title: Diagnostic challenge for ovarian malignant melanoma in premenopausal women: primary or metastatic?
abstract: BACKGROUND
  In the ovary, metastatic malignant melanoma may be confused with primary malignant melanoma and presents a diagnosis challenge. Most cases are associated with disseminated diseases and poor prognosis. We present this case report of a metastatic ovarian malignant melanoma simulating primary ovarian cancer.
  
  
  METHODS
  A 45-year-old premenopausal woman was incidentally found to have an abdominal mass, 3 years after removal of a cutaneous melanoma lesion. Ultrasound and CT scan revealed left two solid masses, which were found to be an ovarian tumor at laparotomy. Left oophorectomy was performed. Histopathology and immunohistochemistry showed melanoma metastasis to the ovary. Nine months later, the patient developed epilepsy and confusion. Magnetic Resonance Imaging showed unique Wright frontal lobe lesion. She underwent stereotactic radio surgery and dacarbazine monotherapy. For months later, the patient is died from disseminate disease progression.
  
  
  CONCLUSIONS
  Ovarian metastasis is an unusual presentation of cutaneous melanoma and the prognosis was dismal. As illustrated by this case report, a differential diagnosis of a metastatic malignant melanoma must be considered.
authors.affiliation: Department of Medical Oncology, University Military Hospital, Rabat, Morocco. sbittiyassir@yahoo.fr
authors.forename: Yassir
authors.initials: Y
authors.lastname: Sbitti
authors.forename: Zouhour
authors.initials: Z
authors.lastname: Fadoukhair
authors.forename: Habiba
authors.initials: H
authors.lastname: Kadiri
authors.forename: Mohamed
authors.initials: M
authors.lastname: Oukabli
authors.forename: Ismail
authors.initials: I
authors.lastname: Essaidi
authors.forename: Saoussan
authors.initials: S
authors.lastname: Kharmoum
authors.forename: Hind
authors.initials: H
authors.lastname: M'rabti
authors.forename: Abderrahmane
authors.initials: A
authors.lastname: Albouzidi
authors.forename: Mohammed
authors.initials: M
authors.lastname: Ichou
authors.forename: Hassan
authors.initials: H
authors.lastname: Errihani
mesh_terms: D003937:Diagnosis, Differential; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008545:Melanoma / Q000175:diagnosis / Q000556:secondary*; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary*; D012878:Skin Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography