Primary Pulmonary Malignant Melanoma: An Unexpected Tumor

Abstract

Malignant melanoma occurs most frequently on the skin. However, it can also arise in other organs and tissues of the body. Primary pulmonary malignant melanoma is a very rare non-epithelial neoplasm accounting for 0.01% of all primary pulmonary tumors. The treatment of choice is surgical resection of the tumor with an oncologically adequate margin as in lobectomy or pneumonectomy. The prognosis of this condition is rather poor. Based on previous data, its 5-year survival is at least 10%. Here, we report a case of an 82-year-old woman whose primary pulmonary melanoma was detected incidentally.

Primary Malignant Melanoma of the Lung (PMML); A Case Report

“…Since there was no history of skin or eye surgeries, no skin and mucosal lesions were found on physical exam, and fundoscopy did not reveal any ocular lesions, it was diagnosed as PMML in our patient. Primary pulmonary malignant melanoma is typically endobronchial, and symptoms are usually correlated to the disruption of this area, with cough, hemoptysis, shortness of breath, pleuritic pain, pneumonia, lobar collapse, or atelectasis among common complaints that cause patients to seek medical attention [1]. Some patients may present with nonspecific or no complaints, and lesions may instead be discovered incidentally, like in our patient.…”

“…The exact pathogenesis of primary pulmonary malignant melanoma is unclear. There are several theories on how it occurs, the most popular two being the migration of melanocytes during embryonic development or the proliferation of melanocytes in the larynx and esophagus [1]. When no primary lesion can be identified, some studies have pointed to the possibility of primary malignant cutaneous melanocytes that form and disappear after metastasizing (5 to 10 percent of patients with metastatic melanoma have a primary melanoma of unknown origin) [3].…”

“…Surgical intervention to resect the tumor within an acceptable oncological margin, lobectomy, or pneumonectomy is the treatment of choice [1]. In cases where surgery is impossible or not desired by the patient, chemotherapy, radiation, and immunotherapy may be considered.…”

“…Unfortunately, the prognosis for primary pulmonary malignant melanoma is grim -five-year survival estimates may be at least 10%. However, many patients have rapid progression and short survival, even with the intervention [1,7].…”

“…Malignant melanoma accounts for approximately 160,000 new cancer cases yearly and causes about 41,000 deaths annually [1]. Melanoma primarily occurs on the skin due to exposure to ultraviolet rays.…”