胆囊黑色素瘤并出血1例影像征象分析并文献复习

A Case Analysis of Imaging Manifestations of Gallbladder Melanoma with Hemorrhage and Literature Review

摘要: 目的：该文旨在探讨影像表现为胆囊内高密度出血块样的原发性胆囊黑色素瘤患者的临床表现、鉴别诊断及诊治要点。方法：对山东大学附属威海市立医院收治的1例原发性胆囊黑色素瘤的患者进行回顾性分析并针对相关文献进行复习归纳。结果：原发性胆囊黑色素瘤是胆囊恶性肿瘤的一种特殊类型，其发病率较低，常常伴有出血坏死，密度极不均匀，是否有强化难以明确，容易误诊为胆囊炎或胆囊癌伴出血。结论：胆囊黑色素瘤伴大量出血的病变缺乏特异性临床表现，影像学特征的总结归纳对其鉴别诊断有重要意义，因其为高度恶性程度的肿瘤，手术为首选治疗方法，最终确诊要依靠手术探查及术后病理结果及免疫组化验证、确诊。

Abstract: Objective: This article aims to explore the clinical manifestations, differential diagnosis, and key points of diagnosis and treatment for patients with primary gallbladder melanoma presenting as high-density hemorrhagic masses in imaging. Method: A retrospective analysis was conducted on a case of primary gallbladder melanoma treated at Weihai Municipal Hospital Affiliated with Shandong University, and a review of relevant literature was performed. Results: Primary gallbladder melanoma is a special type of malignant tumor in the gallbladder with a low incidence rate, often accompanied by hemorrhagic necrosis, extremely uneven density, and uncertain enhancement, which can be easily misdiagnosed as cholecystitis or gallbladder cancer with bleeding. Conclusion: The lesions of gallbladder melanoma with massive hemorrhage lack specific clinical manifestations, and the summary of imaging characteristics is of great significance for its differential diagnosis. Because it is a highly malignant tumor, surgery is the preferred treatment method, and the final diagnosis relies on surgical exploration and postoperative pathological results as well as immunohistochemical verification and confirmation.