Melanoma of unknown primary in the pancreas: should it be considered primary?

BACKGROUND: Malignant melanoma is characterized as highly malignant due to its rapid growth and early metastasis. Metastatic melanoma from occult primary is rare. Melanoma of unknown primary in pancreas are even rear. But it is a biologically ill-defined and clinically understudied concept. CASE PRESENTATION: In this report, a 43-year-old man was diagnosed with pancreatic carcinoma. Extended total pancreatectomy together with portal vein reconstruction and extensive lymphadenectomy were performed in our hospital. The patient was diagnosed with pancreatic malignant melanoma after pathological examination. He was still alive 20 months after the operation without any evidence of recurrence. CONCLUSION: The described case highlights the possibility of primary pancreatic malignant melanoma and the treatment strategies of this rare carcinoma.