Melanoma Arising From a Pre-existing Neurofibroma in a Patient With No Prior Diagnosis of Systemic Neurofibromatosis 1 or 2: A Case Report

Abstract

The pathophysiology of melanoma involves malignant transformation of melanocytes. These can arise de novo or result from malignant transformation of a pre-existing nevus. This case report presents a patient with a new pigmented lesion, arising from a pre-existing neurofibroma, on her left scapula and no personal or family history of systemic neurofibromatosis. Biopsy confirmed the lesion to be malignant melanoma and, after excision, postoperative pathology showed a pre-existing neurofibroma. A review of the literature suggests there may be a link between the pathogenesis of neurofibroma and malignant melanoma, because NF1 mutations are observed in both neurofibromatosis and malignant melanoma. We hypothesize that the pre-existing neurofibroma created a proliferative environment that gave rise to the adjacent neoplasm. Further research is required to understand the shared pathway, because this may lead to novel forms of surveillance and treatment.

Intersection of scalp melanoma and nurofibromatosis type 1 rare case report

“…In most of the reported cases in literature, melanoma arises from pigmented nevus on different location. Nasir, Wasim et al described melanoma arising on top of neurofibroma without a pervious diagnosis of neurofibromatosis [8] . The association between the two diseases can be explained by RAS mutations described in patients with NF-1 this mutations also recognized in patients with melanoma described as unholy [9] , which may explain the development of melanoma in patient with NF-1.…”