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+This is the case of a 58-year-old white Hispanic woman with a history of uveal melanoma in her right eye (Fig.1).
+She was admitted to the hospital with jaundice and abdominal pain for 10 days.
+On admission, laboratory tests were obtained (a complete blood count was within normal limits, amylase: 136 U/L, total bilirubin: 6.37 mg/dL with a direct fraction of 5.30 mg/dL).
+Cross-sectional, abdominal computed tomography (CT) with contrast, showed a low-attenuating lesion localized in the pancreatic head (measuring 4 × 3 cm) and a thinner section of the distal bile duct suspicious for compression).
+After a multidisciplinary meeting, our patient was scheduled for EUS-FNA.
+EUS showed a solid, heteroechoic with predominantly hypoechoic areas, well-defined lesion with regular contours (measuring 3.1 × 2.6 cm), localized between the head and neck of the pancreas (Fig.2).
+There was no vascular or lymph node invasion identified.
+EUS-FNA was performed with a 22G needle using the fanning technique.
+In the cytology specimens (Fig.3), the cells presented have a discohesive dispersed pattern, with marked variation in size and shape including epithelioid and spindle-shaped cells with plasmacytoid and round nuclei.
+The nuclear chromatin is clumping and irregular with excessive parachromatin clearing, there are single or multiple macronucleoli, and abundant cytoplasm with deep brownish-black granules obscuring the cell details.
+The background shows necrosis and hemorrhage.
+Our patient underwent right orbital exenteration and followed by duodenopancreatectomy (the Whipple procedure), without any complications (Fig.4).
+The surgical specimen showed undifferentiated cells, with extended disposition of brown pigment, infiltrating the pancreas and the serosa of the duodenal wall.
+Immunohistochemistry was positive for Melan-A, HMB45, vimentin, S-100 protein and negative for cytokeratin, all consistent with metastatic malignant melanoma.
+At the moment, our patient is receiving adjuvant chemotherapy at an outside oncology clinic.