[Total Gastrectomy for Gastric Invasion of Multiple Myeloma-A Case Report].

A 65-year-old woman was referred to our hospital for lumbago. The patient was diagnosed with multiple myeloma in 2020. She underwent chemotherapy and radiation therapy, and the disease progression stabilized. In 2022, the patient presented with severe anemia(Hb 4.9 mg/dL), and upper gastrointestinal endoscopy revealed a type 1 tumor in the middle body of the stomach. Computed tomography showed masses in the stomach and pancreas. The patient required a large volume of blood transfusion and underwent total gastrectomy to control the bleeding. Histological examination of the resected specimen indicated infiltration of myeloma cells. The patient died from invasive lesions in other organs, a year after surgery. Usually, extramedullary multiple myeloma lesions occur in the liver, spleen, and lymph nodes. Gastric invasion of multiple myeloma is very rare. Because of poor prognosis, surgery for gastric invasion of multiple myeloma is even rarer. We report a case of gastric invasion of multiple myeloma with a literature review.

[Primary Malignant Melanoma of the Gallbladder].

Primary malignant melanoma of the gallbladder is a rare disease, and 37 cases have been reported in the literature.The current patient was a 78-year-old man who was admitted with a pelvic tumor and left leg edema due to compression of the external iliac vein by the pelvic tumor.The edema improved following resection of the tumor, which was diagnosed at pathology as a malignant melanoma.After surgery, the patient became anorexic and complained of discomfort in the upper right abdomen.A whole body FDG-PET scan demonstrated significant uptake in the gallbladder and in the lymph nodes of the lower abdomen.The patient underwent open cholecystectomy, and the pathological diagnosis was malignant melanoma. Junctional activity was seen in the gallbladder, suggesting that this was the primary site.No melanocytic lesions of the skin or eyes were detected, further supporting the diagnosis of primary malignant melanoma of the gallbladder.Chemotherapy was initiated, but the patient died on February 28, 2016.