Alshaghel Mohammed Moutaz, Almahairi Lana, Arian Roua, Alyousfi Mohamad Shehab, Majanni Weaam, Alyousfi Rama, Etr Aladdin
Faculty of Medicine, Aleppo University, Aleppo, Syria.
Department of Dermatology, Aleppo University Hospital, Aleppo University, Aleppo, Syria.
Ann Med Surg (Lond). 2022 Jan 26;74:103316. doi: 10.1016/j.amsu.2022.103316. eCollection 2022 Feb.
and importance: Amelanotic melanoma is a rare and aggressive type of melanoma. It is often diagnosed late because of the lack of melanin in its cells, and this causes treatment delay and, eventually, poor prognosis.
We report a case of a 79-year-old female patient that presented to the dermatology clinic with an asymptomatic lesion on the medial heel of the right foot, with no medical history of previous melanoma or related skin cancer. To get the right diagnosis, an incisional biopsy was performed, and the sample was sent to the pathology laboratory. The sample was stained with S100 and HMB-45 stains, and both were positive. Also, no melanin pigmented cells were seen, so the diagnosis was amelanotic nodular melanoma. The patient was then referred to surgery. The lesion was successfully excised with 5cm safety margins, and the whole lesion was sent to the pathology laboratory to ensure that the edges are malignancy-free. After 18 months of follow-up, the patient is in good health.
Accurate and early diagnosis with appropriate clinical intervention can improve the prognosis and reduce mortality and morbidity rates.
及重要性：无色素性黑色素瘤是一种罕见且侵袭性强的黑色素瘤类型。由于其细胞中缺乏黑色素，常常在晚期才被诊断出来，这导致治疗延迟，最终预后不良。
我们报告一例79岁女性患者，该患者因右足跟内侧出现无症状性皮损就诊于皮肤科门诊，既往无黑色素瘤或相关皮肤癌病史。为明确诊断，进行了切开活检，并将样本送至病理实验室。样本用S100和HMB - 45染色，结果均为阳性。此外，未见黑色素沉着细胞，因此诊断为无色素性结节性黑色素瘤。随后患者被转诊至外科。病变以5厘米安全切缘成功切除，整个病变被送至病理实验室以确保切缘无恶性肿瘤。经过18个月的随访，患者健康状况良好。
准确的早期诊断及适当的临床干预可改善预后，降低死亡率和发病率。
