Rare Case Of Malignant Melanoma Research Articles

Gastric outlet obstruction secondary to malignant melanoma: A case report

Gastric Outlet Obstruction (GOO) is a common clinical condition. The commonest causes are benign gastric ulcer and gastric cancer involving the antrum. Malignant melanoma of the duodenum causing GOO is extremely rare. We herein present a rare case of malignant melanoma involving the first part of duodenum and proximal jejunum who presented with features of gastric outlet obstruction.

Atypical Ulcer Arising on Stasis Dermatitis: Achromic Melanoma

Due to venous insufficiency, a vascular ulcer frequently occurs with the progression of stasis dermatitis. Achromic melanoma, a rare form of pigmentless melanoma frequently located on the sole of the foot, is often and easily confused with a typical wound. Diagnosis of ulcerated achromic melanoma is thus often delayed and associated with a poor prognosis. The authors report a very rare case of malignant melanoma in a 70-year-old female with stasis dermatitis. The painless ulcer was present for 1 year before the first visit. Upon clinical examination, a 2-cm diameter hypergranulating ulcer with irregular and pigmented borders was present. Dermoscopy revealed the presence of red globules, a gray-to-blue veil, irregular vessels, and the remains of a pigmented ridge pattern. Histological analysis showed infiltration of atypical melanocytes in the dermis, 2 mitoses, and ulceration. Diagnosis of melanoma was confirmed by positive MART-1 immunochemistry. After removal of the melanoma, the area was covered with an autologous skin graft excised from the inner thigh. In accordance with the guidelines, sentinel lymph node biopsy was performed, and the result was negative for lymph node involvement. A comprehensive clinical dermoscopic evaluation led to the correct diagnosis. The current case highlights the importance of evaluating a chronic, atypical, nonhealing ulcer clinically and dermoscopically as well as through a biopsy procedure.

Two case reports of malignant melanoma rectum

Malignant melanoma of the rectum is an extremely rare disease. It typically presents in the fifth or sixth decade predominantly in female sex. The first symptoms are nonspecific such as bleeding, anal mass or pain. A timely diagnosis of melanoma is made even more difficult due to lack of obvious pigmentation and histologically amelanotic. Anorectal malignant melanoma spread along submucosal planes and are often beyond complete resection at the time of diagnosis. Prognosis is very poor. We present a rare case of malignant melanoma of rectum in a 21-year-old male, who was diagnosed at advanced stage, and a case of malignant melanoma in a 50-year-old male, who underwent abdominoperineal resection with permanent colostomy. Anorectal malignant melanoma is difficult to diagnose and prognosis is poor.

A case of malignant melanoma mixed with a cervical lymph node metastatic lesion of undifferentiated cancer occurring in the maxillary gingiva

The histopathology of metastatic lesions are usually the same as primary lesions in malignant tumors. We report a rare case of malignant melanoma that was mixed with a cervical lymph node metastatic lesion of undifferentiated cancer occurring in the maxillary gingiva. The patient was referred to our department because of pain in the area of the maxillary anterior teeth. After confirmation of undifferentiated cancer by biopsy, a right partial maxillectomy and extended supraomohyoid neck dissection were performed. Histopathological examination revealed that the primary lesion was undifferentiated cancer and the metastatic lesion was malignant melanoma. We suggested the possibility that a malignant melanoma of unknown primary origin and the undifferentiated cancer in the maxillary gingiva metastasized to the same cervical lymph node as a collision tumor.

Pigmentation in the oral cavity – a report of a rare case of malignant melanoma

Pigmentation in the oral cavity – a report of a rare case of malignant melanoma

Malignant melanoma of the female urethra

Backgrounds: Malignant melanoma (MM) of urethra is extremely rare; only 84 cases have been reported in PubMed search.Case: An 84-year-old woman presented dysuria. Physical and endoscopic examination revealed a polypoid tumor in proximal urethra, and endoscopic tumorectomy was performed. The tumor could not be seen in outer genitalia. Grossly, the tumor is brownish soft tumor measuring 15 mm × 26 mm × 23 mm. Multiple sections were made and immunohistochemical procedures were performed. Microscopically, malignant epithelioid cells with brown pigment were seen to proliferate and invade. The size of tumor was circa 13 mm × 21 mm × 18 mm. The depth of invasion was 10 mm (pT4), but it was not clear whether the marginal tissue status is positive or negative. Lymphovascular permeation seen, yet no obvious vascular invasion was noted. The brown pigment was found to be melanin by Masson-Fontana stain. Immunohistochemical study showed tumor cells were positive for vimentin, S100 protein, HMB45, Melan A, p53, and Ki67 (labeling = 85%), KIT and PDGFRA, while they were negative for cytokeratins. Genetic analysis of paraffin-embedded tumor tissue identified no mutations in hot spots of KIT and PDGFRA genes. No apparent metastatic lesions were seen after the diagnosis. The outcome of the patient is unknown because the patient was referred to a large hospital specializing in cancer treatment.Conclusions: The author presented a very rare case of MM of the proximal urethra. The MM showed typical histochemical and immunohistochemical features. No mutations of KIT and PDGFRA were seen.

Primary mediastinal melanoma presenting as superior vena cava syndrome: A case study

The rates of melanoma have increased over the past 30 years. Malignant melanoma most commonly occurs in the skin with secondary involvement of other organs. Here, we present an extremely rare case of malignant melanoma of the mediastinum with presentation of superior vena cava syndrome without clinical evidence of extrathoracic disease. The incidence of this clinical presentation is uncommon, resulting in only a handful of case reports in the literature.

Malignant melanoma and papillary thyroid carcinoma that were diagnosed concurrently and treated simultaneously: A case report.

Malignant melanoma can be successfully treated when it is identified in its early stages, but the disease is associated with a poor prognosis when it is detected in an advanced stage. Papillary thyroid carcinoma is a thyroid cancer that has a good prognosis. The present study reports a rare case of malignant melanoma and papillary thyroid carcinoma that were diagnosed concurrently and treated simultaneously. The present patient was a 37-year-old male, in whom examination of a skin biopsy that was obtained from a lesion in the right retroauricular region revealed the lesion to be consistent with malignant melanoma. The patient underwent radical neck dissection upon the detection of malignant melanoma metastasis to the sentinel lymph node. Metastases of papillary thyroid carcinoma were detected in four out of 38 lymph nodes. The patient was then diagnosed with papillary thyroid carcinoma and underwent total thyroidectomy. The patient was administered with high-dose followed by moderate-dose interferon-α therapy for the treatment of malignant melanoma. The patient also received concurrent radioactive iodine therapy for the treatment of papillary thyroid carcinoma, at the same time as the interferon therapy. The two primary tumors of the patient were treated successfully. During therapy, no serious side-effects were observed, with the exception of fever caused by high-dose interferon therapy. Malignant melanoma and papillary thyroid carcinoma may occur concurrently, although this is rarely observed. The present study reports a rare case that demonstrates that the two tumors can be successfully treated simultaneously.

A Rare Case of Malignant Melanoma to the Jejunem, Diagnosed on Small Bowel Enteroscopy

Introduction: A 63-year-old male was transferred to our center from an outside hospital after presenting with complaints of left hand numbness and dizziness, which had been ongoing for a few days. A head CT revealed 2 masses, which led to his transfer in order to evaluate for a likely malignancy and subsequently, a metastatic work-up. The patient denied any nausea, vomiting, diarrhea, constipation, abdominal pain, fevers, melena, and hematochezia. He also denied any prior endoscopic procedures. The patient had a contrast CT of the chest, abdomen, and pelvis, which revealed a 4 x 5-cm right atrial mass (later thought to be a thrombus based on MRI), and a 9 x 7-cm mid small bowel mass with surrounding lymphadenopathy and fat stranding, concerning for a primary small intestinal malignancy. Small bowel enteroscopy was performed and a large circumferential, fungating, ulcerated, and infiltrated mass with no bleeding was found in the proximal jejunum at 50-60 cm from the pylorus. This was biopsied and pathology returned positive for metastatic melanoma. After further evaluation, the patient was also found to have a lesion on the skin of his back, which was also biopsied and returned positive for melanoma in situ. The patient was then started on whole brain radiation and trametinib for palliative therapy. The patient underwent a complicated hospital course, which ultimately resulted in comfort care measures and ultimately, expiration. Small bowel tumors only account for 3-6% of all GI tumors, and only 1.5-4% of GI metastases from cutaneous melanoma are ever diagnosed in a patient’s lifetime. Our case highlights a rare presentation that lent itself to diagnosis via push enteroscopy. While there is some suggestion of the possibility for primary GI melanoma, some authors have suggested that there is no such entity and that they all result from a non-GI primary site, such as a regressed cutaneous source. The gold standard for therapy at this time remains surgical resection of metastatic bowel, but as a means of palliation and not cure. Newer systemic chemotherapies and immunotherapies are being FDA-approved in recent years, which may show promise in the coming future.

P2–100 - Severe Iron-Deficiency Anemia Diagnosed as Having Malignant Melanoma of Unknown Origin

Introduction: Gastrointestinal malignant tumors should be considered as a cause of iron-deficiency anemia especially in elderly people. Here we report a rare case of severe iron-deficiency anemia diagnosed as having malignant melanoma of unknown origin. Case: A 63-year-old female presented to a local hospital with dyspnea on effort and was referred to our facility for an investigation of the cause of severe anemia. After diagnosis of iron-deficiency anemia was fixed, she was hospitalized for further detailed examination. On admission her consciousness was impaired (Japan Coma Scale: between I-3 and II-10) and the head computed tomography (CT) revealed multiple metastatic lesions in her bilateral cerebral hemispheres. Furthermore, a 4-cm tumor was found in the occipital skin, whole body CT revealed multiple micronodules in the breasts, lungs and abdominal cavity, and upper gastrointestinal endoscopy showed neoplastic lesions in the duodenum. Although the primary lesion could not be determined, biopsy from the occipital, breast and duodenal tumors led to the diagnosis of malignant melanoma. Before the pathological results were established, her condition deteriorated and she died on the 12th day of hospitalization. Discussion: Malignant melanoma of unknown origin is rare disease and lymph node is considered to be the most common primary location in that case. Although we were unable to investigate the lesions in the colon, to our knowledge, this is a rare case of malignant melanoma where anemia was the first presented symptom. I will make a presentation with bibliographic consideration.

Primary Oral Malignant Melanoma

Malignant melanoma (MM) is a malignant neoplasm of epidermal melanocytes. Primary malignant melanoma (PMM) is rarely found in the oral cavity. It is estimated at between 0.2 and 8% of all melanomas and approximately four times more frequently in the oral mucosa of the upper jaw, usually on the palate and anterior gingiva. It is more prevalent in the older population having 50 to 80 years of age. Males are more commonly affected than females. Some rare cases of involvement of lip, mandibular gingiva and buccal mucosa were also reported previously. Here, we are reporting a rare case of MM in the oral cavity of 60-year-old male patient involving mandibular gingiva.

Posterior Fossa Malignant Melanoma Mimicking Meningioma: a Case Report

Malignant melanoma [pigmented tumours] of brain is relatively rare in clinical practice. These tumours may be primary or secondary in origin. We are reporting a rare case of malignant melanoma, primary/metachronous (a secondary deposit elsewhere after a decade of primary excision). On CT scan, this lesion was mimicking like falx cerebellar meningioma, which was totally extra-axial in nature. Nearly 40% of melanoma patients will have metastasis to brain. Despite good chemo and radio therapy these patients carry poor prognosis. About 14% cases have no identifiable primary tumour.

Bilateral testicular metastases in malignant melanoma

Ultrasound is the imaging modality of choice in the delineation of scrotal pathology and readily differentiates testicular from extratesticular disease. Primary testicular malignancy is widely recognized; metastatic disease within the testes is a relatively unusual occurrence arising most frequently in patients with lymphoma or disseminated prostate or bronchial cancer. Testicular metastases secondary to malignant melanoma is a particularly rare finding, which is invariably confined to postmortem examinations. We present the ultrasonic appearances of a rare case of malignant melanoma with bilateral testicular metastases which arose during the course of the illness.

Identification of Biomarkers in an Oral Malignant Melanoma Case with Potential for Therapeutic Intervention

A 32-year old female patient presented with the tumor of the oral cavity at the Kidwai Memorial Institute of Oncology, Bangalore, India. Clinical examination and histopathological analyses confirmed the neoplasm as malignant melanoma. This rare melanoma of the buccal mucosa expressed carcinoembryonic antigen (CEA) as well as contained cells that expressed elevated levels of the c-myc oncogene product as identified by immunohistochemistry of the tumor biopsy. Presence of these tumor makers in the rare case of malignant melanoma with poor prognosis should allow exploration of novel targeted therapy against CEA and c-Myc.

Radiculopathy due to malignant melanoma in the sacrum with unknown primary site

Melanoma is an interesting tumor, showing the appearance of metastasis without any trace of its primary lesion. To report a very rare case of malignant melanoma in the sacrum with unknown primary origin. The authors present a case of a 52-year-old man who was admitted with increasing lower back, left buttock, and left lower extremity pain, and dysuria. Plain radiograph, computed tomography scan, and magnetic resonance imaging revealed a destructive lesion in the sacrum and left ilium, which infiltrated the spinal canal and sacroiliac joint. The tumor cells were immunoreactive for HMB-45. The pathological diagnosis was malignant melanoma. No obvious primary malignant melanoma was detected on the skin surface, on the oral or anal mucosa, or in the fundus oculi. Following radiotherapy and chemotherapy, the severe buttock pain disappeared and the patient was able to walk without impediment. However the patient died nine months after initial diagnosis. Malignant melanoma in the sacrum with an unknown primary site, showing S1 radiculopathy is reported for the first time. The melanoma could have been a metastatic tumor of the sacrum, although the primary site was not detected. The incidence of primary melanoma is increasing faster than any other cancer. Thus treatment of patients with spinal metastasis of melanoma is an important challenge for orthopedic surgeons.

Melanoma In Situ Involving an Epidermal Inclusion (Infundibular) Cyst

Epidermal inclusion (infundibular) cysts are common tumors encountered in the practice of dermatology and dermatopathology. Although benign, numerous pathological processes, including benign and malignant tumors, inflammatory dermatoses, and certain infectious entities, have been reported to occur within the epithelial lining of infundibular cysts. We report a rare case of malignant melanoma in situ involving the epithelium of an epidermal inclusion cyst in contiguity with an adjacent malignant melanoma.

Malignant melanoma originating on the female nipple: A case report

We report a very rare case of malignant melanoma arising on a female nipple. A 42-year-old housewife had suffered from a small dark brown nevus on her left nipple for about thirty years without any changes. Six months before her initial visit it had begun to enlarge and rapidly changed from dark brown to black. A small bleeding ulcer was also present in the center of the lesion. Malignant melanoma rather than mammary Paget's disease was suggested based on its clinical course. Excisional biopsy was performed to differentiate between mammary Paget's disease and malignant melanoma. The histopathological examination revealed malignant melanoma, about 4 mm in thickness. She then underwent wide excision with axillary lymph node dissection. The surgical margin was made in a 3 cm radius around the biopsy site. The excision included nipple, areola, and part of the underlying breast parenchyma, adipose tissue and corresponding superficial layer of fascia. Microscopy showed metastasis in one of 13 axillary lymph nodes. After the operation, the patient received adjuvant DAV-Ferron therapy. In such a case, conserving surgery based on correct diagnosis can achieve a good cosmetic result and optimal tumor control.

頭部の熱傷はん痕局面に悪性黒色腫と有きょく細胞癌の同時発生をみた１例

We reported a rare case of malignant melanoma and multiple squamous cell carcinoma, occurring simultaneously on a burn scar. A 49-year-old woman had been burned on her scalp in childhood, resulting in a scar. At the age of 48, she was diagnosed breast cancer, and received a breast resection. After two or three months, she found an enlarged multiple tumor on the burn scar. Histologically, one was nodular melanoma, the other was squamous cell carcinoma. The cause is likely to be a reduction of tumor immunity. [Skin Cancer (Japan) 2002; 17: 79-82]

Malignant transformation of an optic disk melanocytoma

PURPOSE: To report a case of malignant transformation of an optic disk melanocytoma with a second melanocytoma in the ciliary body. METHODS: Clinical data including visual acuity, visual fields, color fundus photographs, fluorescein angiogram, and ultrasonogram and histopathologic studies of this case were reviewed. RESULTS: The right eye of a 65-year-old white woman was diagnosed with melanocytoma of the optic nerve. Four years later, the tumor became significantly larger. The best-corrected visual acuity declined from 20/40 to counting fingers and the size of the tumor increased fourfold in 2 years. The right globe was enucleated. Histopathologic studies demonstrated moderately pigmented spindle-B malignant melanoma cells adjacent to and within a population of large, polyhedral, heavily pigmented melanocytoma cells that extended to the lamina cribrosa and optic nerve. There was also a deeply pigmented melanocytoma in the ciliary body. CONCLUSION: This is a rare case of malignant melanoma transformed from an optic disk melanocytoma. Periodic follow-up of the patient with optic disk melanocytoma is necessary.

MALIGNANT MELANOMA METASTASIZED TO THE SMALL INTESTINE-REPORT OF A CASE-

We experienced a rare case of malignant melanoma metastasized to the small intestine. A 59-year-old man, who had been diagnosed as having a malignant melanoma of the nasal cavity two years earlier, had been admitted to the Department of Otorhinolaryngology in our hospital several times for anticancer drug treatment. On November 6, 1994, he was seen at the Department of Surgey in the hospital because of upper abdominal pain. He had a protuberant tense abdomen with slight tenderness and bilateral nasal bleeding with anemia. Plain abdominal roentgenograms showed multiple, small fluid levels of the small bowel. These findings were suggestive of obstruction of the small intestine. Nasogastric long tube suction was continued and intravenous hyperalimentation was given. After relief of the intestinal obstruction, an abdominal firm mass was palpated and a barium meal study demonstrated a filling defect in the ileum. The preoperative diagnosis was made as metastatic malignant melanoma to the ileum. At operation, endoscopic examination of the small intestine showed a 3.0×3.0 cm nodular mass in the ileum with no other lesions. Partial resection of the ileum with the tumor was performed. Macroscopic examination of the resected specimen revealed a brown nodular mass with an ulcer, 2.5×2.5 cm in size, which occupied most of the intestinal wall area. In immunohistological stainig, S-100 antibody was positive. The histological diagnosis was thus established as metastatic malignant melanoma to the ileum. The patient was discharged on the 14th day after the surgery following an uneventful postoperative course. However, he died of metastatic lung cancer with no abdominal complaints one year after the operation.