ABSTRACT
Gastric metastasis of melanoma are rare, and usually secondary to a cutaneous location. Gastric metastasis of choroidal melanoma are exceptional. Clinical symptoms are absent or atypical causing delay diagnosis. Only earlier diagnosis and complete surgical removal can improve survival of metastatic melanoma. 60 years old patient, treated for choroidal melanoma in 2007, admitted to the emergency for hematemesis. The patient also reported epigastric pain for three months and a weight loss of 10 kg. Upper gastrointestinal endoscopy revealed multiple ulcers with bleeding. Histology revealed a metastasis of melanoma. CT showed no other secondary locations. A total gastrectomy was contemplated. However a fatal gastrointestinal bleeding leads to death of the patient. Clinical symptoms of these metastases are atypical, and complications are rarely revealing. In oesgastroduodénale endoscopy, the presence of one or more nodules sometimes topped by ulcer can suggest the diagnosis. The himmunohistochimie confirm the diagnosis and mainly to amelanotic lesions. Staging must search for other secondary sites: lung, liver, peritoneal. Treatment is surgical and should be considered if complete resection is possible or in case of complications. Survival of gastric metastases of melanoma related to the completeness of resection The occurrence of digestive disorders in patients treated for melanoma must invite practicians to propose a gastrointestinal endoscopy with multiple biopsies to make an early diagnosis of gastric metastasis because only a surgical resection will allow a chance for these patients
ABSTRACT
The coronary circulation has its own particuliarity, it is variable in time and space as it irrigates a constantly movbile organ. Regulation of this circulation is assured by complicated mechanisms, Neural, humoral, and local metabolic factors [autoregulation]. The coronary endothelium plays a fundamental role in liberation of different vasodilator substances mainly nitrous monoxide. Recently, considerable efforts have been directed towards the exploration of functional characteristics of coronary circulation using Doppler methods