Department of Dermatology, Larkin Community Hospital, South Miami, FL.
Nova Southeastern University-KPCOM, Ft. Lauderdale, FL.
Am J Dermatopathol. 2021 Apr 1;43(4):291-293. doi: 10.1097/DAD.0000000000001888.
The pathophysiology of melanoma involves malignant transformation of melanocytes. These can arise de novo or result from malignant transformation of a pre-existing nevus. This case report presents a patient with a new pigmented lesion, arising from a pre-existing neurofibroma, on her left scapula and no personal or family history of systemic neurofibromatosis. Biopsy confirmed the lesion to be malignant melanoma and, after excision, postoperative pathology showed a pre-existing neurofibroma. A review of the literature suggests there may be a link between the pathogenesis of neurofibroma and malignant melanoma, because NF1 mutations are observed in both neurofibromatosis and malignant melanoma. We hypothesize that the pre-existing neurofibroma created a proliferative environment that gave rise to the adjacent neoplasm. Further research is required to understand the shared pathway, because this may lead to novel forms of surveillance and treatment.
黑色素瘤的病理生理学涉及黑素细胞的恶性转化。这些可以是从头发生的，也可以是先前存在的痣发生恶性转化的结果。本病例报告介绍了一位患者，她的左肩胛骨上出现了一个新的色素性病变，源于先前存在的神经纤维瘤，且患者无系统性神经纤维瘤病的个人或家族史。活检证实病变为恶性黑色素瘤，切除后，术后病理显示先前存在的神经纤维瘤。文献回顾表明，神经纤维瘤和恶性黑色素瘤的发病机制之间可能存在联系，因为 NF1 突变在神经纤维瘤病和恶性黑色素瘤中都有观察到。我们假设先前存在的神经纤维瘤创造了一个增殖环境，导致了相邻的肿瘤。需要进一步的研究来了解共同的途径，因为这可能导致新的监测和治疗形式。
