Malignant Melanoma Presenting as A Parotid Mass in A Middle Aged Woman with Metastasis to the Breast

سال انتشار: 1398
نوع سند: مقاله کنفرانسی
زبان: انگلیسی
مشاهده: 399

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شناسه ملی سند علمی:

ACPLMED21_032

تاریخ نمایه سازی: 6 آبان 1398

چکیده مقاله:

Introduction: Malignant melanomas of the parotid gland are relatively uncommon. They occur invariably as metastases from cutaneous, or mucous sites of head and neck region. Some malignant melanomas may metastasize and subsequently regress. Therefore, it may not be possible to find the primary origin of metastatic melanoma, simultaneously. In addition, metastasis to breast from an extra mammary site is also uncommon and challenging. It may present as a well-defined rounded mass clinically and mimic a variety of architecture and cellular phenotype histopathologically. Furthermore, metastatic melanoma sometimes shows equivocal results of immunohistochemical stains. Case presentation: We present here a case of malignant melanoma in a 42-year-old woman, first presented with a left cervical mass. The initial biopsy of the lesion was diagnosed as malignant peripheral nerve sheath tumor. A week later, the patient had undergone left parotid tumor resection. Morphological and immunohistochemical findings of the tumor supported the diagnosis of malignant melanoma. After four months, radiological investigations demonstrated a mass in the left breast (BIRADS: 4a). The core needle biopsy of the lesion showed a malignant spindle cell tumor without definite immunoreactivity for melanoma markers. One month later, the aforementioned mass was excised. Morphological findings were in favor of malignant melanoma; however, immunostaining was not contributory. Considering the previous history of the patient and comparing the morphology of both tumors, a metastatic malignant melanoma was suggested as a final diagnosis. No skin or mucosa lesion as the primary site of this tumor has been found in this patient. Conclusion: This case introduces a patient with malignant melanoma of the parotid gland and metastasis to the breast. Breast lesion showed complete loss of immune-reactivity for melanoma markers. Therefore, it is important to be aware of previous history of the patient to make a correct diagnosis. Review of literature could improve our understanding of the disease and enhance our ability to recognize similar cases.

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نویسندگان

Fereshteh Ameli

Department of pathology, Cancer Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Science. Tehran, Iran

Dorsa Ghasemi

Department of pathology, Cancer Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Science. Tehran, Iran

Fatemeh Nili Ahmadabadi

Department of pathology, Cancer Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Science. Tehran, Iran