case_images: PMC6109490_01
case_images: Left: gross whole specimen of the subtotal gastrectomy specimen, 14 cm in length. Preoperatively marked on endoscopy with ink along the greater curvature. Right: proximal lesion near the serosa measured to be 1.1cm x 1 cm was found to be normal gastric mucosa. Distal and proximal margins of the resection were found to be negative.
case_images: CRIGM2018-6040693.001.jpg
case_images: PMC6109490_01_CRIGM2018-6040693.001.jpg
case_images: fig1
case_images: The proximal lesion was near the GE junction and another was located more distally closer to the antrum.  Figure 1 demonstrates the proximal lesion that was located near the greater curvature of the stomach.  Figure 2 displays the distal lesion marked preoperatively located near the antrum of the stomach with no surrounding necrosis or bleeding but was significant for raised mucosal margins in a wheel pattern.
case_images: Subtotal gastrectomy distal lesion measuring 0.7 cm x 0.7 cm x 0.5 cm. The lesion was found to be malignant melanoma of the stomach that is invasive into the submucosa. No lymphovascular invasion was identified. Six negative lymph nodes appreciated with the specimen.
case_images: CRIGM2018-6040693.002.jpg
case_images: PMC6109490_01_CRIGM2018-6040693.002.jpg
case_images: fig2
case_images: The proximal lesion was near the GE junction and another was located more distally closer to the antrum.  Figure 1 demonstrates the proximal lesion that was located near the greater curvature of the stomach.  Figure 2 displays the distal lesion marked preoperatively located near the antrum of the stomach with no surrounding necrosis or bleeding but was significant for raised mucosal margins in a wheel pattern.
case_images: Histological Specimens of Gastric Melanoma. Histological sections of gastrectomy specimen demonstrating primary gastric melanoma. (a) Right side of the image depicts neoplastic cells that do not invade past the submucosa that still retains normal gastric architecture (H&E x100). (b) Primary gastric melanoma positive stain for Melanin A (H&E x100). (c) Primary gastric melanoma positive stain for HMB-45 (H&E x100). (d) Malignant melanocytic neoplasm producing brown melanin pigment with a cherry red nucleoli and mitotic figures (H&E x 400).
case_images: CRIGM2018-6040693.003.jpg
case_images: PMC6109490_01_CRIGM2018-6040693.003.jpg
case_images: fig3
case_images: The pathology associated with the gross specimens is seen in Figures 3 and 4.
case_images: Histological Specimens of Gastric Melanoma. Primary gastric melanoma positive stain for S100. Weak and high intensity staining are seen throughout the section (H&E x100).
case_images: CRIGM2018-6040693.004.jpg
case_images: PMC6109490_01_CRIGM2018-6040693.004.jpg
case_images: fig4
case_images: The pathology associated with the gross specimens is seen in Figures 3 and 4.