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CLINICOPATHOLOGIC ANALYSIS OF MELANOMA METASTASES TO GASTROINTESTINAL SITES FOR A TISSUE MICROARRAY
David G. Su
*, Irvin Yi, Noam Savion Gaiger, David Schoenfeld, Adebowale Adeniran, Sajid A. Khan, Kelly Olino, Harriet M. Kluger
Surgery, Yale New Haven Hospital, New Haven, CT
BackgroundMalignant melanoma is the most common carcinoma to metastasize to the gastrointestinal (GI) tract and has an affinity to spread to the small bowel. Understanding the metastatic patterns can provide valuable insights into disease progression and therapeutic challenges. This study details the construction of a tissue microarray (TMA) representing GI melanoma metastases and the associated clinical characteristics of the cohort.
MethodsThe TMA was developed from specimens derived from patients with melanoma metastases to GI organs, such as the small bowel, colon, stomach, and liver. It features matched pairs of GI and non-gastrointestinal metastatic tissues, as well as tumor tissues adjacent to normal tissues.
Clinical data, including patient demographics, metastatic patterns, and outcomes, were collected and analyzed.
ResultsThe TMA comprises 57 cases of GI melanoma metastases, with 26 cases (46%) in the small bowel, 5 (8.7%) in the colon, and 8 (14%) in the liver. The age at diagnosis was 54 +/- 14.7 years (mean +/- SD). Samples of tumor-adjacent normal tissue were included in 70% of cases (n=40), and 33% of the cases provided matched pairs of GI and non-GI tissues. Clinically, 14% of the patients were diagnosed with stage IV melanoma presenting synchronously with other metastases, whereas 86% had earlier stages (I-III). Genetic analyses revealed BRAF mutations in 35% of the small bowel samples, NRAS mutations in 4 cases, and a cKit mutation in 1 case. The median overall survival was recorded at 8.9 years.
ConclusionThis tissue microarray of melanoma metastases to GI organs constitutes a valuable resource for examining the molecular and pathological attributes of melanoma’s metastatic behavior to the GI tract. The array facilitates a deeper understanding of the organ-specific metastatic patterns, providing a basis for future studies to identify new therapeutic targets and prognostic biomarkers.
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