[Primitive myxoid melanoma: An unusual histological aspect].
Mélanome myxoïde primitif : une forme histologique inhabituelle.
Melanoma
Myxoid melanoma
Mélanome
Mélanome myxoïde
SOX10
Journal
Annales de dermatologie et de venereologie
ISSN: 0151-9638
Titre abrégé: Ann Dermatol Venereol
Pays: France
ID NLM: 7702013
Informations de publication
Date de publication:
May 2019
May 2019
Historique:
received:
16
07
2018
revised:
21
09
2018
accepted:
30
01
2019
pubmed:
27
3
2019
medline:
27
12
2019
entrez:
27
3
2019
Statut:
ppublish
Résumé
Myxoid melanoma is a rare variant of melanoma that must be recognised. Herein we describe a new metastatic case. A 78-year-old woman consulted for a firm, pinkish nodule measuring 25mm and present for six months on her left leg. Analysis of the biopsy revealed achromic fusiform tumour cells separated by large myxoid plaques. Labeling of SOX10, HMB45 and PS100 was diffuse and of moderate to strong intensity. A diagnosis of myxoid melanoma was considered, with Breslow thickness of 9mm. Surgery was carried out with a 2-cm margin and confirmed the diagnosis. Dermatological follow-up at one year revealed metastatic spread to the ganglia, pleura, liver and bone. Few cases of primary myxoid melanoma have been described, and the condition is probably underdiagnosed. The classic clinical presentation of this condition consists of a solitary achromic nodule found chiefly on the limbs. The microscopic appearance is relatively non-specific. Immunohistochemical analysis may indicate melanocytic involvement: cells exhibit expression of SOX10, diffuse expression of protein S100, and less consistent and more variable expression of HMB45. The increasingly common use of anti-SOX10 is of value since it is expressed in the nucleus of melanocytes. Mastocytes and TGF-ß secretion appear to be involved in myxoid stroma production. In the absence of specific codification, management of myxoid melanoma is comparable to that of other types of melanoma. There is uncertainty about the prognosis, with the involvement of TGF-ß possibly indicating the aggressive potential of this type of tumour.
Sections du résumé
BACKGROUND
BACKGROUND
Myxoid melanoma is a rare variant of melanoma that must be recognised. Herein we describe a new metastatic case.
PATIENTS AND METHODS
METHODS
A 78-year-old woman consulted for a firm, pinkish nodule measuring 25mm and present for six months on her left leg. Analysis of the biopsy revealed achromic fusiform tumour cells separated by large myxoid plaques. Labeling of SOX10, HMB45 and PS100 was diffuse and of moderate to strong intensity. A diagnosis of myxoid melanoma was considered, with Breslow thickness of 9mm. Surgery was carried out with a 2-cm margin and confirmed the diagnosis. Dermatological follow-up at one year revealed metastatic spread to the ganglia, pleura, liver and bone.
DISCUSSION
CONCLUSIONS
Few cases of primary myxoid melanoma have been described, and the condition is probably underdiagnosed. The classic clinical presentation of this condition consists of a solitary achromic nodule found chiefly on the limbs. The microscopic appearance is relatively non-specific. Immunohistochemical analysis may indicate melanocytic involvement: cells exhibit expression of SOX10, diffuse expression of protein S100, and less consistent and more variable expression of HMB45. The increasingly common use of anti-SOX10 is of value since it is expressed in the nucleus of melanocytes. Mastocytes and TGF-ß secretion appear to be involved in myxoid stroma production. In the absence of specific codification, management of myxoid melanoma is comparable to that of other types of melanoma. There is uncertainty about the prognosis, with the involvement of TGF-ß possibly indicating the aggressive potential of this type of tumour.
Identifiants
pubmed: 30910333
pii: S0151-9638(19)30055-9
doi: 10.1016/j.annder.2019.01.015
pii:
doi:
Substances chimiques
Biomarkers, Tumor
0
Melanoma-Specific Antigens
0
PMEL protein, human
0
S100 Proteins
0
SOX10 protein, human
0
SOXE Transcription Factors
0
gp100 Melanoma Antigen
0
Types de publication
Case Reports
Journal Article
Langues
fre
Sous-ensembles de citation
IM
Pagination
372-376Informations de copyright
Copyright © 2019 Elsevier Masson SAS. All rights reserved.