Mitschler A, Grange F, Koessler A, Chenard M-P, Krzisch S, Grosshans E, Guillaume J-C
Service de Dermatologie, Hôpital Pasteur, Colmar.
Ann Dermatol Venereol. 2003 Jun-Jul;130(6-7):631-4.
Melanoma of the soft tissue is a rare tumor that develops in most cases in the deep structures, only rarely involving the skin surface. We report an exceptional case of melanoma of the superficial soft tissue, exclusively involving the skin surface.
A 35-year-old man presented with a superficial, pink, soft, mobile, lesion on the thigh. The histological examination revealed a tumoral proliferation of the reticular dermis and hypodermis, composed of pale giant cells grouped in nests or in lobules separated by connective ducts. Immunostaining was positive for HMB45, protein S-100, vimentine and NKIC3. It was negative for EMA, CD34, smooth muscle actin, cytokeratine and desmine. The search for a metastatic localization was negative. Extensive exeresis was performed. Three years later, the patient was still in complete remission. The macroscopic, histological and immunohistochemical examinations concluded in the diagnosis of a strictly dermohypodermic melanoma of the soft tissues.
Our case report of a melanoma of the soft tissues is original because of the superficial localization of the tumor that, to our knowledge, has never been reported. It underlines the interest of performing systematic biopsies of any fast growing cutaneous lesion of recent discovery.
软组织黑色素瘤是一种罕见肿瘤,多数情况下发生于深部结构,极少累及皮肤表面。我们报告一例特殊的浅表软组织黑色素瘤病例,仅累及皮肤表面。
一名35岁男性患者,大腿出现一个浅表、粉红色、质地柔软、可活动的病变。组织学检查显示网状真皮层和皮下组织有肿瘤性增生,由淡色巨细胞组成,这些细胞聚集成巢状或小叶状,被结缔组织导管分隔。免疫组化结果显示HMB45、蛋白S-100、波形蛋白和NKIC3呈阳性。EMA、CD34、平滑肌肌动蛋白、细胞角蛋白和结蛋白呈阴性。未发现转移灶。进行了广泛切除。三年后,患者仍处于完全缓解状态。宏观、组织学和免疫组化检查最终诊断为软组织单纯性真皮皮下黑色素瘤。
我们的软组织黑色素瘤病例报告具有独特性,因为肿瘤位于浅表,据我们所知,此前从未有过相关报道。这凸显了对任何新发现的快速生长的皮肤病变进行系统活检的重要性。