{"id":"https://openalex.org/W7223670170","doi":"https://doi.org/10.70352/scrj.cr.26-0580","title":"Absence of Viable Tumor Cells in Macroscopically Pigmented Regional Lymph Nodes after Immune Checkpoint Inhibitor Therapy in Duodenal Metastasis of Cutaneous Melanoma: A Case Report","display_name":"Absence of Viable Tumor Cells in Macroscopically Pigmented Regional Lymph Nodes after Immune Checkpoint Inhibitor Therapy in Duodenal Metastasis of Cutaneous Melanoma: A Case Report","publication_year":2026,"publication_date":"2026-01-01","ids":{"openalex":"https://openalex.org/W7223670170","doi":"https://doi.org/10.70352/scrj.cr.26-0580","pmid":"https://pubmed.ncbi.nlm.nih.gov/42959015","pmcid":"https://www.ncbi.nlm.nih.gov/pmc/articles/13716546"},"language":"en","primary_location":{"id":"doi:10.70352/scrj.cr.26-0580","doi":"https://doi.org/10.70352/scrj.cr.26-0580","is_oa":true,"landing_page_url":"https://doi.org/10.70352/scrj.cr.26-0580","pdf_url":"https://www.jstage.jst.go.jp/article/scrj/12/1/12_cr.26-0580/_pdf","source":{"id":"https://openalex.org/S2738567394","display_name":"Surgical Case Reports","issn_l":"2198-7793","issn":["2198-7793"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","poland-20","russia-white-list-3"],"host_organization":"https://openalex.org/P4310319965","host_organization_name":"Springer Nature","host_organization_lineage":["https://openalex.org/P4310319965"],"host_organization_lineage_names":["Springer Nature"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Surgical Case Reports","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref","doaj","pubmed"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://www.jstage.jst.go.jp/article/scrj/12/1/12_cr.26-0580/_pdf","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5015315236","display_name":"\u6d77\u91ce\u826f\u592a","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I115498069","display_name":"Jikei University School of Medicine","ror":"https://ror.org/039ygjf22","country_code":"JP","type":"education","lineage":["https://openalex.org/I115498069"]}],"countries":["JP"],"is_corresponding":false,"raw_author_name":"Ryota Unno","raw_affiliation_strings":["Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan","institution_ids":["https://openalex.org/I115498069"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5101428121","display_name":"Yoshihiro Shirai","orcid":"https://orcid.org/0000-0002-4907-0101","observed_orcids":["https://orcid.org/0000-0002-4907-0101"]},"institutions":[{"id":"https://openalex.org/I115498069","display_name":"Jikei University School of Medicine","ror":"https://ror.org/039ygjf22","country_code":"JP","type":"education","lineage":["https://openalex.org/I115498069"]}],"countries":["JP"],"is_corresponding":true,"raw_author_name":"Yoshihiro Shirai","raw_affiliation_strings":["Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan"],"raw_orcid":"https://orcid.org/0000-0002-4907-0101","affiliations":[{"raw_affiliation_string":"Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan","institution_ids":["https://openalex.org/I115498069"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5054893133","display_name":"Yoshimasa Nobeyama","orcid":"https://orcid.org/0000-0002-0125-8930","observed_orcids":["https://orcid.org/0000-0002-0125-8930"]},"institutions":[{"id":"https://openalex.org/I115498069","display_name":"Jikei University School of Medicine","ror":"https://ror.org/039ygjf22","country_code":"JP","type":"education","lineage":["https://openalex.org/I115498069"]}],"countries":["JP"],"is_corresponding":false,"raw_author_name":"Yoshimasa Nobeyama","raw_affiliation_strings":["Department of Dermatology, The Jikei University School of Medicine, Tokyo, Japan"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Dermatology, The Jikei University School of Medicine, Tokyo, Japan","institution_ids":["https://openalex.org/I115498069"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5139397301","display_name":"Tafu Watatani","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I115498069","display_name":"Jikei University School of Medicine","ror":"https://ror.org/039ygjf22","country_code":"JP","type":"education","lineage":["https://openalex.org/I115498069"]}],"countries":["JP"],"is_corresponding":false,"raw_author_name":"Tafu Watatani","raw_affiliation_strings":["Department of Pathology, The Jikei University School of Medicine, Tokyo, Japan"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Pathology, The Jikei University School of Medicine, Tokyo, Japan","institution_ids":["https://openalex.org/I115498069"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5075524860","display_name":"Takeshi Gocho","orcid":"https://orcid.org/0000-0002-8463-905X","observed_orcids":["https://orcid.org/0000-0002-8463-905X"]},"institutions":[{"id":"https://openalex.org/I115498069","display_name":"Jikei University School of Medicine","ror":"https://ror.org/039ygjf22","country_code":"JP","type":"education","lineage":["https://openalex.org/I115498069"]}],"countries":["JP"],"is_corresponding":false,"raw_author_name":"Takeshi Gocho","raw_affiliation_strings":["Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan"],"raw_orcid":"https://orcid.org/0000-0002-8463-905X","affiliations":[{"raw_affiliation_string":"Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan","institution_ids":["https://openalex.org/I115498069"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5049959626","display_name":"Michinori Matsumoto","orcid":"https://orcid.org/0000-0002-5860-1103","observed_orcids":["https://orcid.org/0000-0002-5860-1103"]},"institutions":[{"id":"https://openalex.org/I115498069","display_name":"Jikei University School of Medicine","ror":"https://ror.org/039ygjf22","country_code":"JP","type":"education","lineage":["https://openalex.org/I115498069"]}],"countries":["JP"],"is_corresponding":false,"raw_author_name":"Michinori Matsumoto","raw_affiliation_strings":["Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan"],"raw_orcid":"https://orcid.org/0000-0002-5860-1103","affiliations":[{"raw_affiliation_string":"Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan","institution_ids":["https://openalex.org/I115498069"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5067080279","display_name":"Munetoshi Akaoka","orcid":"https://orcid.org/0000-0002-3252-3055","observed_orcids":["https://orcid.org/0000-0002-3252-3055"]},"institutions":[{"id":"https://openalex.org/I115498069","display_name":"Jikei University School of Medicine","ror":"https://ror.org/039ygjf22","country_code":"JP","type":"education","lineage":["https://openalex.org/I115498069"]}],"countries":["JP"],"is_corresponding":false,"raw_author_name":"Munetoshi Akaoka","raw_affiliation_strings":["Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan"],"raw_orcid":"https://orcid.org/0000-0002-3252-3055","affiliations":[{"raw_affiliation_string":"Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan","institution_ids":["https://openalex.org/I115498069"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5159730892","display_name":"Isamu Suzuki","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I115498069","display_name":"Jikei University School of Medicine","ror":"https://ror.org/039ygjf22","country_code":"JP","type":"education","lineage":["https://openalex.org/I115498069"]}],"countries":["JP"],"is_corresponding":false,"raw_author_name":"Isamu Suzuki","raw_affiliation_strings":["Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan","institution_ids":["https://openalex.org/I115498069"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5037753214","display_name":"Koichiro Haruki","orcid":"https://orcid.org/0000-0002-1686-3228","observed_orcids":["https://orcid.org/0000-0002-1686-3228"]},"institutions":[{"id":"https://openalex.org/I115498069","display_name":"Jikei University School of Medicine","ror":"https://ror.org/039ygjf22","country_code":"JP","type":"education","lineage":["https://openalex.org/I115498069"]}],"countries":["JP"],"is_corresponding":false,"raw_author_name":"Koichiro Haruki","raw_affiliation_strings":["Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan"],"raw_orcid":"https://orcid.org/0000-0002-1686-3228","affiliations":[{"raw_affiliation_string":"Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan","institution_ids":["https://openalex.org/I115498069"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5025740085","display_name":"Kenei Furukawa","orcid":"https://orcid.org/0000-0002-5081-6417","observed_orcids":["https://orcid.org/0000-0002-5081-6417"]},"institutions":[{"id":"https://openalex.org/I115498069","display_name":"Jikei University School of Medicine","ror":"https://ror.org/039ygjf22","country_code":"JP","type":"education","lineage":["https://openalex.org/I115498069"]}],"countries":["JP"],"is_corresponding":false,"raw_author_name":"Kenei Furukawa","raw_affiliation_strings":["Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan"],"raw_orcid":"https://orcid.org/0000-0002-5081-6417","affiliations":[{"raw_affiliation_string":"Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan","institution_ids":["https://openalex.org/I115498069"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5056881700","display_name":"Toru Ikegami","orcid":"https://orcid.org/0000-0001-5792-5045","observed_orcids":["https://orcid.org/0000-0001-5792-5045"]},"institutions":[{"id":"https://openalex.org/I115498069","display_name":"Jikei University School of Medicine","ror":"https://ror.org/039ygjf22","country_code":"JP","type":"education","lineage":["https://openalex.org/I115498069"]}],"countries":["JP"],"is_corresponding":false,"raw_author_name":"Toru Ikegami","raw_affiliation_strings":["Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan"],"raw_orcid":"https://orcid.org/0000-0001-5792-5045","affiliations":[{"raw_affiliation_string":"Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan","institution_ids":["https://openalex.org/I115498069"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":1,"corresponding_author_ids":["https://openalex.org/A5101428121"],"corresponding_institution_ids":["https://openalex.org/I115498069"],"apc_list":{"value":1535,"currency":"USD","value_usd":1535},"apc_paid":{"value":1535,"currency":"USD","value_usd":1535},"fwci":0.0,"has_fulltext":true,"cited_by_count":0,"citation_normalized_percentile":{"value":0.7987473,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"12","issue":"1","first_page":"n/a","last_page":"n/a"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10392","display_name":"Cutaneous Melanoma Detection and Management","score":0.4934000074863434,"subfield":{"id":"https://openalex.org/subfields/2730","display_name":"Oncology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10392","display_name":"Cutaneous Melanoma Detection and Management","score":0.4934000074863434,"subfield":{"id":"https://openalex.org/subfields/2730","display_name":"Oncology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10158","display_name":"Cancer Immunotherapy and Biomarkers","score":0.47749999165534973,"subfield":{"id":"https://openalex.org/subfields/2730","display_name":"Oncology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T12992","display_name":"Metastasis and carcinoma case studies","score":0.008999999612569809,"subfield":{"id":"https://openalex.org/subfields/2740","display_name":"Pulmonary and Respiratory Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/cutaneous-melanoma","display_name":"cutaneous melanoma","score":0.8949999809265137},{"id":"https://openalex.org/keywords/duodenal-metastasis","display_name":"duodenal metastasis","score":0.9929999709129333},{"id":"https://openalex.org/keywords/immune-checkpoint-inhibitors","display_name":"immune checkpoint inhibitors","score":0.8360000252723694},{"id":"https://openalex.org/keywords/peripancreatic-lymph-nodes","display_name":"peripancreatic lymph nodes","score":0.8159999847412109},{"id":"https://openalex.org/keywords/pancreaticoduodenectomy","display_name":"pancreaticoduodenectomy","score":0.9570000171661377},{"id":"https://openalex.org/keywords/gastrointestinal-metastasis","display_name":"gastrointestinal metastasis","score":0.625},{"id":"https://openalex.org/keywords/tumor-draining-lymph-nodes","display_name":"tumor-draining lymph nodes","score":0.7080000042915344},{"id":"https://openalex.org/keywords/histopathological-evaluation","display_name":"histopathological evaluation","score":0.44699999690055847}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.8295999765396118},{"id":"https://openalex.org/C2779720271","wikidata":"https://www.wikidata.org/wiki/Q179422","display_name":"Lymph","level":2,"score":0.6456000208854675},{"id":"https://openalex.org/C142724271","wikidata":"https://www.wikidata.org/wiki/Q7208","display_name":"Pathology","level":1,"score":0.5008000135421753},{"id":"https://openalex.org/C2779013556","wikidata":"https://www.wikidata.org/wiki/Q181876","display_name":"Metastasis","level":3,"score":0.4943999946117401},{"id":"https://openalex.org/C8891405","wikidata":"https://www.wikidata.org/wiki/Q1059","display_name":"Immune system","level":2,"score":0.48919999599456787},{"id":"https://openalex.org/C502942594","wikidata":"https://www.wikidata.org/wiki/Q3421914","display_name":"Cancer research","level":1,"score":0.4745999872684479},{"id":"https://openalex.org/C2780851360","wikidata":"https://www.wikidata.org/wiki/Q21686041","display_name":"Immune checkpoint","level":4,"score":0.39480000734329224},{"id":"https://openalex.org/C3020616263","wikidata":"https://www.wikidata.org/wiki/Q1216998","display_name":"Tumor cells","level":2,"score":0.38850000500679016},{"id":"https://openalex.org/C2777701055","wikidata":"https://www.wikidata.org/wiki/Q1427096","display_name":"Immunotherapy","level":3,"score":0.32179999351501465},{"id":"https://openalex.org/C2777658100","wikidata":"https://www.wikidata.org/wiki/Q180614","display_name":"Melanoma","level":2,"score":0.3131999969482422},{"id":"https://openalex.org/C2992571226","wikidata":"https://www.wikidata.org/wiki/Q170758","display_name":"Lymph node metastasis","level":4,"score":0.2847999930381775},{"id":"https://openalex.org/C169382597","wikidata":"https://www.wikidata.org/wiki/Q21208025","display_name":"Programmed cell death 1","level":5,"score":0.28049999475479126},{"id":"https://openalex.org/C2780283643","wikidata":"https://www.wikidata.org/wiki/Q2110267","display_name":"Primary tumor","level":4,"score":0.2705000042915344},{"id":"https://openalex.org/C2778326572","wikidata":"https://www.wikidata.org/wiki/Q7852668","display_name":"Tumor-infiltrating lymphocytes","level":4,"score":0.26330000162124634},{"id":"https://openalex.org/C181152851","wikidata":"https://www.wikidata.org/wiki/Q712604","display_name":"Lymphatic system","level":2,"score":0.26080000400543213},{"id":"https://openalex.org/C2780849966","wikidata":"https://www.wikidata.org/wiki/Q170758","display_name":"Lymph node","level":2,"score":0.2590999901294708}],"mesh":[],"locations_count":3,"locations":[{"id":"doi:10.70352/scrj.cr.26-0580","doi":"https://doi.org/10.70352/scrj.cr.26-0580","is_oa":true,"landing_page_url":"https://doi.org/10.70352/scrj.cr.26-0580","pdf_url":"https://www.jstage.jst.go.jp/article/scrj/12/1/12_cr.26-0580/_pdf","source":{"id":"https://openalex.org/S2738567394","display_name":"Surgical Case Reports","issn_l":"2198-7793","issn":["2198-7793"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","poland-20","russia-white-list-3"],"host_organization":"https://openalex.org/P4310319965","host_organization_name":"Springer Nature","host_organization_lineage":["https://openalex.org/P4310319965"],"host_organization_lineage_names":["Springer Nature"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Surgical Case Reports","raw_type":"journal-article"},{"id":"pmh:oai:pubmedcentral.nih.gov:13716546","doi":null,"is_oa":true,"landing_page_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13716546/","pdf_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13716546/pdf/scr-12-01-26-0580.pdf","source":{"id":"https://openalex.org/S2764455111","display_name":"PubMed Central","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Surg Case Rep","raw_type":"Text"},{"id":"pmid:42959015","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/42959015","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Surgical case reports","raw_type":"Case Reports"}],"best_oa_location":{"id":"doi:10.70352/scrj.cr.26-0580","doi":"https://doi.org/10.70352/scrj.cr.26-0580","is_oa":true,"landing_page_url":"https://doi.org/10.70352/scrj.cr.26-0580","pdf_url":"https://www.jstage.jst.go.jp/article/scrj/12/1/12_cr.26-0580/_pdf","source":{"id":"https://openalex.org/S2738567394","display_name":"Surgical Case Reports","issn_l":"2198-7793","issn":["2198-7793"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","poland-20","russia-white-list-3"],"host_organization":"https://openalex.org/P4310319965","host_organization_name":"Springer Nature","host_organization_lineage":["https://openalex.org/P4310319965"],"host_organization_lineage_names":["Springer Nature"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Surgical Case Reports","raw_type":"journal-article"},"sustainable_development_goals":[{"score":0.98580002784729,"id":"https://metadata.un.org/sdg/3","display_name":"Good health and well-being"}],"study_designs":[{"id":"https://openalex.org/study-designs/case-report","display_name":"Case Report"}],"awards":[{"id":"https://openalex.org/G4150582425","display_name":"MHC-I\u9ad8\u767a\u73fe\u81b5\u764c\u306b\u304a\u3051\u308b\u304c\u3093\u95a2\u9023\u7dda\u7dad\u82bd\u7d30\u80de\u306b\u7740\u76ee\u3057\u305f\u514d\u75ab\u56de\u907f\u6a5f\u69cb\u306e\u89e3\u660e","funder_award_id":"26K11655","funder_id":"https://openalex.org/F4320334764","funder_display_name":"Japan Society for the Promotion of Science"}],"funders":[{"id":"https://openalex.org/F4320334764","display_name":"Japan Society for the Promotion of Science","ror":"https://ror.org/00hhkn466"}],"has_content":{"grobid_xml":true,"pdf":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7223670170.pdf","grobid_xml":"https://content.openalex.org/works/W7223670170.grobid-xml"},"referenced_works_count":0,"referenced_works":[],"related_works":["https://openalex.org/W7067540810","https://openalex.org/W2414567129","https://openalex.org/W4285405153","https://openalex.org/W4210433978","https://openalex.org/W3157900239","https://openalex.org/W4308572063","https://openalex.org/W2895508627","https://openalex.org/W4387304712","https://openalex.org/W4403846636","https://openalex.org/W2334155869"],"abstract_inverted_index":{"INTRODUCTION:":[0],"Malignant":[1],"melanoma":[2,59],"frequently":[3],"metastasizes":[4],"to":[5,171],"the":[6,24,32,61,71,87,98,132,143,178,192,195],"gastrointestinal":[7,43],"tract,":[8],"but":[9],"duodenal":[10,67,88],"metastasis":[11,44],"is":[12,20,169],"uncommon,":[13],"and":[14,66,116,124,165],"pancreaticoduodenectomy":[15],"(PD)":[16],"for":[17,86,184,194],"this":[18],"indication":[19],"rare,":[21],"particularly":[22],"in":[23],"era":[25],"of":[26,35,56,60,180,197],"immune":[27],"checkpoint":[28],"inhibitors":[29],"(ICIs).":[30],"Moreover,":[31],"histological":[33],"consequences":[34],"ICI":[36,79,158,189],"therapy":[37,159],"within":[38,142],"regional":[39,95,144],"lymph":[40,100,145,186,198],"nodes":[41,101,187],"draining":[42],"remain":[45,201],"poorly":[46],"documented.":[47],"CASE":[48],"PRESENTATION:":[49],"A":[50],"67-year-old":[51],"woman":[52],"with":[53,76,112],"a":[54],"history":[55],"cutaneous":[57],"malignant":[58],"thumb":[62],"developed":[63],"metachronous":[64],"ileocecal":[65],"metastases":[68],"years":[69],"after":[70,157],"initial":[72],"resection,":[73],"during":[74,188],"treatment":[75],"ICIs.":[77],"After":[78],"therapy,":[80,190],"she":[81],"underwent":[82],"subtotal":[83],"stomach-preserving":[84],"PD":[85],"metastasis.":[89,107],"Although":[90],"preoperative":[91],"PET/CT":[92],"showed":[93],"no":[94,117],"nodal":[96,106],"uptake,":[97],"peripancreatic":[99],"appeared":[102],"macroscopically":[103],"black,":[104],"mimicking":[105],"Histopathological":[108],"examination":[109],"revealed":[110],"fibrosis":[111],"CD68-positive,":[113],"melanin-laden":[114],"macrophages":[115],"viable":[118,137,163],"tumor":[119,138],"cells;":[120],"Melan-A":[121],"was":[122,134,150],"negative,":[123],"Berlin":[125],"blue":[126],"staining":[127],"excluded":[128],"hemosiderin,":[129],"confirming":[130],"that":[131],"pigment":[133],"melanin.":[135],"No":[136],"cells":[139],"were":[140],"identified":[141],"nodes.":[146],"The":[147],"postoperative":[148],"course":[149],"uneventful.":[151],"CONCLUSIONS:":[152],"Macroscopically":[153],"pigmented":[154],"\"black":[155],"nodes\"":[156],"may":[160],"not":[161],"represent":[162],"metastasis,":[164],"detailed":[166],"pathological":[167],"evaluation":[168],"essential":[170],"avoid":[172],"misinterpretation.":[173],"This":[174],"case":[175],"also":[176],"raises":[177],"possibility":[179],"an":[181],"immunological":[182],"role":[183],"tumor-draining":[185],"although":[191],"implications":[193],"timing":[196],"node":[199],"dissection":[200],"uncertain.":[202]},"counts_by_year":[],"updated_date":"2026-11-08T12:12:28.789561","created_date":"2026-10-27T00:00:00"}