Amelanotic metastasing melanoma mimicking lung cancer
AbstractLung is one of the most common site of metastasis in patients with malignant melanoma. We report a 64 year old man, who was submitted to our hospital. He complained of increasing intensity of shortage of breath, cough, and loss of weight within the last weeks. Serum analysis was normal. X-ray and CT images displayed a circumscribed density in the lower left lung, suspicious for lung cancer. Bronchoscopy and biopsy indicated a non differentiated malignancy which could not be further classified. Excision of the lower left lobe and of mediastinal lymph nodes was performed. The post surgical definite histological diagnosis revealed an amelanocytic epithelioid melanoma (positive for HMB-45, S-100). Pathologists, pulmonologists and thoracic surgeons should be aware of different cell types of intrapulmonary malignancies although primary lung cancer contributes to the outstanding majority of large and solid lung lesions.
 Siegel R, Naishadham D, Jemal A. Cancer statistics. CA Cancer J Clin 2012; 62:10–29.
 Balch CM, Gershenwald JE, Soong SJ, et al. Final version of 2009 AJCC melanoma staging and classification. J Clin Oncol 2009;27(36):6199-6206.
 Landy SH, Murray T, Bolden S, et al: Cancer statistics, 1999. CA Cancer J Clin; 49: 8-31.
 Barth A, Wanek LA, Morton DL. Prognostic factors in 1,521 melanoma patients with distant metastases. J Am Coll Surg 1995;181:193-201.
 Manola J, Atkins M, Ibrahim J, Kirkwood J Prognostic factors in metastatic melanoma: a pooled analysis of Eastern Cooperative Oncology Group trials. J Clin Oncol 2000; 18:3782-3793.
 Ollila DW, Hsueh EC, Stern SL, Morton DL. Metastasectomy for recurrent stage IV melanoma. J Surg Oncol 1999; 71: 209–213.
 Neuman H, Patel A, Hanlon C et al. Stage-IV melanoma and pulmonary metastases: factors predictive of survival. Ann Surg Oncol 2007; 14: 2847–2853.
 Pastorino U, Buyse M, Friedel G et al. Long-term results of lung metastasectomy: prognostic analyses based on 5206 cases. J Thorac Cardiovasc Surg 1997;113: 37–49.
 Tafra L, Dale PS, Wanek LA et al. Resection and adjuvant immunotherapy for melanoma metastatic to the lung and thorax. J Thorac Cardiovasc Surg 1995; 110: 119–129.
 Petersen RP, Hanish SI, Haney JC et al. Improved survival with pulmonary metastasectomy: an analysis of 1720 patients with pulmonary metastatic; J Thorac Cardiovasc Surg. 2007 Jan;133(1):104-10.
 Balch CM, Buzaid AC, Soong SJ, Atkins MB, Cascinelli N, Coit DG, et al. Final version of the American Joint Committee on cancer staging system for cutaneous melanoma. J Clin Oncol 2001;19:3635-48.
 American Cancer Society.Skin Cancer—Melanoma Detailed Guide. Available at:http://www.cancer.org/Cancer/SkinCancer-Melanoma/DetailedGuide/index. Accessed August 20, 2010.
 Busam KJ, Hester K, Charles C, et al. Detection of clinically amelanotic malignant melanoma and assessment of its margins by in vivo confocal scanning laser microscopy. Arch Dermatol. 2001;137:923–929.
 Koch SE, Lange JR. Amelanotic melanoma: the great masquerader. J Am Acad Dermatol. 2000;42:731–734.
 Scolyer RA, Bishop JF, Thompson JF. Primary Melanoma of the lung. In: Raghavan D, Brecher ML, Johnson DH, Meropol NJ, Moots PL, et al., eds. Textbook of Uncommon Cancer. 3rd ed. West Sussex: John Wiley & Sons Ltd, 2006; pp 293–8.
 Kayser K, Analytical Lung Pathology, 1992, Springer, Berlin, Heidelberg, New York.
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
Authors who publish with this journal agree to the following terms:
1. Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
2. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
3. Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).
4. In case of virtual slide publication the authors agree to copy the article in a structural modified version to the journal's VS archive.