Coexisting Malignant Melanoma and Blue Nevus of the Uterine Cervix: An Unusual Combination

Abstract

Malignant melanoma (MM) and blue nevi of the uterine cervix are an extremely rare neoplasm, probably derived from embryologic migration of melanocytes from the neural crest. MM displays aggressive behavior with a poor prognosis. We report the case of a 76-year-old postmenopausal woman abnormal vaginal bleeding. She underwent a hysterectomy and bilateral salpingo-oophorectomy with paraaortic-iliac lymphadenectomy. Histopathological and immunohistochemical studies were consistent with the diagnosis of MM and blue nevi in the uterine cervix. Although it is extremely rare, this case suggests that MM of the uterine cervix should be considered in the differential diagnosis of undifferentiated neoplasm. Early diagnosis is essential in order to warrant a better prognosis, although there are no cases of cure described.

Blue nevus presenting as an endocervical polyp

“…Concerning immunohistochemical features, the tumor cells were described as being positive for S100 protein, HMB45 and MART-1 [2,3,4,5,6,7,13]. Surprisingly, however, the immunohistochemical features described in latest edi- tion of a gynecopathology textbook were different from our findings and previous reports; that is, this textbook stated that endocervical blue nevi are usually negative for HMB45 and MART-1 [10].…”

“…Blue nevi of the uterine cervix are benign melanocytic neoplasms, which were once considered to be rare and were usually found incidentally in hysterectomy specimens [1,2,3,4,5,6,7,8].…”

Melanoma arising in association with blue nevus: a clinical and pathologic study of 24 cases and comprehensive review of the literature

“…Regarding pathologic findings, the reported cases (in order of frequency) included malignant melanocytic proliferations mimicking a cellular blue nevus but lacking an identifiable benign component (in 38% of cases) 5,11,[13][14][15]18,20,25,28,30,33,36,47,49 or melanomas arising in association with a distinctive blue nevus component, including (a) cellular blue nevus (26%), 4,5,11,16,18,29,40,46,50,51,53 (b) common blue nevus (21%), 5,13,22,24,27,31,32,34,37,39,41,43,52 (c) both cellular and common blue nevus (13%), 12,16,21,23,35,38,44,45,48 (d) neurocristic hamartoma (1%) 42 and (e) nevus of Ota (1%). 17 In contrast, all of the cases in our series consisted of distinctly biphenotypic melanocytic proliferations (melanoma together with a benign blue nevus component).…”

“…Not every parameter is provided for each reported case in the literature and therefore, the figures represent cases for which the specific respective parameters were reported. (a) Provides a breakdown of the associated nevus component for our cases as well as those reported in the literature (n ¼ 108) 4,5,7, (b) Age (n ¼ 111), 4,5,7,[37][38][39][40][41][42][43][44][45][46][47][48][49][50][51][52][53][54] (c) gender (n ¼ 131) 4,5,7,[37][38][39][40][41][42][43][44][45][46][47][48][49][50][51][52][53][54] and (d) anatomic distribution (n ¼ 135) 4,5,7, for all cases.…”

Primary intra‐abdominal melanoma arising in association with extracutaneous blue naevus: a report of two cases

“…15,18 Melanoma arising within extracutaneous blue naevi is vanishingly rare, with only a single reported case, involving the uterine cervix. 19 Herein we describe the clinicopathological, immunohistochemical and molecular genetic features of two additional cases, both occurring within the abdominal cavity, emphasising their distinction from potential mimics such as metastatic melanoma, gastrointestinal stromal tumour and malignant melanotic nerve sheath tumour (previously referred to as melanotic schwannoma).…”