Ann Dermatol.  2009 Nov;21(4):409-412. 10.5021/ad.2009.21.4.409.

Coexistence of Amelanotic Melanoma and Liposarcoma

• Jeong TJ
• Lee EJ
• Lee S
• Shin MK
• Haw CR

• KMID: 2156508
• DOI: http://doi.org/10.5021/ad.2009.21.4.409

Abstract

An amelanotic malignant melanoma is characterized by little or no pigment. It is frequently misdiagnosed because it is a rare entity in general, and because of its unusual clinical features. Liposarcoma is one of the most common adult soft tissue sarcomas. We encountered a case of amelanotic melanoma with a concurrent liposarcoma. A 68-year-old man presented with a single, 1.5x1.5 cm round erythematous, eroded nodule on the left heel. A biopsy specimen showed atypical, pleomorphic tumor cells with little melanin pigment. The tumor cells were positive for S-100, HMB-45 and negative for cytokeratins. These findings were consistent with amelanotic melanoma. On positron emission tomography/computed tomography (PET/CT), a hypermetabolic lesion was found in the left buttock. This lesion was excised and diagnosed as a well-differentiated liposarcoma. An association between sarcomas and other primary malignancies has been reported. However, an association between melanoma and liposarcoma is rare.

Keyword

Amelanotic melanoma; Liposarcoma

MeSH Terms

Adult
Aged
Biopsy
Buttocks
Cytochrome P-450 CYP1A1
Electrons
Heel
Humans
Keratins
Liposarcoma
Melanins
Melanoma
Melanoma, Amelanotic
Sarcoma
Cytochrome P-450 CYP1A1
Keratins
Melanins

Figure

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  Fig. 1 1.5×1.5 cm round erythematous nodule with central erosion.

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  Fig. 2 (A) Histopathologic finding of the excised mass showing a diffuse dermal nodule consisting of atypical epitheloid tumor cells devoid of pigment (H&E, ×40). (B) These tumor cells had enlarged hyperchromatic nuclei with prominent nucleoli, irregular nuclear membranes, but little melanin pigment (H&E, ×200). (C) The immunohistochemical staining reaction for S-100 protein was strongly positive (Immunoperoxidase, ×100).

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  Fig. 3 PET/CT revealed a well-demarcated, 6×4×3 cm mass which presented with FDG high uptake in the left buttock.

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  Fig. 4 Cells with hyperchromatic nuclei in a fibrous septum, which partitioned a tumor of univacuolated adipose cells of various sizes (H&E, ×100).

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