Small cell type malignant melanoma which developed in a 16-year-old female with a congenital dermal nevus and metastasized 12 years after excision.
A case of malignant melanoma arising from a congenital dermal nevus on the right forehead of a 16-year-old female is presented. In the mole, small pigmented nevoid cells gathered around the skin appendages and between the collagen fibers. From the age of 17, a verrucous nevoid melanoma consisting of lymphoblast-like large nevoid cells, which were positive for HMB-45 and had a high Ki-67 index up to 18.7%, gradually increased in size. The melanoma cells vertically invaded the dermis to a depth of 3 mm and radially spread in the papillary dermis. Twelve years after undergoing a wide local resection and additional chemotherapy, metastatic lesions were found in the lung and the anterior mediastinum, which gradually increased in size and caused death a few months later. Metastatic melanoma cells were positive for HMB-45 and had a high Ki-67 index up to 33.7%. Most metastatic melanoma cells were positive for p53 while the primary ones were negative. Deteriorating mutations probably accumulated during the latent period.
Miura
K
K
Division of Pathology, Hamamatsu University School of Medicine, Japan. kmiura@hama-med.ac.jp
Harada
H
H
Tsutsui
Y
Y
D000293:Adolescent; D000951:Antigens, Neoplasm; D001706:Biopsy; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D019394:Ki-67 Antigen / Q000378:metabolism; D008175:Lung Neoplasms / Q000378:metabolism / Q000556:secondary; D008479:Mediastinal Neoplasms / Q000556:secondary; D008545:Melanoma / Q000378:metabolism / Q000556:secondary*; D058950:Melanoma-Specific Antigens; D009363:Neoplasm Proteins / Q000378:metabolism; D018330:Nevus, Intradermal / Q000151:congenital / Q000473:pathology*; D009418:S100 Proteins / Q000378:metabolism; D012878:Skin Neoplasms / Q000378:metabolism / Q000473:pathology*; D013995:Time; D016159:Tumor Suppressor Protein p53 / Q000378:metabolism
D000951:Antigens, Neoplasm; D019394:Ki-67 Antigen; D058950:Melanoma-Specific Antigens; D009363:Neoplasm Proteins; D009418:S100 Proteins; D016159:Tumor Suppressor Protein p53