[Metastatic ovarian melanoma in a 26-year-old patient]

In a 16 year old patient a superficially spreading malignant melanoma had been excised from the left temple. Ten years later, she represented with lower abdominal pain. On examination cystic adnexal masses were found and median laparotomy was performed. Intraoperatively bilateral polycystic, dark-coloured ovarian tumors were found, each measuring about 10 x 10 x 10 cm. Hysterectomy with bilateral salpingo-oophorectomy and resection of the great omentum was performed. Uterus and ovaries weighed 3.480 g. At microscopic examination large metastases of a pigmented melanoblastoma were found in both ovaries. Two months after surgery she succumbed to multiple cerebral metastases. For primary ovarian melanoma radical surgery with lymphonodectomy is mandatory. The operation is to be followed by immuno- and chemotherapy. In case of metastatic melanoma of the ovaries individual decisions concerning the extent of the surgical procedure are to be made. In any case, however, bilateral salpingo-oophorectomy should be performed, preferably combined with hysterectomy.