLUSION Primary gall bladder melanoma is even rarer than described in the literature, and the question whether this entity really exists remains open.
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Affiliation(s)
- Schmidt Adrian
- Department of Internal Medicine, Division of Medical Oncology and Hematology, Triemli Hospital, Birmensdorferstrasse 497, 8063 Zurich, Switzerland
| | - Caspar Clemens
- Department of Internal Medicine, Division of Medical Oncology and Hematology, Cantonal Hospital Baden, Im Ergel 1, 5404 Baden, Switzerland
| | - Schmidt-Weiss Elisabeth
- Centre for Hematology and Oncology, Clinic of Medical Oncology, University Hospital Zurich, Rämistrasse 100, 8091 Zürich, Switzerland
| | - Stadlmann Sylvia
- Division of Pathology, Cantonal Hospital Baden, Im Ergel 1, 5404 Baden, Switzerland
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Wang JK, Su F, Ma WJ, Hu HJ, Yang Q, Liu F, Li QS, Li FY. Primary malignant melanoma of the gallbladder with multiple metastases: A case report. Medicine (Baltimore) 2017; 96:e8793. [PMID: 29145341 PMCID: PMC5704886 DOI: 10.1097/md.0000000000008793] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
RATIONAL Primary malignant melanoma of the gallbladder is an extremely rare tumor, with fewer than 40 cases reported in the literature worldwide. The majority of patients presented as a solitary lesion in the gallbladder. To our knowledge, only one case of primary malignant melanoma of the gallbladder with multiple metastases has been reported, which involved the stomach, duodenum, pancreas, jejunum and a mesenteric lymph node. PATIENT CONCERNS We report a case of primary malignant melanoma of the gallbladder with metastases to the duodenal bulb, right adrenal and a celiac lymph node. DIAGNOSES Primary malignant melanoma of the gallbladder with multiple metastases. INTERVENTIONS Gastrojejunostomy, cholecystectomy, and biopsy of the three metastatic lesions were performed. Histopathologic examination revealed melanin pigments were within the tumor cells of the four lesions, however, junctional activity was noted only in the gallbladder, supporting that the gallbladder was the primary site. No pigmented lesions were detected on the skin or eyes. The postoperative recovery was uneventful, and subsequently, chemotherapy with paclitaxel and carboplatin was administered. OUTCOMES The patient survived for 16 months due to tumor. progression. LESSONS The current case was unique due to the adrenal involvement. For patients with multiple metastases of malignant melanoma, gallbladder origin should be considered in the differential diagnosis from cutaneous origin.
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Affiliation(s)
| | - Fei Su
- Department of Pathology, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China
| | | | | | | | - Fei Liu
- Department of Biliary Surgery
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Virgilio E, Scorsi A, Amodio PM, Goglia A, Macarone Palmieri R. Primary malignant melanoma of the gallbladder: an outstandingly rare tumor. Clin Exp Med 2015; 16:479-80. [DOI: 10.1007/s10238-015-0378-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Accepted: 07/08/2015] [Indexed: 10/23/2022]
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10
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Christou D, Katodritis N, Decatris MP, Katodritou A, Michaelides I, Nicolaou N, Kounoushis M, Hadjicostas P. Melanoma of the gallbladder: appropriate surgical management and review of the literature. Clin Case Rep 2014; 2:313-8. [PMID: 25548636 PMCID: PMC4270716 DOI: 10.1002/ccr3.121] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2014] [Accepted: 06/28/2014] [Indexed: 12/23/2022] Open
Abstract
KEY CLINICAL MESSAGE Melanomas of the gallbladder (GB) are extremely rare with a very poor prognosis. They feature in the literature as a few case reports and the method of their management is not clear. We report a case of patient with metastatic cutaneous melanoma to the GB, and our treatment suggestion.
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Affiliation(s)
- Demetris Christou
- Department of General Surgery, Larnaca General HospitalLarnaca, Cyprus
| | - Nicos Katodritis
- Department of Radiation Oncology, Bank of Cyprus Oncology CentreNicosia, Cyprus
| | - Marios P Decatris
- Department of Medical Oncology, Bank of Cyprus Oncology CentreNicosia, Cyprus
| | | | | | - Nicolaos Nicolaou
- Department of General Surgery, Larnaca General HospitalLarnaca, Cyprus
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11
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The immunohistochemistry of invasive and proliferative phenotype switching in melanoma: a case report. Melanoma Res 2010; 20:349-55. [PMID: 20526217 DOI: 10.1097/cmr.0b013e32833bd89e] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
To date there is no effective therapy for metastatic melanoma and at the molecular level the disease progression is poorly understood. A recent study by our group led to the development of a novel phenotype switching model for melanoma progression, wherein cells transition back-and-forth between states of proliferation and invasion to drive disease progression. To explore the model's clinical relevance we interrogated phenotype-specific expression patterns in human melanoma patient material. A matched primary/metastasis pair from a human melanoma patient was obtained and immunohistochemically stained for proliferative and invasive phenotype markers. These were also stained for hypoxia and blood vessel markers. Proliferative phenotype markers Melan-A and Mitf showed consistent anti-correlation with invasive phenotype marker Wnt5A and hypoxia marker Glut-1. These also correlated with observed intra-tumoural vascularization patterns. Similar pattern distributions were present in both primary and metastasis samples. Strikingly, we observed that late phase metastatic melanoma cells adopt morphologies and behaviours identical to very early phase cells. The expression patterns observed closely matched expectations derived from previous in vitro and xenografting experiments. These results highlight the likelihood that disease progression involves melanoma cells retaining the capacity to regulate the expression of metastatic potential critical factors according to changing microenvironmental conditions.
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12
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Andreano A, Laeseke P, Lava M, Zimbaro F, Daniela V, Meloni MF. Asymptomatic metastatic melanoma of the gallbladder diagnosed with contrast-enhanced ultrasonography. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2010; 29:1133-1137. [PMID: 20587437 DOI: 10.7863/jum.2010.29.7.1133] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Affiliation(s)
- Anita Andreano
- Department of Radiology, University of Milan-Bicocca, 33 Pergolesi St, 20052 Monza, Italy.
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13
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Alimova E, Gorin I, Gressier L, Hugol D, Bouillot JL, Cavalcanti A, Terrier-Lacombe MJ, Blondet C, Franck N, Morini JP, Dupin N, Avril MF. [Metastatic melanoma of the gallbladder: two cases]. Ann Dermatol Venereol 2009; 136:368-70. [PMID: 19361709 DOI: 10.1016/j.annder.2008.11.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2008] [Accepted: 11/21/2008] [Indexed: 11/26/2022]
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14
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Gastrointestinal melanoma or clear cell sarcoma? Molecular evaluation of 7 cases previously diagnosed as malignant melanoma. Am J Surg Pathol 2008; 32:858-66. [PMID: 18408594 DOI: 10.1097/pas.0b013e31815b8288] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Clear cell sarcoma (CCS) is a rare tumor classically associated with the tendons and aponeuroses of distal extremities of young adults. CCS and malignant melanoma (MM) share immunohistochemical profiles and ultrastructural features, but classic CCS has characteristic morphology with low mitotic activity and minimal pleomorphism. Occasional cases show pleomorphism, high mitotic index, and/or melanin pigmentation, making CCS indistinguishable from MM based on morphology. However, CCS is genetically distinct owing to its consistent association with a t(12;22)(q13;q12) chromosomal translocation, leading to the formation of the EWS/ATF1 fusion transcript. This translocation has never been documented in cutaneous melanoma, and thus is regarded as specific for CCS. Recent evidence suggests that primary "malignant melanomas" in unusual anatomic sites, most notably the gastrointestinal (GI) tract, may be CCS. This is supported by 11 cases of primary GI CCS with the t(12;22) translocation. We used reverse-transcription polymerase chain reaction and fluorescence in situ hybridization to examine whether a proportion of cases diagnosed as MM of the GI tract in patients without a history of cutaneous MM actually represent primary GI CCS. In total, we examined 7 cases: Four with no prior history of MM, 2 with histories of cutaneous MM, and 1 with an anal MM. All 4 cases for which there was no history of cutaneous/mucosal MM harbored the EWS/ATF1 fusion transcript. We report the largest series of GI CCS and have shown that molecular studies may be warranted in cases that otherwise seem to represent MM of unusual primary locations.
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