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Zhang Q, Yang H, Gao J, Lv R, Zheng K, Zhang P, Ding C. NIR Fluorescence Strategy for the Early Diagnosis of Melanoma Liver Metastasis Based on the Cascade Reaction of Two Specific Bioenzymes. Anal Chem 2025; 97:3125-3135. [PMID: 39894995 DOI: 10.1021/acs.analchem.4c06407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2025]
Abstract
Melanoma liver metastasis poses a serious risk to patient health, leading to deterioration of liver function accompanied by symptoms such as jaundice, abdominal pain, and weight loss. Early detection is paramount as it allows for timely intervention, potentially improving treatment efficacy and patient outcomes. Herein, a dual-target probe activated by butyrylcholinesterase (BChE) and tyrosinase (TYR) was proposed by initiating an enzyme cascade reaction, revealing NIR-emissive methylene blue (MB) as a responsive product. The cascade reaction mechanism was confirmed by enzyme activity inhibition experiments and high-resolution mass spectrometry. Intercellular imaging was carried out on the coincubation model of Hep G2 and B16 cell lines, which is the first attempt to the best of our knowledge. The results showed that BChE expressed in liver cells and TYR overexpressed in B16 cells jointly activated NIR fluorescence, which provides the possibility for the precise detection of melanoma liver metastasis. In vivo studies further proved that this method holds promise for the early diagnosis and postoperative adjunctive therapy of hepatic melanoma, ultimately enhancing survival rates.
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Affiliation(s)
- Qian Zhang
- MOE Key Laboratory of Optic-electric Sensing and Analytical Chemistry for Life Science, Shandong Key Laboratory of Biochemical Analysis, Key Laboratory of Analytical Chemistry for Life Science in Universities of Shandong, College of Chemistry and Molecular Engineering, Qingdao University of Science and Technology, Qingdao 266042, P. R. China
| | - Huiwen Yang
- MOE Key Laboratory of Optic-electric Sensing and Analytical Chemistry for Life Science, Shandong Key Laboratory of Biochemical Analysis, Key Laboratory of Analytical Chemistry for Life Science in Universities of Shandong, College of Chemistry and Molecular Engineering, Qingdao University of Science and Technology, Qingdao 266042, P. R. China
| | - Jian Gao
- MOE Key Laboratory of Optic-electric Sensing and Analytical Chemistry for Life Science, Shandong Key Laboratory of Biochemical Analysis, Key Laboratory of Analytical Chemistry for Life Science in Universities of Shandong, College of Chemistry and Molecular Engineering, Qingdao University of Science and Technology, Qingdao 266042, P. R. China
| | - Ruidian Lv
- MOE Key Laboratory of Optic-electric Sensing and Analytical Chemistry for Life Science, Shandong Key Laboratory of Biochemical Analysis, Key Laboratory of Analytical Chemistry for Life Science in Universities of Shandong, College of Chemistry and Molecular Engineering, Qingdao University of Science and Technology, Qingdao 266042, P. R. China
| | - Ke Zheng
- MOE Key Laboratory of Optic-electric Sensing and Analytical Chemistry for Life Science, Shandong Key Laboratory of Biochemical Analysis, Key Laboratory of Analytical Chemistry for Life Science in Universities of Shandong, College of Chemistry and Molecular Engineering, Qingdao University of Science and Technology, Qingdao 266042, P. R. China
| | - Peng Zhang
- MOE Key Laboratory of Optic-electric Sensing and Analytical Chemistry for Life Science, Shandong Key Laboratory of Biochemical Analysis, Key Laboratory of Analytical Chemistry for Life Science in Universities of Shandong, College of Chemistry and Molecular Engineering, Qingdao University of Science and Technology, Qingdao 266042, P. R. China
| | - Caifeng Ding
- MOE Key Laboratory of Optic-electric Sensing and Analytical Chemistry for Life Science, Shandong Key Laboratory of Biochemical Analysis, Key Laboratory of Analytical Chemistry for Life Science in Universities of Shandong, College of Chemistry and Molecular Engineering, Qingdao University of Science and Technology, Qingdao 266042, P. R. China
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Krishan R, Pandey S, Sakhuja P, Goyal S, Bhardwaj K, Vageesh BG, Agarwal AK. Primary Hepatic Melanoma: A Diagnostic Surprise. Int J Surg Pathol 2025; 33:117-124. [PMID: 38567400 DOI: 10.1177/10668969241236858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Melanoma is a relatively rare malignancy with a highly aggressive biological behavior. Metastases to other sites, like lymph nodes and liver are common, but primary hepatic melanoma is a rarity with poor survival ranging from months to few years. Diagnosis of primary hepatic melanoma via clinical features and imaging technology is difficult because of its ambiguous features. Here, we present a 26-year-old North Indian woman admitted in the department of gastrointestinal surgery at our tertiary care hospital with the complaint of pain in the abdomen for a month associated with the loss of appetite and subsequent weight loss. The liver function tests were within normal limits and viral markers were negative. The triple-phase computed tomography scan of abdomen showed significant hepatomegaly and two well-defined lesions in both lobes of the liver. Histopathological evaluation was performed on the core liver biopsies submitted from the liver lesions. A malignant tumor with abundant black intracytoplasmic pigment was identified. Immunohistochemistry proved the tumor to be melanoma. The detailed clinical history, laboratory, and radiological investigations were acquired and analyzed to rule out a metastatic lesion of the same. A final diagnosis of primary hepatic melanoma was thus rendered. Primary hepatic melanoma is extremely uncommon and has been rarely reported. Preoperative diagnosis is challenging due to low index of suspicion and nonspecific clinical features. In this case report, we discuss the clinicopathological features of primary hepatic melanoma and review the literature so as to increase the awareness and improve our understanding of the disease.
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Affiliation(s)
- Ram Krishan
- Department of Pathology, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research, New Delhi, India
| | - Sachita Pandey
- Department of Pathology, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research, New Delhi, India
| | - Puja Sakhuja
- Department of Pathology, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research, New Delhi, India
| | - Surbhi Goyal
- Department of Pathology, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research, New Delhi, India
| | - Krishna Bhardwaj
- Department of Radiodiagnosis, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research, GIPMER, New Delhi, India
| | - B G Vageesh
- Department of GI Surgery, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research, GIPMER, New Delhi, India
| | - Anil K Agarwal
- Department of GI Surgery, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research, GIPMER, New Delhi, India
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Fontinha GN, Gama JM, Caetano Oliveira R, Cipriano A. Embryonal Sarcoma of the Liver in the Adult: Challenges in the Diagnosis of a Rare Entity. GE PORTUGUESE JOURNAL OF GASTROENTEROLOGY 2024; 31:54-59. [PMID: 38476302 PMCID: PMC10928870 DOI: 10.1159/000528121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 10/17/2022] [Indexed: 03/14/2024]
Abstract
Introduction Embryonal sarcoma of the liver (ESL) is a rare neoplasm of the liver occurring mainly in paediatric ages. Making the correct diagnosis can be challenging as the laboratory and radiological findings that are often nonspecific, and the tumour immunophenotype is poorly defined and even somewhat variable. Case Presentation A large epigastric mass was detected in a computerized tomography scan of a 43-year-old woman presenting with abdominal pain and bloating. The mass was biopsied and submitted to histopathological study. Microscopically the tumour had sarcomatoid features and showed multinucleated cells with periodic acid-Schiff (PAS)-positive globules. Immunostaining revealed positivity for vimentin, CD10, glypican-3, and α1-antitrypsin and negativity for keratins, muscle, adipocytic, and melanocytic differentiation markers. The patient was then submitted to a left hepatectomy with similar histological findings. Discussion ESL in adults is a rarity and its diagnosis requires the exclusion of other entities. While some microscopic features are very common, they remain nonspecific. The main feature is the presence of multinucleated cells with PAS-positive hyaline globules. While ancillary testing is key, the immunophenotype also lacks specificity and ESL may have variable staining for glypican-3 and epithelial or muscle differentiation markers. Although it has been described for more than 3 decades, the prognosis and optimal treatment are still not well defined, but surgery has yielded favourable results.
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Yuan Z, Guo HY, Lu WT, Wang YH, He J, Zhang F, Che JY, Qiao F. Report on a case of liver-originating malignant melanoma of unknown primary. Open Life Sci 2023; 18:20220750. [PMID: 37941789 PMCID: PMC10628584 DOI: 10.1515/biol-2022-0750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 09/01/2023] [Accepted: 09/11/2023] [Indexed: 11/10/2023] Open
Abstract
Malignant melanoma (MM) frequently occurs in the skin or mucosa, whereas malignant melanoma of unknown primary (MUP) is diagnosed in patients with lymph nodes or visceral organs as the site of origin, where it is challenging to detect the primary lesion by comprehensive examination. MUP is possibly related to the spontaneous regression of the primary lesion. In addition, primary hepatic melanoma (PHM) usually refers to the primary MM occurring in the liver, with no typical primary lesions and no manifestations of tumor metastasis. A 61-year-old male patient with liver as the site of origin was diagnosed with MM by Melan-A, HMB-45, and S-100 immunohistochemistry staining of liver biopsy tissue. Based on a comprehensive examination, no basis was found for melanoma in sites such as the skin, mucosa, five sense organs, brain, digestive tract, respiratory tract, or genitalia, and the patient was subsequently diagnosed with MUP. MMs require a comprehensive inspection, beginning with the liver, to search for the primary lesion; if the primary lesion is not found, the possibility of PHM or MUP should be considered.
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Affiliation(s)
- Zheng Yuan
- Department of Infectious Diseases, Affiliated Hospital of Nanjing University of Chinese Medicine, No. 155 of Hanzhong Road, Qinhuai District, Nanjing210000, China
| | - Hai-yan Guo
- Department of Infectious Diseases, Affiliated Hospital of Nanjing University of Chinese Medicine, No. 155 of Hanzhong Road, Qinhuai District, Nanjing210000, China
| | - Wei-ting Lu
- Department of Infectious Diseases, Affiliated Hospital of Nanjing University of Chinese Medicine, No. 155 of Hanzhong Road, Qinhuai District, Nanjing210000, China
| | - Yao-hui Wang
- Department of Pathology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing210000, China
| | - Jing He
- Department of Infectious Diseases, Affiliated Hospital of Nanjing University of Chinese Medicine, No. 155 of Hanzhong Road, Qinhuai District, Nanjing210000, China
| | - Fan Zhang
- Department of Infectious Diseases, Affiliated Hospital of Nanjing University of Chinese Medicine, No. 155 of Hanzhong Road, Qinhuai District, Nanjing210000, China
| | - Jun-yong Che
- Department of Infectious Diseases, Affiliated Hospital of Nanjing University of Chinese Medicine, No. 155 of Hanzhong Road, Qinhuai District, Nanjing210000, China
| | - Fei Qiao
- Department of Infectious Diseases, Affiliated Hospital of Nanjing University of Chinese Medicine, No. 155 of Hanzhong Road, Qinhuai District, Nanjing210000, China
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Yang L, Lei Y, Zhang R, Liu Y, Dai W, Tian F, Liu J. Concurrence of primary pulmonary malignant melanoma with invasive pulmonary adenocarcinoma: a case report. J Cardiothorac Surg 2020; 15:51. [PMID: 32216825 PMCID: PMC7098140 DOI: 10.1186/s13019-020-01091-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Accepted: 03/17/2020] [Indexed: 12/02/2022] Open
Abstract
Background Primary pulmonary malignant melanoma (PPMM) is an extreme rarity in clinic practice, accounting for only 0.01% of all primary pulmonary tumors. And its diagnosis should meet clinical and pathological diagnosis criteria in addition to excluding the possibility of metastatic melanoma. The mainstay of treatment is surgery. The concurrence of primary pulmonary malignant melanoma and invasive pulmonary adenocarcinoma has not been reported before. Case presentation Herein we report the case of a 39-year-old woman who was asymptomatic and accidently found to have the concurrence of PPMM with invasive pulmonary adenocarcinoma. Before considering the diagnosis of primary pulmonary malignant melanoma, a systemic positron emission tomography-computed tomography (PET-CT) was done to excluding primary tumor metastasis from other sites. The pathological biopsy proved that two lesions in the right middle lobe were invasive pulmonary adenocarcinomas and the mass in the right lower lobe was malignant melanoma. She underwent right middle and lower lobectomy of the lung with mediastinal and hilar lymph dissection. She refused adjuvant chemotherapy, genetic molecular testing or immunotherapy. Fifteen months later she had brain metastasis. Then she received brain radiotherapy and underwent follow-up at the outpatient clinic regularly. Conclusions We experienced a case of concurrent PPMM and invasive pulmonary adenocarcinoma. The patient reported here is the first case of primary pulmonary malignant melanoma combined with invasive pulmonary adenocarcinoma. This patient remained disease-free 15 months after lung surgery.
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Affiliation(s)
- Luhuan Yang
- Department of Emergency and Critical Care Medicine, The First College of Clinical Medical Science, Three Gorges University, Yichang Central People's Hospital, Yiling Road 183, Yichang City, 443003, Hubei Province, China
| | - Yunhong Lei
- Department of Emergency and Critical Care Medicine, The First College of Clinical Medical Science, Three Gorges University, Yichang Central People's Hospital, Yiling Road 183, Yichang City, 443003, Hubei Province, China
| | - Rong Zhang
- Department of Emergency and Critical Care Medicine, The First College of Clinical Medical Science, Three Gorges University, Yichang Central People's Hospital, Yiling Road 183, Yichang City, 443003, Hubei Province, China
| | - Yufei Liu
- Department of Pathology, The First College of Clinical Medical Science, Three Gorges University, Yichang Central People's Hospital, Yichang City, 443003, Hubei Province, China
| | - Wenli Dai
- Department of Nuclear Medicine, The First College of Clinical Medical Science, Three Gorges University, Yichang Central People's Hospital, Yichang City, 443003, Hubei Province, China
| | - Fei Tian
- Department of Emergency and Critical Care Medicine, The First College of Clinical Medical Science, Three Gorges University, Yichang Central People's Hospital, Yiling Road 183, Yichang City, 443003, Hubei Province, China
| | - Jinglan Liu
- Department of Emergency and Critical Care Medicine, The First College of Clinical Medical Science, Three Gorges University, Yichang Central People's Hospital, Yiling Road 183, Yichang City, 443003, Hubei Province, China.
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Murakami K, Tobino K, Yamaji Y, Ooi R, Munechika M, Enzan Y, Yoshimatsu Y, Tsuruno K, Ide H, Ebi N. Primary Pleural Melanoma: A Case Report and Literature Review. Intern Med 2019; 58:3273-3276. [PMID: 31327838 PMCID: PMC6911739 DOI: 10.2169/internalmedicine.3111-19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Primary pleural melanoma is an extremely rare neoplasm, and to the best of our knowledge, there have been only 8 case reports of this condition in the English literature. We herein report a rare case in which the cytological and immunocytochemical analyses of pleural fluid and ultrasonography (US)-guided biopsy of a pleural lesion were useful for the diagnosis primary pleural melanoma. This case highlights the importance of careful physical examinations, cytomorphologic and immunocytochemical analyses of pleural fluid, as well as the utility of US-guided biopsy of the pleural lesions in the diagnosis of primary pleural melanoma.
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Affiliation(s)
- Kojin Murakami
- Department of Respiratory Medicine, Iizuka Hospital, Japan
| | - Kazunori Tobino
- Department of Respiratory Medicine, Iizuka Hospital, Japan
- Department of Respiratory Medicine, Juntendo University Graduate School of Medicine, Japan
| | - Yoshikazu Yamaji
- Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, Japan
| | - Ryunosuke Ooi
- Department of Respiratory Medicine, Iizuka Hospital, Japan
| | | | - Yuki Enzan
- Department of Respiratory Medicine, Iizuka Hospital, Japan
| | | | - Kosuke Tsuruno
- Department of Respiratory Medicine, Iizuka Hospital, Japan
| | - Hiromi Ide
- Department of Respiratory Medicine, Iizuka Hospital, Japan
| | - Noriyuki Ebi
- Department of Respiratory Medicine, Iizuka Hospital, Japan
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Ao W, Wang J, Mao G, Yang G, Han X, Jia Y, Cheng Y. Primary hepatic melanoma: A case report of computed tomography and magnetic resonance imaging findings. Medicine (Baltimore) 2019; 98:e16165. [PMID: 31232974 PMCID: PMC6636915 DOI: 10.1097/md.0000000000016165] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
RATIONALE Malignant melanoma predominantly develops in middle-aged and older adults, most commonly occurring on the skin and rarely on internal organs. Malignant melanoma originating in the liver is extremely rare. Imaging findings of primary hepatic melanoma (PHM) are scarce in relevant literature. PATIENT CONCERNS The patient was a 69-year-old woman from Zhejiang, China, who was admitted to the hospital because of upper abdominal pain that persisted for >10 days. DIAGNOSES Computed tomography (CT) findings indicated the presence of a circular low-density shadow of approximately 7.5 × 8.0 cm in the hepatic hilar region. Magnetic resonance imaging (MRI) indicated a heterogeneous solid cystic mass in the hepatic hilar region. The mass exhibited heterogeneous low-signal intensity on a T1-weighted image (T1WI) and slightly higher signal intensity on a T2-weighted image (T2WI). The tumor appeared as multiple irregular strips with high-signal intensity on T1WI and low-signal intensity on T2WI. The diffusion-weighted image revealed increased signal intensity. The tumor continued to be enhanced after enhancement. Clinical data suggested that the tumor was a malignant liver tumor. INTERVENTIONS The patient underwent a CT guide puncture hepatic biopsy. The tumor was located in the hepatic hilar region adjacent to the large blood vessels and invaded the portal vein. Because a resection was highly risky, conservative treatment was conducted. OUTCOMES Postoperative pathology and clinical examination confirmed that the tumor was malignant PHM. The patient has been followed up for 6 months. The patient underwent CT reexamination 2 months after conservative treatment, the results of which revealed that the tumor progressed. Multiple lesions were identified; moreover, the tumor size had increased and the tumor had invaded the portal vein and intrahepatic bile duct. The patient was reexamined by CT in another hospital 6 months after conservative treatment. The results revealed peritoneal, omental metastases and multi bone metastases. LESSONS To our best knowledge, this is the first reported case of a PHM with complete imaging data, including preoperative CT and MRI examinations and a follow-up CT examination. From compiling the CT and MRI findings of this patient and those of relevant studies, this study can serve as a reference for the preoperative diagnosis and differential diagnosis of PHM.
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Affiliation(s)
| | | | | | | | - Xiaoyu Han
- Department of Pathology, Tongde Hospital of Zhejiang Province, Hangzhou, Zhejiang, China
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Shi Y, Bing Z, Xu X, Cui Y. Primary pulmonary malignant melanoma: Case report and literature review. Thorac Cancer 2018; 9:1185-1189. [PMID: 30062692 PMCID: PMC6119615 DOI: 10.1111/1759-7714.12798] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2018] [Revised: 06/07/2018] [Accepted: 06/09/2018] [Indexed: 01/13/2023] Open
Abstract
Primary malignant melanoma of the lung is an extremely rare pulmonary carcinoma. Only 45 cases have been reported in the literature. Herein, we report a case of a 46‐year‐old male patient with an O Rh negative blood type who presented with pulmonary bronchial symptoms and underwent lobectomy. Genetic testing was also performed but no targetable mutations were found, and the patient's PD‐L1 RNA level was low. He developed brain metastasis four months after surgery and received radiotherapy but died 21 months after diagnosis. We review the published cases of this rare pulmonary lesion.
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Affiliation(s)
- Yuequan Shi
- Department of Critical Care Medicine, First Affiliated Hospital of China Medical University, Shenyang, China
| | - Zhongxing Bing
- Department of Thoracic Surgery, Peking Union Medical College Hospital, Beijing, China
| | - Xiaohui Xu
- Department of Thoracic Surgery, Peking Union Medical College Hospital, Beijing, China
| | - Yushang Cui
- Department of Thoracic Surgery, Peking Union Medical College Hospital, Beijing, China
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Abstract
PURPOSE OF REVIEW Mucosal melanoma is of great interest due to its aggressive behavior and less favorable prognosis. The literature is mainly case reports and case series. Here, we will collect the knowledge on mucosal melanoma from the last decade and review the literature. The main focus is being site-specific clinical features, treatment, and prognosis. RECENT FINDINGS The use of immunotherapy gain ground as for others subsets of melanoma. Anti-CTLA-4 and anti-PD-1/ PD-L1 blockade in mucosal melanoma have been evaluated in recent studies. Clinical trials are ongoing. The etiology of mucosal melanomas remains unknown. Head and neck mucosal melanomas are most common. Wide excision surgery is the treatment of choice. The effect of adjuvant therapy on survival remains questionable due to the limited knowledge. Radiotherapy seems to give better local control. The overall five-year survival rate for mucosal melanomas is 0-45%. Recent data indicates that this may be improved by the immunotherapy in the years to come.
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Affiliation(s)
- Simon Skovsted Yde
- Plastic Surgical Research Unit, Department of Plastic Surgery, Aarhus University Hospital, Noerrebrogade 44, 8000, Aarhus C, Denmark.
| | - Pia Sjoegren
- Plastic Surgical Research Unit, Department of Plastic Surgery, Aarhus University Hospital, Noerrebrogade 44, 8000, Aarhus C, Denmark
| | - Martin Heje
- Plastic Surgical Research Unit, Department of Plastic Surgery, Aarhus University Hospital, Noerrebrogade 44, 8000, Aarhus C, Denmark
| | - Lars B Stolle
- Plastic Surgical Research Unit, Department of Plastic Surgery, Aarhus University Hospital, Noerrebrogade 44, 8000, Aarhus C, Denmark
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Primary Esophageal Melanoma with Aberrant CD56 Expression: A Potential Diagnostic Pitfall. Case Rep Pathol 2017; 2017:9052637. [PMID: 29230340 PMCID: PMC5694584 DOI: 10.1155/2017/9052637] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Revised: 07/07/2017] [Accepted: 10/17/2017] [Indexed: 12/23/2022] Open
Abstract
Primary esophageal malignant melanoma (MM) is rare and extremely aggressive. For pathologists, it can be challenging to diagnose and differentiate from other poorly differentiated malignant neoplasms in the esophagus. Complicating this fact, MM can have divergent differentiation and express nonmelanocytic immunohistochemical markers including epithelial markers (cytokeratins) and rarely neuroendocrine markers. Lack of awareness of this fact by a pathologist can lead to an erroneous diagnosis and delay treatment for an already aggressive disease. Herein, we report a case of primary esophageal malignant melanoma with aberrant CD56 expression without accompanying synaptophysin or chromogranin expression.
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11
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Primary Pulmonary Malignant Melanoma: Report of an Important Entity and Literature Review. Case Rep Oncol Med 2017; 2017:8654326. [PMID: 28352484 PMCID: PMC5352873 DOI: 10.1155/2017/8654326] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Revised: 02/12/2017] [Accepted: 02/14/2017] [Indexed: 01/08/2023] Open
Abstract
Malignant melanoma involving the respiratory tract is nearly always metastatic in origin, and primary tumors are extremely rare. Published data on primary pulmonary malignant melanomas are limited. Up to now 40 relevant cases have been reported in the English literature. Herein, we report a case of a 56-year-old female patient who presented with intracranial metastases due to primary pulmonary melanoma. She underwent bronchoscopy and died 5 months after the initial diagnosis despite the administered biochemotherapy and subsequent immunotherapy. To establish the diagnosis of primary pulmonary malignant melanoma, any extrapulmonary origin was excluded by detailed examination and radiographic imaging. Moreover, an extensive review of the literature regarding this rare entity has been performed.
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12
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Agarwal P, Nambiyar K, Manju Kaushal, Bhardwaj M. Primary Malignant Melanoma of Pleura: A Case Report and Literature Review. Diagn Cytopathol 2016; 44:648-52. [PMID: 27164972 DOI: 10.1002/dc.23497] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Revised: 04/19/2016] [Accepted: 04/23/2016] [Indexed: 12/19/2022]
Abstract
Malignant melanoma is one of the most aggressive and treatment resistant skin cancers. India enjoys a low incidence of melanoma, and age specific incidence rates for cutaneous malignant melanoma (CMM) are being less than 0.5 per 1,000,000. This could be due to under-reporting of melanoma on account of a low index of suspicion by clinicians and pathologists alike. Most common site for origin of primary melanoma is skin, accounting for about 91.2% of all reported primary malignant melanoma cases. Other primary sites are relatively uncommon. Primary pleural melanoma is a very rare tumor and to the best of our knowledge, only seven cases have been reported so far worldwide. We hereby discuss a new case, only second from India. Our patient also had coexistent congenital hairy nevus, an unusual association also noted in two previously reported cases. Excluding primary cutaneous melanoma with pleural metastasis was a diagnostic challenge in this case but multiple cutaneous biopsies together with clinical and findings helped us arrive at this unusual diagnosis. Unfortunately, the patient succumbed to his illness. Diagn. Cytopathol. 2016;44:648-652. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Poojan Agarwal
- Department of Pathology, PGIMER, Dr. RML Hospital, New Delhi, India
| | | | - Manju Kaushal
- Department of Pathology, PGIMER, Dr. RML Hospital, New Delhi, India
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13
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Xie YY, Chen MF, Li GG. Primary malignant melanoma of the liver: A case report. Shijie Huaren Xiaohua Zazhi 2015; 23:5903-5906. [DOI: 10.11569/wcjd.v23.i36.5903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Primary malignant melanoma of the liver is a rare clinical entity. Since it has no specific clinical manifestations or computed tomography characteristics, it is difficult to diagnose. Here we report a patient who was initially misdiagnosed with a benign tumor but was finally diagnosed with primary malignant melanoma of the liver by pathological examination. Surgery is the primary therapeutic option for this rare entity.
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14
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Hwang KB, Hwang KE, Jung JW, Oh SJ, Park MJ, Jeong YH, Choi KH, Jeong ET, Kim HR. Primary Pulmonary Malignant Melanoma: An Unexpected Tumor. Tuberc Respir Dis (Seoul) 2015; 78:272-5. [PMID: 26175784 PMCID: PMC4499598 DOI: 10.4046/trd.2015.78.3.272] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2014] [Revised: 12/08/2014] [Accepted: 12/09/2014] [Indexed: 11/24/2022] Open
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.
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Affiliation(s)
- Kyo-Bum Hwang
- Department of Internal Medicine, Institute of Wonkwang Medical Science, Wonkwang University School of Medicine, Iksan, Korea
| | - Ki-Eun Hwang
- Department of Internal Medicine, Institute of Wonkwang Medical Science, Wonkwang University School of Medicine, Iksan, Korea
| | - Jae-Wan Jung
- Department of Internal Medicine, Institute of Wonkwang Medical Science, Wonkwang University School of Medicine, Iksan, Korea
| | - Su-Jin Oh
- Department of Internal Medicine, Institute of Wonkwang Medical Science, Wonkwang University School of Medicine, Iksan, Korea
| | - Mi-Jeong Park
- Department of Internal Medicine, Institute of Wonkwang Medical Science, Wonkwang University School of Medicine, Iksan, Korea
| | - Young-Hoon Jeong
- Department of Internal Medicine, Institute of Wonkwang Medical Science, Wonkwang University School of Medicine, Iksan, Korea
| | - Keum-Ha Choi
- Department of Pathology, Institute of Wonkwang Medical Science, Wonkwang University School of Medicine, Iksan, Korea
| | - Eun-Taik Jeong
- Department of Internal Medicine, Institute of Wonkwang Medical Science, Wonkwang University School of Medicine, Iksan, Korea
| | - Hak-Ryul Kim
- Department of Internal Medicine, Institute of Wonkwang Medical Science, Wonkwang University School of Medicine, Iksan, Korea
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15
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Filippini A, Zorzi F, Bna' C, Arnaboldi A, Sabatini T. Dark sputum: An atypical presentation of primary pulmonary malignant melanoma. Respir Med Case Rep 2015; 15:118-20. [PMID: 26236620 PMCID: PMC4501519 DOI: 10.1016/j.rmcr.2015.03.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Primary melanoma of the lung is an extremely rare clinical entity. We found only 32 cases reported in literature, and in two of these multiple brain metastases were present. We describe a case of primary lung melanoma with brain and skin metastases that presented with an initial clinical diagnosis of pneumonia. A 55-year-old white man presented with cough productive of dark sputum and fever. A chest x-ray showed a right lung infiltration. After failure to respond to usual treatment for pneumonia, bronchoscopy examination and CT scan revealed a right pulmonary mass. The CT-guided biopsy confirmed a diagnosis of malignant melanoma. The primary lung origin of the tumor was demonstrated by the characteristic junctional pattern of melanoma cells. Further evaluation revealed metastases in the brain and in skin. Primary lung melanoma is an uncommon neoplasm that may be confused with more conventional types of lung cancer. Careful interpretation of histopathological information in correlation with all other clinical, laboratory and imaging studies may be needed to establish a diagnosis. Evaluation for metastases should include looking at the eyes, brain, skin. Due to the small number of cases reported in literature, there is no experience on the management and the prognosis of the disease.
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Affiliation(s)
- Alida Filippini
- Department of Internal Medicine, Gastroenterology and Digestive Endoscopy, Poliambulanza Hospital Clinical Institute, Via Bissolati 57, 25124 Brescia, Italy
| | - Fausto Zorzi
- Department of Pathology, Poliambulanza Hospital Clinical Institute, Via Bissolati 57, 25124 Brescia, Italy
| | - Claudio Bna'
- Department of Radiology, Poliambulanza Hospital Clinical Institute, Via Bissolati 57, 25124 Brescia, Italy
| | - Antonio Arnaboldi
- Department of Internal Medicine, Gastroenterology and Digestive Endoscopy, Poliambulanza Hospital Clinical Institute, Via Bissolati 57, 25124 Brescia, Italy
| | - Tony Sabatini
- Department of Internal Medicine, Gastroenterology and Digestive Endoscopy, Poliambulanza Hospital Clinical Institute, Via Bissolati 57, 25124 Brescia, Italy
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16
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Biswas S, Rajoriya N, Wang LM, Collier J. A liver lesion in primary sclerosing cholangitis. BMJ Case Rep 2015; 2015:bcr-2014-207685. [PMID: 25827915 DOI: 10.1136/bcr-2014-207685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Primary sclerosing cholangitis is associated with an increased risk of cholangiocarcinoma; appropriate surveillance should be undertaken for this. Our case illustrates an unexpected liver lesion in such a patient, which would not have been detected with imaging alone. In suspected cancer, if a patient is not a candidate for liver resection, liver biopsy should be considered in case there is a treatment option for an alternative cause of the liver lesion. This is a careful decision to be made due to the risk of tumour seeding compromising cure and needs to be discussed via the hepatobiliary multidisciplinary team.
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Affiliation(s)
- Sujata Biswas
- Translational Gastroenterology Unit, John Radcliffe Hospital, Oxford, UK
| | - Neil Rajoriya
- Translational Gastroenterology Unit, John Radcliffe Hospital, Oxford, UK
| | - Lai Mun Wang
- Department of Cellular Pathology, John Radcliffe Hospital, Oxford, UK
| | - Jane Collier
- Translational Gastroenterology Unit, John Radcliffe Hospital, Oxford, UK
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17
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Du F, Yang M, Fang J, Jing C. Primary hepatic malignant melanoma: a case report. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2015; 8:2199-2201. [PMID: 25973128 PMCID: PMC4396328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/30/2014] [Accepted: 01/28/2015] [Indexed: 06/04/2023]
Abstract
Primary hepatic malignant melanoma is a very rare disease. In order to provide clues concerning diagnosis, differential diagnosis and pathogenesis of the disease, a case of a 49 year-old female patient with primary hepatic malignant melanoma is presented. B-mode ultrasound and Contrast-enhanced abdominal computerized tomography (CT) examinations revealed that nodules of varying sizes are diffusely distributed in her enlarged liver. Pathological examination revealed that tumor cells with poor differentiation were located in nests with prominent melanin deposition. Immuno-histochemical staining showed that the tumor cells were positive for HMB-45 and S-100 protein. No evidence for primary malignant melanoma of other sites had been found by comprehensive examinations. Therefore, the patient was diagnosed with primary malignant melanoma of liver. Our case showed that primary malignant melanoma of liver is of histological heterogeneity, and immunohistochemical staining may aid in differential diagnosis between it and other hepatic neoplasms.
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Affiliation(s)
- Fangjuan Du
- Department of Gastroenterology, The Second People’s Hospital of Liaocheng Affiliated to Taishan Medical CollegeLiaocheng 252600, Shandong, China
| | - Maowu Yang
- Department of Gastroenterology, The Second People’s Hospital of Liaocheng Affiliated to Taishan Medical CollegeLiaocheng 252600, Shandong, China
| | - Jingzhong Fang
- Department of Ultrasonography, The Second People’s Hospital of Liaocheng Affiliated to Taishan Medical CollegeLiaocheng 252600, Shandong, China
| | - Changchun Jing
- Department of Gastroenterology, The Second People’s Hospital of Liaocheng Affiliated to Taishan Medical CollegeLiaocheng 252600, Shandong, China
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18
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Du SD, Mao YL, Li SH, Sang XT, Lu X, Xu YY, Xu HF, Zhao L, Bai CM, Zhong SX, Huang JF. Surgical resection plus biotherapy/chemotherapy improves survival of hepatic metastatic melanoma. World J Hepatol 2012; 4:305-10. [PMID: 23293716 PMCID: PMC3536837 DOI: 10.4254/wjh.v4.i11.305] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2012] [Revised: 10/12/2012] [Accepted: 11/02/2012] [Indexed: 02/06/2023] Open
Abstract
AIM To analyze the correlation of treatment method with the outcome of all the hepatic metastatic melanoma (HMM) patients from our hospital. METHODS There were altogether nine cases of HMM that had been treated in the PUMCH hospital during the past 25 years, from December 1984 to February 2010. All of the cases developed hepatic metastasis from primary cutaneous melanoma. A retrospective review was performed on all the cases in order to draw informative conclusion on diagnosis and treatment in correlation with the prognosis. Clinical features including symptoms, signs, blood test results, B-ultrasound and computed tomography (CT) imaging characteristics, and pathological data were analyzed in each case individually. A simple comparison was made on case by case basis instead of performing statistical analysis since the case numbers are low and patients were much diversified in each item that has been analyzed. Literatures on this subject were reviewed in order to draw a safe conclusion and found to be supportive to our finding in a much broad scope. RESULTS There are six males and three females whose ages ranged 39-74 years old with an average of 58.8. Patients were either with or without symptoms at the time of diagnosis. The liver function and tumor marker exam were normal in all but one patient. The incidence of HMM does not affect liver function and was not related to virus infection status in the liver. Most of these HMM patients were also accompanied by the metastases of other locations, including lung, abdominal cavity, and cervical lymph nodes. Ultrasound examinations showed lesions ranging 2-12 cm in diameter, with no- or low-echo peripheral areola. Doppler showed blood flow appeared inside some tumors as well as in the surrounding area. CT image demonstrated low density without uniformed lesions, characterized with calcification in periphery, and enhanced in the arterial phase. Contrast phase showed heterogeneous enhancement, with a density higher than normal liver tissue, which was especially apparent at the edge. Patients were treated differently with following procedures: patients #1, #6 and #8 were operated with hepatectomy with or without removal of primary lesion, and followed by comprehensive biotherapy/chemotherapy; patient #9 received hepatectomy only; patient #2 received bacille calmette-guerin treatment only; patient #7 had Mile's surgery but no hepatectomy; and patients #3, #4 and #5 had supportive treatment without specific measurement. The patients who had resections of metastatic lesions followed by post-operative comprehensive therapy have an average survival time of 30.7 mo, which is much longer than those did not receive surgery treatment (4.6 mo). Even for the patient receiving a resection of HMM only, the post-operative survival time was 18 mo at the time we reviewed the data. This patient and the patient #6 are still alive currently and subjected to continue following up. CONCLUSION Surgical operation should be first choice for HMM treatment, and together with biotherapy/chemotherapy, hepatectomy is likely to bring better prognosis.
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Affiliation(s)
- Shun-Da Du
- Shun-Da Du, Yi-Lei Mao, Shao-Hua Li, Xin-Ting Sang, Xin Lu, Yi-Yao Xu, Hai-Feng Xu, Shou-Xian Zhong, Jie-Fu Huang, Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
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19
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Gong L, Liu XY, Zhang WD, Zhu SJ, Yao L, Han XJ, Lan M, Li YH, Zhang W. Primary pulmonary malignant melanoma: a clinicopathologic study of two cases. Diagn Pathol 2012; 7:123. [PMID: 22992473 PMCID: PMC3502413 DOI: 10.1186/1746-1596-7-123] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2012] [Accepted: 09/15/2012] [Indexed: 12/03/2022] Open
Abstract
Abstract Malignant melanoma involving the respiratory tract is nearly always metastatic in origin, and primary tumors are very rare. To our knowledge, about 30 cases have been reported in the English literature, one of which involved multiple brain metastases. Here, we report two cases of primary pulmonary malignant melanoma. The first case, which occurred in a 52-year-old Chinese female patient who died 4 months after the initial diagnosis, involved rapid intrapulmonary and intracranial metastases. The second patient, a 65-year-old female, underwent surgical excision, and clinical examination, histopathological characteristics, and immunohistochemical features supported the diagnosis of pulmonary malignant melanoma. No evidence for recurrence and/or metastasis has been found more than one year after the initial surgery. To establish the diagnosis of primary pulmonary malignant melanoma, any extrapulmonary origin must be excluded by detailed examination. Moreover, the tumor should be removed surgically whether it occurs as a single lesion or multiple lesions. Virtual slide The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1480477335765055.
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Affiliation(s)
- Li Gong
- The Helmholtz Sino-German Laboratory for Cancer Research, Department of Pathology, Tangdu Hospital, The Fourth Military Medical University, Xi'an, PR China
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