Primary gastric melanoma: A case report with imaging findings and 5-year follow-up

BACKGROUND Most melanomas identified in the stomach are metastatic;primary gastric melanoma(PGM)is extremely rare,and the relevant studies are relatively scarce.PGM may be incorrectly diagnosed as other gastric malignant tumor types.CASE SUMMARY We describe a rare case of PGM confirmed through long-term clinical observation and pathological diagnosis.A 67-year-old woman presented to our hospital with recurrent chest tightness and chest pain.Digital gastrointestinal radiography revealed a circular shadow in the gastric cardia.Computed tomography(CT)revealed a heterogeneous tumor with uneven enhancement.Enlarged lymph nodes were noted in the lesser curvature of the stomach.On magnetic resonance imaging(MRI),T1-and T2-weighted imaging revealed hyperintensity in and hypointensity in the tumor,respectively,both of which increased substantially after uneven enhancement.Near total gastrectomy was performed,and the tumor was pathologically confirmed to be a gastric melanoma.Because no other possible primary site of malignant melanoma was suspected,a clinical diagnosis of PGM was made.The patient was followed for nearly 5 years,during which she received CT reexamination,but no recurrence or metastasis was observed.CONCLUSION Certain imaging characteristics could be revealed in PGM.Imaging examination can be of great value in preoperative diagnosis,differential diagnosis,and followup of patients with PGM.

Radiological insights of ectopic thyroid in the porta hepatis: A case report and review of the literature

BACKGROUND Ectopic thyroid is defined as a rare developmental anomaly where thyroid tissues are atypically found in locations other than its normal anatomical position:Anterolateral to the second,third,and fourth tracheal cartilages.An intemperate descent or a migration failure of the thyroid anlage results in sub-diaphragmatic thyroid ectopia,a sparse clinical entity.CASE SUMMARY This case portrays a 63-year-old female patient presenting with chronic abdominal discomfort at a local hospital whereby a computed tomography(CT)scan revealed a well-defined mass in the hepatic entrance.For further examination,the patient underwent a CT scan with contrast,magnetic resonance imaging(MRI),and CT-angiography(CTA)at our department.The CT scan showed a welldefined and high attenuated mass measuring 43 mm×38 mm in the hepatic entrance with calcification.The CTA revealed an additional finding:Blood supply to the mass from the right hepatic artery.MRI of the upper abdomen demonstrated a mass with mixed signal intensity on T1 and T2 weighted images in the hepatic entrance.The patient underwent surgery with resection of the mass which was sent for histopathology.Ectopic thyroid at the level of porta hepatis with nodules was the definitive diagnosis since histopathological report revealed presence of thyroid tissue in the resected liver mass.CONCLUSION This case delivers a rare insight of pre-operative radiological imaging of an ectopic thyroid located in the liver.These findings can aid in narrowing down potential differential diagnosis when managing a patient with those subsequent findings.