Ann Dermatol.  2011 Oct;23(Suppl 2):S155-S159. 10.5021/ad.2011.23.S2.S155.

Primary Malignant Rhabdoid Melanoma

Affiliations
  • 1Department of Dermatology, College of Medicine, Hallym University, Seoul, Korea. dermlee@yahoo.co.kr

Abstract

Melanoma with rhabdoid features is an uncommon variant of malignant melanoma. Here, we describe a rare case of primary rhabdoid malignant melanoma. A 54-year-old man presented with a black tumor measuring 3x4 cm on the right forearm. Histologic sections showed a tumor mass with rhabdoid features composed entirely of polygonal neoplastic cells with eccentric nuclei, prominent nucleoli, and large hyaline cytoplasmic inclusions. The tumor cells were immunoreactive with HMB-45, S100, Fontana-Masson silver and vimentin, and negative for smooth muscle actin, CD68, CD34, CD99, synaptophysin, desmin, and PAS. The differential diagnosis for this tumor included malignant peripheral nerve sheath tumor, malignant peripheral neuroectodermal tumor and rhabdomyosarcoma. The patient was treated with a wide excision and a local skin graft. The excised tumor was entirely composed of rhabdoid tumor cells. No recurrence or metastasis was evident 4 months after removal. This article is relevant to rare cases of primary malignant melanomas showing rhabdoid tumor cells over the entire excised lesion.

Keyword

Malignant melanoma; Rhabdoid

MeSH Terms

Actins
Desmin
Diagnosis, Differential
Forearm
Humans
Hyalin
Inclusion Bodies
Melanoma
Middle Aged
Muscle, Smooth
Neoplasm Metastasis
Neuroectodermal Tumors, Primitive, Peripheral
Peripheral Nerves
Recurrence
Rhabdoid Tumor
Rhabdomyosarcoma
Silver
Skin
Synaptophysin
Transplants
Vimentin
Actins
Desmin
Silver
Synaptophysin
Vimentin

Figure

  • Fig. 1 A solitary, well-defined sessile black tumor measuring 3×4 cm with a granulating protrusion in the central area of the right forearm.

  • Fig. 2 An ulcerated tumor nodule showed neoplastic proliferation of polygonal cells with rhabdoid features and scattered melanin pigments (H&E, ×40).

  • Fig. 3 Tumor cells exhibited eosinophilic cytoplasm displacing a round eccentric vesicular nucleus with a prominent central nucleolus and a large intracytoplasmic hyalin inclusion (arrows) (H&E, ×400).

  • Fig. 4 Immunohistochemically, the neoplastic cells were positive for vimentin (A), S100 (B), Fontana-Masson silver (C) and HMB-45 (D), and negative for smooth muscle actin (E), CD68 (F), CD34 (G), CD99 (H), synaptophysin (I), desmin (J), and PAS (K). Vimentin staining showed intense, diffuse, and globular perinuclear accentuations (A) (A~D: H&E, ×400, E~K: H&E, ×200).


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