A Resected Melanoma of the Lung Metastasized from an Occult Skin Lesion: A Case Report

Abstract

An 86-year-old woman with a history of right breast cancer resected seven years ago had a small pulmonary nodule located in left S5. Diagnosis was made by bronchoscopy using the endobronchial ultrasonography-guided sheath (EBUS-GS) method, but a histological diagnosis was not obtained. Wedge resection was performed due to suspicion of a metastatic lesion from breast cancer based on radiological findings. The tumor was subsequently found to be malignant melanoma of the lung. An initial diagnosis of primary melanoma of the lung was made because a melanoma lesion at another site was not seen despite a detailed work up. However, 8 months after surgery, a malignant melanoma appeared at the tip of the right index finger. We rediagnosed the lung lesion as a metastatic malignant melanoma based on the low incidence of primary melanoma of the lung and on the pathological features.

Aggressive Behaviour of Metastatic Melanoma in a Patient with Neurofibromatosis Type 1

“…However the importance of a full physical examination, including oral cavity, cannot be overemphasized [ 11 ]. Similar to this case, however, it can take up to 8 months to locate the primary melanoma [ 12 ]. It is hypothesized that some lesions diagnosed as primary pulmonary melanomas are, in fact, metastases from occult primary lesions which have undergone spontaneous regression.…”

Oral malignant melanoma detected after resection of amelanotic pulmonary metastasis

“…A detailed physical examination revealed a black tumor in the oral cavity, and this was suspected to have been the primary. Shimmyo et al also demonstrated a case of malignant melanoma that primary lesion was detected 8 month after resection of lung metastasis 2 . In view of the rarity of primary lung melanoma, physical examination of the entire skin and mucosa, including the oral cavity, was necessary.…”

“…Shimmyo et al also demonstrated a case of malignant melanoma that primary lesion was detected 8 month after resection of lung metastasis. 2 In view of the rarity of primary lung melanoma, physical examination of the entire skin and mucosa, including the oral cavity, was necessary. Although positron emission tomography (PET) scanning is useful for detecting malignant diseases, we were unable to detect the primary tumor by PET preoperatively in this case.…”