Uncommon case of the acral melanoma with chondro-osseous metaplasia
- Authors: Bychkova E.Y.1, Grigoruk O.G.1,2,3, Kuratov D.O.1, Afanasieva E.A.1, Bazulina L.M.2, Bykova N.A.1
-
Affiliations:
- Biysk Oncological Dispensary
- Altai Regional Oncological Dispensary
- The Altai State Medical University, Ministry of Health of Russia
- Issue: Vol 25, No 6 (2020)
- Pages: 208-212
- Section: Case Reports
- URL: https://journals.rcsi.science/1028-9984/article/view/79435
- DOI: https://doi.org/10.17816/1028-9984-2020-25-6-208-212
- ID: 79435
Cite item
Abstract
Aim. This study aimed to improve the diagnostics of acral melanoma and investigate tumor morphological features of the chondroid and osseous matrix.
Materials and methods. The article presents a clinical case of metastatic acral melanoma with chondroid and osseous metaplasia in a 60-year-old patient. Cytological, histologic, immunohistochemical, and molecular genetic studies were performed.
Results. A conglomerate of lymph nodes was noted in the inguinal region of the patient. Oxyphilic chondroid masses and tumor cells with morphological features of sarcoma were revealed using thin-needle aspiration biopsy. On physical examination, pink-colored subcutaneous neoplasm was discovered in the skin of the heel. Histological examination of the primary neoplasm and inguinal lymph node was performed. Melanoma with chondro-osseous metaplasia was diagnosed. Immunohistochemical examination of the tumor revealed some pronounced diffuse expressions of S-100 protein, HMB-45, and focal expression of Melan A in tumor cells. The sample was tested to detect BRAF mutation, and no mutations were found.
Conclusion. Morphological diagnostics of acral melanoma with chondro-osseous metaplasia is characterized by a high risk of diagnostic error. Therefore, additional immunohistological, molecular, and genetic studies should be used in the diagnostics of acral melanoma with chondro-osseous metaplasia.
Full Text
##article.viewOnOriginalSite##About the authors
E. Yu. Bychkova
Biysk Oncological Dispensary
Email: cytolakod@rambler.ru
Russian Federation, Biysk, Altai Krai, 659325
Olga G. Grigoruk
Biysk Oncological Dispensary; Altai Regional Oncological Dispensary; The Altai State Medical University, Ministry of Health of Russia
Author for correspondence.
Email: cytolakod@rambler.ru
заведующий цитологической лабораторией, доктор биологических наук, доцент кафедры биологической химии, клинической лабораторной диагностики
Russian Federation, Biysk, Altai Krai, 659325; Barnaul, 656045; Barnaul, 656038D. O. Kuratov
Biysk Oncological Dispensary
Email: cytolakod@rambler.ru
Russian Federation, Biysk, Altai Krai, 659325
E. A. Afanasieva
Biysk Oncological Dispensary
Email: cytolakod@rambler.ru
Russian Federation, Biysk, Altai Krai, 659325
L. M. Bazulina
Altai Regional Oncological Dispensary
Email: cytolakod@rambler.ru
Russian Federation, Barnaul, 656045
N. A. Bykova
Biysk Oncological Dispensary
Email: cytolakod@rambler.ru
Russian Federation, Biysk, Altai Krai, 659325
References
- WHO. WHO Classification of Skin Tumours. Description: Fifth edition. I Lyon: International Agency for Besearch on Cancer; 2018.
- Malishevskaya NP, Sokolova AV, Demidov LV, Lakomova IN. Acral Lentiginous Melanoma. Effektivnaya farmakoterapiya. 2018;(5):16-19. (In Russ).
- Magro CM, Crowson AN, Mihm MC. Unusual variants of malignant melanoma. Mod Pathol. 2006;19 Suppl 2:S41-70. doi: 10.1038/modpathol.3800516
- Joana Devesa P, Labareda JM, Bartolo EA, et al. Cartilaginous melanoma: case report and review of the literature. An Bras Dermatol. 2013;88(3):403-407. doi: 10.1590/abd1806-4841.20131595
- Ali AM, Wang WL, Lazar AJ. Primary chondro-osseous melanoma (chondrosarcomatous and osteosarcomatous melanoma). J Cutan Pathol. 2018;45(2):146-150. doi: 10.1111/cup.13067
- Berro J, Abdul Halim N, Khaled C, Assi HI. Malignant melanoma with metaplastic cartilaginous transdifferentiation: A case report. J Cutan Pathol. 2019;46(12):935-941. doi: 10.1111/cup.13539
- Hioki M, Asai J, Ohshita A, et al. Acral malignant melanoma exhibiting cartilaginous differentiation in a metastatic lymph node. J Dermatol. 2020;47(2):e39-e41. doi: 10.1111/1346-8138.15188
- Crowson AN, Magro C, Mihm MC, Jr. Unusual histologic and clinical variants of melanoma: implications for therapy. Curr Treat Options Oncol. 2006;7(3):169-180. doi: 10.1007/s11864-006-0010-0