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Melanoma of unknown primary origin coexisting with early-onset multifocal basal cell carcinoma.

Kiedrowicz M, Halczak M, Kładny J, Królicki A, Maleszka R - Postepy Dermatol Alergol (2015)

View Article: PubMed Central - PubMed

Affiliation: Department of Dermatology and Venereology, Pomeranian Medical University, Szczecin, Poland. Head of the Department: Prof. Romuald Maleszka MD, PhD.

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Skin is the most common localization of primary melanoma, however in 2–6% of patients a metastasis of melanoma without a detectable primary tumor is found... This is referred to as melanoma of unknown primary origin (MUP)... In support of the last two theories, in melanomas a partial spontaneous regression connected with immunological mechanisms frequently occurs, moreover ectopic melanocytes may be found in lymph nodes and the other tissues, being a potential reservoir of the cells, which may undergo a neoplastic transformation... In patients with MUP metastases may be found primarily in the skin, subcutaneous tissue, internal organs, bones and brain... Skin biopsy from the remaining slightly pigmented macule at this site revealed only a scant inflammatory infiltration with lymphoid cells... No other evidence of potential regression was found... No evidence of primary tumor in thorough physical assessment could confirm this assumption in the presented case... Another unusual observation was the coexistence of MUP with multifocal BBC in the presented female... Also genetic defects, as in basal cell nevus syndrome, Muir-Torre syndrome and xeroderma pigmentosum are risk factors for the accelerated development of early-onset BCC... A decrease in DNA repair may determine the genetic susceptibility of non-melanoma skin cancer at a young age... The presented patient had no noticeable symptoms of any genetic syndrome coexisting with a higher risk of BCC development... However, she declared a cumulative sun exposure in the past and that, with concomitance of defects in DNA repair, could have resulted in the development of melanoma and non-melanoma skin cancer... To the best our knowledge, this is the first description of MUP coexisting with early-onset multifocal BCC diagnosed at the same time.

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An ultrasound picture of an enlarged lymph node within the right inguinal region
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Figure 0001: An ultrasound picture of an enlarged lymph node within the right inguinal region

Mentions: A 33-year-old female patient, generally healthy, with a positive history of drug abuse in the past, presented with a few centimeters’ large, painless nodule within the right inguinal region. Ultrasound examination revealed a longitudinal tumor, partly solid and partly polycystic with vascularized septa. The nodule was surrounded by the capsule and revealed no features of infiltration of the adjacent tissues (Figure 1). Histopathological examination of an excised lesion showed the presence of nodal tissue with the metastasis of melanoma with HMB45 positive, S-100 positive, Melan-A positive, V-9 positive, MIB-1 (a proliferation marker which recognizes the Ki-67 antigen) locally positive (Figures 2 A, B). Keratin AE1/AE3, CG30 and leucocyte common antigen (LCA) were negative in neoplastic cells. There was no history of any surgically excised melanocytic or pigmented lesions. The patient declared extensive exposure to ultraviolet in the past, but without any episodes of sun burns. Family melanoma history was negative, however the patient's mother had a history of one basal cell carcinoma (BCC) at the age of 62.


Melanoma of unknown primary origin coexisting with early-onset multifocal basal cell carcinoma.

Kiedrowicz M, Halczak M, Kładny J, Królicki A, Maleszka R - Postepy Dermatol Alergol (2015)

An ultrasound picture of an enlarged lymph node within the right inguinal region
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4565829&req=5

Figure 0001: An ultrasound picture of an enlarged lymph node within the right inguinal region
Mentions: A 33-year-old female patient, generally healthy, with a positive history of drug abuse in the past, presented with a few centimeters’ large, painless nodule within the right inguinal region. Ultrasound examination revealed a longitudinal tumor, partly solid and partly polycystic with vascularized septa. The nodule was surrounded by the capsule and revealed no features of infiltration of the adjacent tissues (Figure 1). Histopathological examination of an excised lesion showed the presence of nodal tissue with the metastasis of melanoma with HMB45 positive, S-100 positive, Melan-A positive, V-9 positive, MIB-1 (a proliferation marker which recognizes the Ki-67 antigen) locally positive (Figures 2 A, B). Keratin AE1/AE3, CG30 and leucocyte common antigen (LCA) were negative in neoplastic cells. There was no history of any surgically excised melanocytic or pigmented lesions. The patient declared extensive exposure to ultraviolet in the past, but without any episodes of sun burns. Family melanoma history was negative, however the patient's mother had a history of one basal cell carcinoma (BCC) at the age of 62.

View Article: PubMed Central - PubMed

Affiliation: Department of Dermatology and Venereology, Pomeranian Medical University, Szczecin, Poland. Head of the Department: Prof. Romuald Maleszka MD, PhD.

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

Skin is the most common localization of primary melanoma, however in 2–6% of patients a metastasis of melanoma without a detectable primary tumor is found... This is referred to as melanoma of unknown primary origin (MUP)... In support of the last two theories, in melanomas a partial spontaneous regression connected with immunological mechanisms frequently occurs, moreover ectopic melanocytes may be found in lymph nodes and the other tissues, being a potential reservoir of the cells, which may undergo a neoplastic transformation... In patients with MUP metastases may be found primarily in the skin, subcutaneous tissue, internal organs, bones and brain... Skin biopsy from the remaining slightly pigmented macule at this site revealed only a scant inflammatory infiltration with lymphoid cells... No other evidence of potential regression was found... No evidence of primary tumor in thorough physical assessment could confirm this assumption in the presented case... Another unusual observation was the coexistence of MUP with multifocal BBC in the presented female... Also genetic defects, as in basal cell nevus syndrome, Muir-Torre syndrome and xeroderma pigmentosum are risk factors for the accelerated development of early-onset BCC... A decrease in DNA repair may determine the genetic susceptibility of non-melanoma skin cancer at a young age... The presented patient had no noticeable symptoms of any genetic syndrome coexisting with a higher risk of BCC development... However, she declared a cumulative sun exposure in the past and that, with concomitance of defects in DNA repair, could have resulted in the development of melanoma and non-melanoma skin cancer... To the best our knowledge, this is the first description of MUP coexisting with early-onset multifocal BCC diagnosed at the same time.

No MeSH data available.