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The Old Endoscopy Quiz (and Answer) of the Month
July 2006

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Question:
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This middle aged man had a malignant melanoma some years earlier, adequately treated. Now he came to an upper endoscopy as he was found to have a significande iron deficiency anaemia. This is the finding in the stomach. There were two lesions. One was in the border zone between corpus and antrum (here seen in the upper row) and one high up in the corpus (here seen in the lower row). Obviously these are not ordinary stomach adenocarcinomas. What are these findings?

Answer:

    Gastric metastatic lesions of a malignant melanoma.

    Melanoma is a malignancy the prevalence of which is increasing. Metastases of malignant melanomas can be found in the small intestine, stomach and colon more commonly than the liver. Metastatic lesions can be found years after the initial and treated skin tumour, and the main symptom of gastrointestinal involvment is anaemia.

Correct answers and comments were emailed by


    		 Beirut was once "Paris of the Near East". New hotels have been built and however sad things are at present, in the future Beirut will surely once again be the centre of fashion and culture in this region of the world.

    Zahreddine Radwan, Beirut, Lebanon
    cevale karslioglu sgouros, Istanbul, Turkey
    Christos Zavos, Thessaloniki, Greece
    Robert J Popken, Carvoeiro, Portugal
    SRIDHAR Subbaramiah, AUGUSTA, Georgia, USA
    jose augusto messias, Rio de Janeiro, Brazil
    Marion ricket, Orlando, Fla, USA
    Hong, Gao, China-mainland
    Claudia Iacobescu, Bucharest, Romania
    Ayyakannu Kumar, Brentwood, United Kingdom
    Klaudia Niepsuj, Gliwice, Poland
    FAHAD, HALIFAX, CA
    fahad, Toronto, Canada
    Christos Karalis, MD, Athens, Greece
    Balas Maria, Le Mans, France
    mehmet, kayseri, Turkey
    Jeannot Dumaresq, Québec, Canada
    PARABOLI SILVA, Marcio Luiz , SAO JOSE DO RIO PRETO-SP-, BRAZIL
    Monica Monnerat, RJ, Brasil
    haissam nourallah, Montreal, canada
    Leynaud, Monyluçon, France
    celalettin çetin, Bursa, Turkey
    Amrani khalil, Constantine, Algeria
    Lavrentios Papalavrentios, Thessaloniki, Greece
    mirela popa, Bucharest, Romania
    Helena Sousa, Coimbra, Portugal

    Bernard, London, UK
    ISA, SUMGAIT, AZERBAIJANIAN
    Julia Dahl MD, Germantown, TN, USA
    Pierre Gholam, Cleveland, Ohio, USA
    ADAM, HALIFAX, UK
    rene arroyo de anda, Mexicali, Mexico
    Dr Enrique Agraz, Cd Valles, S:L:P:, S:L:P:, MEXICO
    InKoo Kang, Seoul, South Korea
    DR.P. HARI HARA SASTRY, TIRUPATI, ANDHRA PRADESH, INDIA
    Bassam Adil Abdulla Ghazalah, Al Ain, UAE
    Radha.R, Chennai, India/Tamil nadu

Comments:

    metastatic malignant melanoma. those lesions represent the endoscopic appearance of the radiographic lesion named "bull eye sign".


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