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Aggressive osteogenic desmoplastic melanoma: a case report.

Patrick O Emanuel1, Muhammad T Idrees, Anatoly Leytin

  • 1Department of Dermatopathology, Mount Sinai Medical Center, New York, NY, USA. patrick.emanuel@mssm.edu

Journal of Cutaneous Pathology
|April 24, 2007
PubMed
Summary

This case report details an osteogenic desmoplastic melanoma on a patient's foot. This rare melanoma variant presented with bone formation and lymph node metastasis, requiring differentiation from osteosarcoma.

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Area of Science:

  • Dermatopathology
  • Skeletal Pathology

Background:

  • Desmoplastic melanoma is a rare subtype of melanoma.
  • Osteogenic differentiation within melanoma is exceptionally uncommon.

Observation:

  • A 60-year-old African American man presented with a large (4.8 cm) tumor on the sole of his foot.
  • Histopathology revealed a desmoplastic melanoma with areas of osteoid formation and malignant epithelioid melanocytes rimming bone trabeculae.
  • The tumor invaded to a depth of 2.2 cm and metastasized to 40% of inguinal lymph nodes.

Findings:

  • Immunohistochemistry confirmed S100 positivity.
  • Imaging excluded continuity with the underlying calcaneus.
  • The tumor exhibited a mixed desmoplastic and osteogenic phenotype with atypical lentiginous epidermal hyperplasia.

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Implications:

  • This case highlights the importance of recognizing osteogenic desmoplastic melanoma.
  • Accurate histopathological differentiation from other bone-forming tumors, such as osteosarcoma, is crucial for appropriate patient management.
  • Awareness of this rare entity aids pathologists in diagnosis and treatment planning.