The Many Faces of Metastases to the Skin from Cutaneous Malignant Melanomas

Beauerle, Johanna; Stevens, Charles S.; Ackerman, A. Bernard

doi:10.1111/j.1524-4725.1981.tb00697.x

Cited by 5 publications

(5 citation statements)

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“…Primary nevoid melanoma is a rare entity that can be extremely difficult to diagnose on histology alone; attention to cytologic and architectural details and high index of suspicion are essential to diagnose correctly these neoplasms. 5,[23][24][25] Histologically, both primary nevoid melanomas and nevoid cutaneous metastases of melanoma may often be indistinguishable; diagnostic pointers that will favor the diagnosis of nevoid cutaneous metastases include the presence of a nodular expansile nodule in the dermis and the presence of a lymphovascular invasion. However, a clinical history of preexistent melanoma is obviously critical to establish the diagnosis of nevoid cutaneous metastasis of melanoma.…”

Section: Discussionmentioning

confidence: 99%

“…The primary tumor could not be evaluated in 16 cases (8.3%); in the remainder of cases, histologic glass slides from the primary tumor were available for comparison. The most frequent site of metastasis included the legs (35 cases), scalp (29), arm (including forearm) (25), face (including forehead and temple) (15), foot (9), neck (7), chest (7), shoulder (5), abdomen (5), breast (5), groin (5), ankle (5), buttock (4), ear (3), axilla (3), calf (3), wrist (2), knee (2), elbow (1), hip (1), and finger (1) ( Table 1). Grossly, the majority of the lesions were described clinically as pigmented nodules.…”

Section: Clinical Findingsmentioning

confidence: 99%

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Cutaneous Metastases of Malignant Melanoma: A Clinicopathologic Study of 192 Cases With Emphasis on the Morphologic Spectrum

Plaza

Torres‐Cabala²,

Evans

et al. 2010

The American Journal of Dermatopathology

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Metastatic melanoma represents one of the most common types of cutaneous metastases. In up to 5% of patients, metastatic melanoma can be the first manifestation of the disease. For the most part, the histologic diagnosis of metastatic melanoma poses little diagnostic difficulty; however, some metastases may adopt unusual or unfamiliar appearances mimicking other benign and malignant conditions. We present a study of 192 cases of cutaneous metastatic melanomas with special emphasis on their spectrum of morphologic features. The patients were 115 men and 77 women, 23-91 years of age (mean 57 years). Most tumors were located on the proximal legs, scalp, and arms and ranged from 0.8 to 3.0 cm. One hundred ten cases showed the classic morphologic appearance of melanoma (well-circumscribed epithelioid dermal/subcutaneous nodule), 82 cases showed unusual histologic appearances that mimicked other benign and malignant neoplasms. In 16 patients (8.3%), there was no evidence of primary melanoma and the cutaneous metastasis was the only manifestation of the disease. The histologic diagnosis of cutaneous metastatic melanoma can pose difficulties for diagnosis, especially in the face of an unknown primary neoplasm. Unusual features observed in this series included examples of cutaneous metastatic melanoma that closely simulated metastatic carcinoma, dermatofibroma, leiomyosarcoma, angiosarcoma, nevoid melanoma, halo nevus, blue nevi, and atypical fibroxanthoma. Several cases also showed rhabdoid, balloon cell, and alveolar features. Immunohistochemical stains plus careful clinical history helped to establish the correct diagnosis. Our series illustrates that the differential diagnosis of cutaneous metastatic melanoma can be broad and difficult. To the best of our knowledge, this is the largest series of cutaneous metastatic melanomas reported in the literature.

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Section: Discussionmentioning

confidence: 99%

Section: Clinical Findingsmentioning

confidence: 99%

Cutaneous Metastases of Malignant Melanoma: A Clinicopathologic Study of 192 Cases With Emphasis on the Morphologic Spectrum

Plaza

Torres‐Cabala²,

Evans

et al. 2010

The American Journal of Dermatopathology

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“…Metastatic melanoma to the skin may at times be difficult to diagnose clinically and/or histopathologically because of overlapping features with primary melanoma or melanocytic nevi 1–8 . Blue nevus‐like melanoma metastases are a notorious example of such a diagnostic pitfall 3,6,9 …”

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confidence: 99%

Diagnosis of blue nevus‐like metastatic uveal melanoma confirmed by fluorescence in situ hybridization (FISH) for monosomy 3

et al. 2012

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Metastatic melanoma can on rare occasion simulate the appearance of a blue nevus clinically and/or histopathologically, which may lead to diagnostic confusion and delay in treatment. Given the known difficulty in recognizing a small dermal blue nevus-like melanoma metastasis by light microscopic findings alone, recent discoveries of unique cytogenetic aberrations in various types of melanomas have led pathologists to explore cytogenetic techniques as an ancillary diagnostic tool. Herein, we report a case of a 58-year-old man with a history of uveal melanoma, in which fluorescence in situ hybridization (FISH) analysis for monosomy 3 helped confirm a diagnosis of blue nevus-like uveal melanoma metastasis. The patient had presented clinically with a new small 1-mm dark blue-gray macule on the forehead. Histopathologically, a small dermal nodule of pigmented epithelioid melanocytes and melanophages was found with a rare mitotic figure. The pathologist's suspicion of a blue nevus-like melanoma metastasis was confirmed by FISH analysis: both the tumor cells of the patient's prior uveal melanoma and the melanocytes of the new dermal blue nevus-like nodule carried only one copy of chromosome 3. Furthermore, deletion of 1p36 and amplifications of 8q32 were also identified.

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“…Cutaneous melanoma metastases (CMMs) have no specific clinical and dermoscopic features, and may be difficult to differentiate from benign lesions 1–4 . Recently, we observed a case of CMM clinically and dermoscopically resembling eruptive, grouped, seborrheic keratoses (SKs).…”

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confidence: 99%

“…From a clinical point of view, skin metastases of melanoma often present as small, roundish, pigmented or nonpigmented areas of 1–3 mm in diameter, and generally nonconfluent 1–4 . On other occasions, they may resemble nevocytic nevi, papillomatous dermal nevi, Spitz nevi, Kaposi’s sarcoma, blue nevi, angiosarcomas, glomus tumor, and sarcoidal granulomas 3–5 . Recently, Bono et al 6 .…”

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confidence: 99%