Background: Melanomas involving the gastrointestinal (GI) tract are usually metastatic from primary cutaneous sites. Primary GI melanoma is a rare entity and mostly presents with non-specific symptoms. The diagnosis in most of the cases is made retrospectively on the immunohistochemistry findings.
Case Presentation: A 32-year-old male presented with massive upper GI bleeding necessitating a total gastrectomy, and to our surprise, on immunohistochemical staining, the diagnosis of primary gastric melanoma was confirmed.
Conclusion: The possibilities of rare mesenchymal tumors of the stomach should be considered while treating such patients. A high index of suspicion in such atypical scenarios should warrant a positron emission tomography integrated with computed tomography to complete the staging workup. The natural course of the disease and its outcome is not known due to the paucity and rarity of this entity. Although the prognosis is dismal, it would help to prognosticate the patient and family before embarking onto a major surgical resection.
Key words: Melanoma, primary gastric melanoma, melanin, S100, immunohistochemistry.
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