Amelanotic metastasing melanoma mimicking lung cancer

  • Daniela Flamur Xhemalaj Department of pathology -University hospital of lung diseases-Tirana
  • Fatmir Caushi Department of Surgery-University Hospital of lung disease-Tirana
  • Linda Ulazzi Department of molecular Biology-Universita di Ferrara
  • Rosa Rinaldi Department of Pathology -Universita di Ferrara
  • Giovanni Lanza Deparment of patholology-Universita di Ferrara
  • Hasan Hafizi Head of Service of Pneumonology-University hospital center of lung diseases-Tirana
  • Mehdi Alimehmeti Head of Department of Pathology-University hospital Center-Tirana
  • Gisela Pumo Department of Pathology-University hospital Center-Tirana
  • Asela Hasa Department of Pathology-University hospital Center-Tirana

Abstract

Lung 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.

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References

[1] Miller AJ, Mihm MC. Melanoma. N Engl J Med 2006;355:51–65.

[2] Siegel R, Naishadham D, Jemal A. Cancer statistics. CA Cancer J Clin 2012; 62:10–29.

[3] 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.

[4] Landy SH, Murray T, Bolden S, et al: Cancer statistics, 1999. CA Cancer J Clin; 49: 8-31.

[5] Barth A, Wanek LA, Morton DL. Prognostic factors in 1,521 melanoma patients with distant metastases. J Am Coll Surg 1995;181:193-201.

[6] 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.

[7] Ollila DW, Hsueh EC, Stern SL, Morton DL. Metastasectomy for recurrent stage IV melanoma. J Surg Oncol 1999; 71: 209–213.

[8] 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.

[9] 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.

[10] 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.

[11] 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.

[12] 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.

[13] American Cancer Society.Skin Cancer—Melanoma Detailed Guide. Available at:http://www.cancer.org/Cancer/SkinCancer-Melanoma/DetailedGuide/index. Accessed August 20, 2010.

[14] 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.

[15] Koch SE, Lange JR. Amelanotic melanoma: the great masquerader. J Am Acad Dermatol. 2000;42:731–734.

[16] 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.

[17] Kayser K, Analytical Lung Pathology, 1992, Springer, Berlin, Heidelberg, New York.
Published
2015-10-30
How to Cite
XHEMALAJ, Daniela Flamur et al. Amelanotic metastasing melanoma mimicking lung cancer. Diagnostic Pathology, [S.l.], oct. 2015. ISSN 2364-4893. Available at: <http://www.diagnosticpathology.eu/content/index.php/dpath/article/view/86>. Date accessed: 11 dec. 2024. doi: https://doi.org/10.17629/www.diagnosticpathology.eu-2015-1:86.
Issue
Section
Case Report

Keywords

Malignant Melanoma, Lung metastasis, Immunohistochemistry, Lobectomy.