Metastatic Malignant Melanoma with Cartilaginous Metaplasia

Grunwald, Marcelo H.; Rothem, A.; Feuerman, Eleasar J.

doi:10.1159/000249542

Cited by 40 publications

(31 citation statements)

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“…Although there is no description of tumors with osteocartilaginous matrix formation in the WHO classification of melanocytic tumors of human skin that was published in 1996 [14], there were some reports of such cases prior to the announcement of this classification [5,12,18,[20][21][22][23]. On the other hand, the WHO classification of melanocytic tumors in canine skin [10] contains the description: "Occasionally, cutaneous or sublingual malignant melanomas show foci of chondroid or osseous metaplasia".…”

Section: Discussionmentioning

confidence: 99%

“…All three tumors had remarkable proliferation of connective tissues and developed homogenous osteoid areas in parts. The existence of osteoid structures in the melanoma tissues has been frequently reported as one of the histologic features of desmoplastic melanosarcoma in human skin [9,12,14,[19][20][21]. Nakagawa et al observing fine structures of the matrix, reported the deposition of hydroxyapatite crystals in the collagen fascicle [21].…”

Section: Discussionmentioning

confidence: 99%

“…Although there have, since the mid-1980s, been many reports of malignant melanomas with bone or cartilage formation in humans [1,2,7,9,11,12,16,18,[20][21][22]26], only a few reports have been published concerning such melanomas in canines [4,8,19,25]. Blanchard et al and Smith et al reported cases involving cartilage formation, and Chenier et al and Maliver et al reported cases of malignant melanomas involving osteoid formation.…”

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confidence: 99%

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Pathology of Canine Oral Malignant Melanoma with Cartilage and/or Osteoid Formation

Oyamada

Tanaka

Park

et al. 2007

The Journal of Veterinary Medical Science

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ABSTRACT. Of 197 cases of canine oral malignant melanoma, 29 cases with myxoid, cartilage, and osteoid formation were studied pathologically and immunohistochemically. Tumor tissues were classified into spindle cell type (13 cases), epithelioid cell type (1 case), and mixed type (15 cases). Myxoid matrixes (29 tumors) were formed mainly in the tissues of spindle cell type and were positive for Alcian blue (pH 2.5). Cartilaginous matrixes (12 tumors) were formed in the myxoid tumor tissues. The morphology of atrophied neoplastic cells, which were embedded in the cartilage cavities, significantly differed from that of spindle cells proliferating in surroundings. There were reticular areas in the process of transitioning from myxoid to cartilaginous matrixes. Osteoid matrixes were not continuous with myxoid or cartilaginous matrixes, and arose as eosinophilic trabeculae in the dense collagenous connective tissues. A calcified bone trabecula was present among the osteoid trabeculae in a case. Melanin-producing melanocytes were proliferating in the collagenous matrixes, while amelanotic cells were in the osteoid matrixes. Immunohistochemistry demonstrated proliferating neoplastic cells as melanocytes. All cells in/out of these three matrixes were positive for Melan-A, S-100 protein, NSE, and vimentin. From these results, it is suggested that cartilage and osteoid matrixes are produced by dedifferentiated melanocytes. KEY WORDS: canine, cartilage, oral melanoma, osteoid.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Pathology of Canine Oral Malignant Melanoma with Cartilage and/or Osteoid Formation

Oyamada

Tanaka

Park

et al. 2007

The Journal of Veterinary Medical Science

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“…[105][106][107][108][109][110][111] Osteosarcomatous metaplasia in a malignant melanoma may be the sequela of an alteration in benign stromal fibroblasts as a host response to the tumor, or it could represent a divergent differentiation pattern, whereby melanoma cells acquire the machinery necessary for the production of malignant osteoid. Cartilaginous metaplasia has also been described, 106,110,112 often combined with bone formation to yield a form of osteocartilaginous metaplasia, such as that reported in one case of a nasal mucosal primary and its metastasis 110 and in cases of subungual melanoma. 111,112 Mesenchymal elements with rhabdomyoblastic, lipoblastic, and neurogenous features have been described in those malignant melanomas that arise in giant congenital nevi.…”

Section: Metaplastic Change In Malignant Melanomamentioning

confidence: 99%

Unusual variants of malignant melanoma

2006

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A potential diagnostic pitfall in the histologic assessment of melanoma is the inability to recognize unusual melanoma variants. Of these, the more treacherous examples include the desmoplastic melanoma, the nevoid melanoma, the so-called 'minimal-deviation melanoma,' melanoma with prominent pigment synthesis or 'animal-type melanoma,' and the malignant blue nevus. Also problematic are the unusual phenotypic profiles seen in vertical growth phase melanomas; these include those tumors whose morphological peculiarities mimic cancers of nonmelanocytic lineage and those melanomas that express aberrant antigenic profiles not commonly associated with a melanocytic histogenesis. Metaplastic change in melanoma, balloon cell melanoma, signet-ring cell melanoma, myxoid melanoma, small cell melanoma and rhabdoid melanoma all have the potential to mimic metastatic and primary neoplasms of different lineage derivations. Abnormal immunohistochemical expression of CD 34, cytokeratins, epithelial membrane antigen, and smooth muscle markers as well as the deficient expression of S100 protein and melanocyte lineage-specific markers such as GP100 protein (ie HMB-45 antibody) and A103 (ie Melan-A) also present confusing diagnostic challenges. In this review, we will discuss in some detail certain of these novel clinicopathologic types of melanoma, as well as the abnormal phenotypic expressions seen in vertical growth phase melanoma. Modern Pathology (2006) 19, S41-S70. doi:10.1038/modpathol.3800516Keywords: melanoma; variants; phenotype; immunohistochemistry; morphology Desmoplastic melanoma Introduction and Clinical FeaturesDemoplastic melanoma is a rare variant of malignant melanoma first recognized in 1971.1 Desmoplastic and neurotropic melanoma may be mistaken clinically for a scar, a fibroma, a basal cell carcinoma, or a fibromatosis. Sometimes there is pronounced mucin deposition that imparts a boggy quality to the lesion. 2,3 The clinical clue to the diagnosis, when present, is cutaneous or mucosal pigmentation overlying a palpable dermal or submucosal nodule. That said, only half of desmoplastic melanomas are clinically pigmented. 3 Desmoplastic melanomas tend to occur in the head and neck area and the upper back [4][5][6][7] but are also seen in mucosal sites such as the vulva or gingiva 8 and in acral locations. Typically, they occur in older patients, with mean ages in the larger series falling into the sixth to eighth decades of life. 4,6,[9][10][11][12][13][14][15] Larger series show a male preponderance of 1.75 to 1. 15 Although any given desmoplastic melanoma can be deeply invasive, when matched for depth of invasion, they are associated with a lesser risk of metastatic disease than conventional melanomas of similar depth. The classical clinical finding is that of a pale or fleshy firm nodule reminiscent of a scar, which tends to delay clinical diagnosis and biopsy. Carlson et al,6 who reported an equal distribution in men and women, found most tumors to be located in the head and neck area (75%) and to be nonpigment...

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“…Some of these cases were associated with iatrogenic procedures, suggesting the role of trauma as an inducing factor [35,36]. Osteosarcomatous metaplasia in a malignant melanoma may be the sequela of an alteration in benign stromal fibroblasts as a host response to the tumor, or it could represent a divergent differentiation pattern.…”

Section: Metaplastic Melanomamentioning

confidence: 99%

Unusual histologic and clinical variants of melanoma: Implications for therapy

Crowson

Magro²,

Mihm³

2007

Curr Oncol Rep

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Unusual histologic variants of melanoma may be problematic to the histopathologist. Several of these variants are sufficiently rare that their biologic behavior remains obscure. As identification of some of these melanoma subtypes has specific implications for the therapeutic approach, and as some may mimic other forms of epithelial or mesenchymal neoplasia, their recognition is key to patient management.

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Metastatic Malignant Melanoma with Cartilaginous Metaplasia

Abstract: A rare case of cartilaginous metaplasia within a metastatic malignant melanoma is described in a 58-year-old female.

Cited by 40 publications

References 5 publications

Pathology of Canine Oral Malignant Melanoma with Cartilage and/or Osteoid Formation

Pathology of Canine Oral Malignant Melanoma with Cartilage and/or Osteoid Formation

Unusual variants of malignant melanoma

Unusual histologic and clinical variants of melanoma: Implications for therapy

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