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Melanoma in situ colonizing basal cell carcinoma: a case report and review of the literature.

Mancebo SE, Marchetti MA, Hollmann TJ, Marghoob AA, Busam KJ, Halpern AC - Dermatol Pract Concept (2015)

Bottom Line: We describe a bluish nodule on the left forearm found during routine skin cancer surveillance examination with suspicious dermatoscopic findings including central-blue-white veil, sparse atypical dots, and a surrounding pink vascular blush with focal irregular tan-brown pigmentation at the periphery.Histopathology demonstrated a pigmented BCC with an overlying and adjacent melanoma in situ (MIS), as well as colonization of the BCC nodule by melanoma cells.The prognostic and management challenges inherent to this distinctive neoplasm are summarized.

View Article: PubMed Central - PubMed

Affiliation: Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA.

ABSTRACT
Colonization of basal cell carcinoma (BCC) by melanoma cells is a unique and uncommonly reported cutaneous entity. We describe a bluish nodule on the left forearm found during routine skin cancer surveillance examination with suspicious dermatoscopic findings including central-blue-white veil, sparse atypical dots, and a surrounding pink vascular blush with focal irregular tan-brown pigmentation at the periphery. Histopathology demonstrated a pigmented BCC with an overlying and adjacent melanoma in situ (MIS), as well as colonization of the BCC nodule by melanoma cells. We performed a review of the literature on the topic and discuss other presentations of cutaneous neoplasms composed of both BCC and melanoma, including collision, combined, and biphenotypic tumors. The prognostic and management challenges inherent to this distinctive neoplasm are summarized.

No MeSH data available.


Related in: MedlinePlus

Histopathologic examination revealed a nodular basaloid tumor island budding from the epidermis, stromal retraction, and small cystic spaces filled with mucin and pigment (hematoxylin-eosin, ×40). (Copyright: ©2015 Mancebo et al.)
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f3-dp0501a04: Histopathologic examination revealed a nodular basaloid tumor island budding from the epidermis, stromal retraction, and small cystic spaces filled with mucin and pigment (hematoxylin-eosin, ×40). (Copyright: ©2015 Mancebo et al.)

Mentions: Clinical concern for melanoma prompted an excisional biopsy. Histopathologic examination of the biopsy specimen revealed a nodular basaloid tumor abutting from the epidermis with mucinous stroma, stromal retraction, and small cystic spaces filled with mucin and melanin pigment (Figure 3). Many atypical melanocytes were identified within the tumor as well as in the adjacent epidermis (Figures 3 and 4). The nodular basaloid tumor stained with BerEp4 (Figure 5). The atypical melanocyte population within the tumor and along the dermal-epidermal junction stained with HMB-45 (Figure 6A and 6B), A103, and Sox10. No invasive melanoma was identified in the dermal stroma outside the basaloid nodule. These findings were interpreted as melanoma in situ (MIS) colonizing a nodular basal cell carcinoma (BCC). Surgical excision with 1 cm margins was performed and revealed residual MIS at a peripheral margin. Two additional excisions, each with 5 mm margins, were required to achieve negative histopathologic margins.


Melanoma in situ colonizing basal cell carcinoma: a case report and review of the literature.

Mancebo SE, Marchetti MA, Hollmann TJ, Marghoob AA, Busam KJ, Halpern AC - Dermatol Pract Concept (2015)

Histopathologic examination revealed a nodular basaloid tumor island budding from the epidermis, stromal retraction, and small cystic spaces filled with mucin and pigment (hematoxylin-eosin, ×40). (Copyright: ©2015 Mancebo et al.)
© Copyright Policy
Related In: Results  -  Collection

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getmorefigures.php?uid=PMC4325687&req=5

f3-dp0501a04: Histopathologic examination revealed a nodular basaloid tumor island budding from the epidermis, stromal retraction, and small cystic spaces filled with mucin and pigment (hematoxylin-eosin, ×40). (Copyright: ©2015 Mancebo et al.)
Mentions: Clinical concern for melanoma prompted an excisional biopsy. Histopathologic examination of the biopsy specimen revealed a nodular basaloid tumor abutting from the epidermis with mucinous stroma, stromal retraction, and small cystic spaces filled with mucin and melanin pigment (Figure 3). Many atypical melanocytes were identified within the tumor as well as in the adjacent epidermis (Figures 3 and 4). The nodular basaloid tumor stained with BerEp4 (Figure 5). The atypical melanocyte population within the tumor and along the dermal-epidermal junction stained with HMB-45 (Figure 6A and 6B), A103, and Sox10. No invasive melanoma was identified in the dermal stroma outside the basaloid nodule. These findings were interpreted as melanoma in situ (MIS) colonizing a nodular basal cell carcinoma (BCC). Surgical excision with 1 cm margins was performed and revealed residual MIS at a peripheral margin. Two additional excisions, each with 5 mm margins, were required to achieve negative histopathologic margins.

Bottom Line: We describe a bluish nodule on the left forearm found during routine skin cancer surveillance examination with suspicious dermatoscopic findings including central-blue-white veil, sparse atypical dots, and a surrounding pink vascular blush with focal irregular tan-brown pigmentation at the periphery.Histopathology demonstrated a pigmented BCC with an overlying and adjacent melanoma in situ (MIS), as well as colonization of the BCC nodule by melanoma cells.The prognostic and management challenges inherent to this distinctive neoplasm are summarized.

View Article: PubMed Central - PubMed

Affiliation: Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA.

ABSTRACT
Colonization of basal cell carcinoma (BCC) by melanoma cells is a unique and uncommonly reported cutaneous entity. We describe a bluish nodule on the left forearm found during routine skin cancer surveillance examination with suspicious dermatoscopic findings including central-blue-white veil, sparse atypical dots, and a surrounding pink vascular blush with focal irregular tan-brown pigmentation at the periphery. Histopathology demonstrated a pigmented BCC with an overlying and adjacent melanoma in situ (MIS), as well as colonization of the BCC nodule by melanoma cells. We performed a review of the literature on the topic and discuss other presentations of cutaneous neoplasms composed of both BCC and melanoma, including collision, combined, and biphenotypic tumors. The prognostic and management challenges inherent to this distinctive neoplasm are summarized.

No MeSH data available.


Related in: MedlinePlus