Concurrence of primary pulmonary malignant melanoma with invasive pulmonary adenocarcinoma: a case report

Abstract

Background: Primary pulmonary malignant melanoma (PPMM) is an extreme rarity in clinic practice, accounting for only 0.01% of all primary pulmonary tumors. And its diagnosis should meet clinical and pathological diagnosis criteria in addition to excluding the possibility of metastatic melanoma. The mainstay of treatment is surgery. The concurrence of primary pulmonary malignant melanoma and invasive pulmonary adenocarcinoma has not been reported before. Case presentation: Herein we report the case of a 39-year-old woman who was asymptomatic and accidently found to have the concurrence of PPMM with invasive pulmonary adenocarcinoma. Before considering the diagnosis of primary pulmonary malignant melanoma, a systemic positron emission tomography-computed tomography (PET-CT) was done to excluding primary tumor metastasis from other sites. The pathological biopsy proved that two lesions in the right middle lobe were invasive pulmonary adenocarcinomas and the mass in the right lower lobe was malignant melanoma. She underwent right middle and lower lobectomy of the lung with mediastinal and hilar lymph dissection. She refused adjuvant chemotherapy, genetic molecular testing or immunotherapy. Fifteen months later she had brain metastasis. Then she received brain radiotherapy and underwent follow-up at the outpatient clinic regularly. Conclusions: We experienced a case of concurrent PPMM and invasive pulmonary adenocarcinoma. The patient reported here is the first case of primary pulmonary malignant melanoma combined with invasive pulmonary adenocarcinoma. This patient remained disease-free 15 months after lung surgery.

Primary Pulmonary Meningioma With Associated Multiple Micronodules: A Case Report With Comprehensive Diagnostic Overview

“…Although meningiomas are commonly associated with the cranial meninges, the occurrence of these tumors in ectopic locations presents unique diagnostic, pathological, and therapeutic challenges. Since the first reported case in 1982, approximately 70 cases have been described in the literature [4–6]. PPM has a distinct predilection for occurrence in elderly women, with this demographic group presenting a higher incidence [7].…”

“…Notably, maximum standardized uptake value (SUVmax) alone cannot reliably distinguish between benign and malignant PPMs. Even PPMs with mild fluorodeoxyglucose uptake can be benign, whereas those with low SUVmax values may be malignant [6]. Moreover, distinguishing PPM from other pulmonary neoplasms and metastatic meningiomas can be complicated and necessitates a comprehensive diagnostic approach.…”

Primary pulmonary melanoma with brain metastasis: a case description and literature analysis

“…Summarizing the literature (1,3,4,7,(11)(12)(13)(14)(15) on lung melanin in recent years, we found that: (I) Pulmonary melanoma has no specific clinical manifestations, but it is frequently characterized by coughing, hemoptysis, dull chest pain, and other symptoms. (II) It is more likely to occur in the lower lobe of the left lung, the metastasis rate of mediastinal lymph nodes is lower than that of lung cancer, and the mutation rate of BRAF is low, but the prognosis is poor, and the median survival is 24.3 months.…”