A case of desmoplastic malignant melanoma

Abstract

A 57-year-old woman showed an elastic hard and light brown tumor with smooth surface on her left leg, which was growing gradually since one year ago. The excisional resection of the tumor was performed at National Kyoto Hospital, and because of strong suspicion of malignant melanoma from pathological findings she was referred to our department for further examination and therapy. The pathological findings of the specimen showed that the tumor was filled with spindle-shaped cells in the dermis and contained melanin deposits in some part. The final pathological diagnosis of desmoplastic malignant melanoma was made with the immunochemical study, which showed the tumor cells with S-100 (+), HMB45 (-), vimentin(+), cytokeratin (-), CD34 (-), desmin (-), EMA (-) and factor XIII a (-). The sentinel lymph node biopsy indicated no metastasis, and systemic examination showed no evidence of metastasis in other organs. The stage of this patient was classified to stage IIB (pT4aMoNo (sn), tumor thickness 7mm, no ulceration, UICC 2002), therefore additional wide resection and chemotherapy were performed.