Mejbel Haider A, Nelson Kelly C, Pradhan Dinesh, Ivan Doina, Zaleski Michael, Nagarajan Priyadharsini, Tetzlaff Michael T, Curry Jonathan L, Torres-Cabala Carlos A, Prieto Victor G, Aung Phyu P
Department of Pathology, East Tennessee State University, Johnson City, Tennessee.
Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
J Cutan Pathol. 2020 Jan;47(1):36-46. doi: 10.1111/cup.13551. Epub 2019 Aug 11.
We report two cases of combined cutaneous tumors composed of melanoma and carcinoma. The first tumor presented as a 5-mm pink-blue macule over the right zygomatic arch in an 85-year-old man. Shave biopsy and immunohistochemical studies revealed that the tumor was composed of melanoma (highlighted by SOX10 and MART-1, with high Ki-67 proliferative index) intermixed with nodular basal cell carcinoma (highlighted by pan-cytokeratin and Ber-EP4). The neoplastic melanocytes were confined to the basal cell carcinoma nodules, and a diagnosis of combined melanoma in situ and basal cell carcinoma was rendered. After therapeutic excision, the patient was disease-free at 9 months after the initial diagnosis. The second tumor presented as a 6-mm pink-brown crusted papule on the right forehead in an 89-year-old man. Shave biopsy and immunohistochemical studies revealed that the tumor was composed of malignant melanoma (MM) (highlighted by S100 and MART-1) intermixed with squamous cell carcinoma (SCC) (highlighted by cytokeratin and p63), and a diagnosis of combined MM-SCC was rendered. These two cases highlight the importance of recognizing these rare types of melanocytic-epithelial cutaneous neoplasms to arrive at an accurate diagnosis that may inform appropriate disease stage and therapy.
我们报告了两例由黑色素瘤和癌组成的皮肤复合肿瘤病例。第一例肿瘤表现为一名85岁男性右侧颧弓上一个5毫米大小的粉蓝色斑疹。剃除活检及免疫组化研究显示，该肿瘤由黑色素瘤（SOX10和MART-1呈阳性，Ki-67增殖指数高）与结节性基底细胞癌（全细胞角蛋白和Ber-EP4呈阳性）混合组成。肿瘤性黑素细胞局限于基底细胞癌结节内，诊断为原位黑色素瘤合并基底细胞癌。经治疗性切除后，患者在初诊后9个月时无疾病复发。第二例肿瘤表现为一名89岁男性右侧前额一个6毫米大小的粉褐色结痂丘疹。剃除活检及免疫组化研究显示，该肿瘤由恶性黑色素瘤（S100和MART-1呈阳性）与鳞状细胞癌（细胞角蛋白和p63呈阳性）混合组成，诊断为黑色素瘤-鳞状细胞癌复合肿瘤。这两例病例凸显了识别这些罕见类型的黑素细胞-上皮性皮肤肿瘤对于做出准确诊断的重要性，而准确诊断可为确定适当的疾病分期和治疗提供依据。
