Ovarian Malignant Melanoma: A Clinicopathologic Study of 5 Cases

Abstract

Primary ovarian malignant melanomas are extremely rare. The wide range of morphologic appearances assumed by melanomas in the ovary can cause considerable difficulty in diagnosis. The clinicopathologic features of 4 definite and 1 probable primary ovarian melanomas are presented. The patients ranged in age from 41 to 71 years. Four tumors were within teratomas with 2 showing a lentiginous pattern of melanoma in the squamous epithelium. Unusual histologic features were noted. Immunostains for S-100, HMB-45, and Melan-A were positive in all tumors. Premelanosomes were identified in 2 tumors ultrastructurally. Metastatic sites included regional nodes, peritoneal surfaces, omentum, lung, liver, brain, and bone. All 5 patients died within 18 months. Immunohistochemistry and electron microscopy aid considerably in the diagnosis of ovarian melanomas where pigmentation or teratomatous elements are absent. Familiarity with the wide range of morphologic patterns presented here will raise awareness and facilitate detection of future cases of ovarian melanoma.

Metastatic malignant ovarian melanoma: A case report

“…Gynecological palpation reveals tumor masses, however the findings are occasionally inconclusive and also indicative of benign lesions of the genital organs, as it was the case with our patient. If the disease is accompanied by dysuria and loss of body weight or signs of acute abdomen, more detailed investigations and treatment are indicated in order to establish the exact diagnosis 11,12 .…”

Melanoma of unknown primary origin metastasizing to the ovary and breast: Case report and review of literature

“…Two major case series of ovarian MM provided detailed insight to these rare cases [7,8]. Individual case reports were also found in the literature [6,[9][10][11][12][13]. Over 60% of these patients had known histories of cutaneous melanomas or pigmented lesions.…”

Diagnostic challenge for ovarian malignant melanoma in premenopausal women: Primary or metastatic?

“…Some authors [2,3] have restricted the diagnosis of primary ovarian malignant melanoma to those cases with no history of malignant melanoma at any other site, where the tumor is confined to the ovary, and where it arises in association with ovarian cystic teratomas. Metastatic ovarian malignant melanomas are more common than primary ovarian malignant melanomas; to date, about 77 cases of malignant melanoma metastatic to the ovary [4-7] compared to only about 31 cases of primary ovarian malignant melanoma including a compilation of 20 cases and individual case reports [8-11] have been reported in the world literature. Although approximately 20% of patients dying of malignant melanoma have ovarian involvement at postmortem examination, the diagnosis of ovarian malignant melanoma is seldom made before autopsy [12].…”