LAUSR

A 41-year-old female was diagnosed with ocular malignant melanoma in May 2020. In August 2021, she presented with hepatic metastases affecting both lobes with lesions measuring up to 12 mm in diameter. Transarterial chemoembolisation (TACE) with fotemustine was started in September 2021. Twelve days after the first course, the patient presented with vague abdominal pain and elevated liver enzymes. Computed tomography scan revealed subacute cholecystitis with perforation and suspicion of pericholecystic abscess. An emergency cholecystectomy was performed. Subsequent second and third TACE courses were uneventful. Eight days after the completion of the fourth course, the patient was readmitted with nausea, vomiting, and epigastric pain. An upper endoscopy revealed a large ulcerated lesion, extending from the corpus to the duodenal bulb (Figure 1). The clinical differential diagnosis included a primary gastric cancer versus metastatic melanoma. Multiple biopsies were obtained. The patient is currently well with conservative treatment.