Amelanotic melanoma of the nail apparatus with regression previously diagnosed as melanoma of unknown primary site with a lymph node metastasis: A case report

Tahara, Jumpei; Kaku, Yo; Ito, Riko Takimoto; Irié, Hiroyuki; Endo, Yuichiro; Egawa, Gyohei; Dainichi, Teruki; Kabashima, Kenji

doi:10.1111/1346-8138.15158

Cited by 2 publications

(2 citation statements)

References 4 publications

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“…While certain presentations of amelanotic NUM may prompt a biopsy, subtle presentations have been described and should be recognized as diagnostic challenges 16–19 . Solitary lichenoid nail changes, such as longitudinal splitting or ridging, nail plate atrophy, or onychodystrophy, should prompt consideration for a NUM 20–23 . Within our group, we previously published cases of NUM that were clinically suspicious for onychomycosis, 24 lichen planus, 25,26 and posttraumatic onychodystrophy 27 .…”

Section: Clinical Challengesmentioning

confidence: 99%

“…[16][17][18][19] Solitary lichenoid nail changes, such as longitudinal splitting or ridging, nail plate atrophy, or onychodystrophy, should prompt consideration for a NUM. [20][21][22][23] Within our group, we previously published cases of NUM that were clinically suspicious for onychomycosis, 24 lichen planus, 25,26 and posttraumatic onychodystrophy. 27 A clue to NUM in a patient with monodactylous nail dystrophy includes the presence of a proximal atypical lentigo.…”

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confidence: 99%

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Clinicohistopathologic challenges and traps in the diagnosis of nail unit melanoma

Jiang¹,

Abbott

Higgins

et al. 2023

J Cutan Pathol

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Melanoma of the nail apparatus is challenging to diagnose for both dermatologists and dermatopathologists. Misdiagnosis or delayed diagnosis of nail unit melanoma can have fatal consequences and legal ramifications. This review educates dermatopathologists on challenges and traps they should be aware of to avoid misdiagnosis of nail unit melanoma. We present illustrative difficult cases that introduce several themes regarding challenges in the diagnosis of nail unit melanoma: specimens with subtle histopathologic findings, challenges in immunoperoxidase interpretation, and how clinical knowledge and surgical procedural knowledge are mandatory to make the diagnosis. Dermatopathologists will be aware of when and how to suspect nail unit melanoma in unusual circumstances.

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Section: Clinical Challengesmentioning

confidence: 99%

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confidence: 99%

Clinicohistopathologic challenges and traps in the diagnosis of nail unit melanoma

Jiang¹,

Abbott

Higgins

et al. 2023

J Cutan Pathol

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Melanoma of Unknown Primary With Metastasis to the Brain: A Case Report and Review of the Literature

Rice-Canetto,

Richard,

Kim

et al. 2024

Cureus

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We present the case of a 72-year-old male found to have melanoma of unknown primary (MUP) in the lung with brain metastasis. The patient has a history of prostate cancer with radical proctectomy in 1999, hypertension with right-sided heart failure, and bilateral cataracts treated operatively. He presented to their home hospital after an unwitnessed fall, with a history of left-sided weakness. He was found to have a parietal lobe mass and two lung masses, where he was transferred to our hospital for a higher level of care. Biopsy of the lung lesion revealed melanoma, and the patient did not have any skin or mucosal foci present to indicate a primary source. We present this case in conjunction with a review of the literature. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, our review resulted in 31 MUP case reports. Data was extracted on epidemiology, clinical presentations, diagnostics, treatment, and outcomes. The mean age was 57.5 with a male-to-female ratio of 1:1.3. The greatest instances of MUP occurred in prior smokers and patients with comorbidities, accounting for 17.95% of cases each. Thirty-one percent of patients presented with a growing palpable mass, 21% with gastrointestinal symptoms, and 21% with B-symptoms. Biopsy was the diagnostic standard, and the majority of patients also underwent biomarker studies. Treatment varied widely, and many patients underwent multiple phases. Outcomes ranged from death within several months to a disease-free period of three years. Our paper highlights the complexity and nuances of diagnosing MUP and primary malignant melanoma of the lung (PMML) and calls for further investigations to improve diagnostic and therapeutic approaches for rare presentations of melanoma. Despite limitations in sample size and data heterogeneity, this study highlights the diverse presentation and disease course of MUP, necessitating further studies to optimize patient outcomes.

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Amelanotic melanoma of the nail apparatus with regression previously diagnosed as melanoma of unknown primary site with a lymph node metastasis: A case report

Cited by 2 publications

References 4 publications

Clinicohistopathologic challenges and traps in the diagnosis of nail unit melanoma

Clinicohistopathologic challenges and traps in the diagnosis of nail unit melanoma

Melanoma of Unknown Primary With Metastasis to the Brain: A Case Report and Review of the Literature

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