Primary malignant melanoma of the biliary tract: A case report and literature review

BACKGROUND: Primary malignant melanoma of the biliary tract (MBT) is a rare condition whose diagnosis requires excluding a primary origin in another location. This paper reviews the most important characteristics of MBT cases published in the literature and reports a new case. The patient reported here is the first case of primary malignant melanoma of the biliary tract with pulmonary metastasis treated with immunotherapy. This patient remains disease-free 36 mo after the treatment of metastatic lung lesions. CASE SUMMARY: A 51-year-old man was admitted to the gastrointestinal department to study obstructive jaundice of a 1 wk clinical course. Magnetic resonance cholangiopancreatography revealed dilatation of the intrahepatic biliary tract and stenosis of the common hepatic duct. Given the suspicion of biliary tract neoplasia, cholecystectomy and resection of the common hepatic duct were performed with hepatic jejunostomy free of complications. Anatomo-pathological diagnosis was melanoma. After intervention, the patient was referred to the Department of Medical Oncology, where a primary origin was excluded in the skin, mucosa, and eyes. This confirmed diagnosis of primary biliary tract melanoma. Computed tomography was performed 12 mo after the procedure revealed several subcentimetric lung nodules. Wedge resection was performed. After confirming the diagnosis of pulmonary metastasis of primary melanoma of the biliary tract, the patient was started on immunotherapy with nivolumab. Tolerance to treatment was excellent. The patient remains disease-free 36 mo after the treatment of metastatic lung lesions. CONCLUSION: The patient reported here is the first case of primary malignant melanoma of the biliary tract with lung metastases successfully treated with immunotherapy

Irrigation with treated wastewater affected the minor components of virgin olive oil from cv. Chemlali in Tunisia

Water limitation for agriculture is a problem in many countries and irrigation with treated wastewater (TWW) can be a tool to face the decreasing availability of water for important domestic crops such as olive. Taking into account this aspect, a research was carried out for 13 years in an olive grove (Chemlali cultivar) located in the area of Sfax (Tunisia). Two different irrigation treatments were applied: (a) irrigation with good quality water (GQW) and (b) irrigation with TWW. The main objective of this 13-year study was to verify the effects of the irrigation with TWW vs. GQW on some minor parameters of the virgin olive oil. Many oil parameters significantly increased in the TWW irrigated plot, in particular lutein, total tocopherols, squalene, campesterol and stigmasterol whereas β-carotene, α-tocopherol, δ-tocopherol, β-sitosterol and total sterols decreased with respect to the GQW treatment. Irrigation with TWW can be a possible tool to irrigate olive groves with two positive effects: saving of freshwater and production of olive oil of good quality