Case Report of a Large Pigmented Epithelioid Melanocytoma With Suspected Lymph Node Metastases

Objective: Pigmented epithelioid melanocytoma was proposed by Zembowicz et al in 2004 including lesions previously diagnosed as human animal-type melanoma and epithelioid blue nevus. Tumors are composed of epithelioid and spindled melanocytes with heavy pigmentation. Methods: We report a case of pigmented epithelioid melanocytoma in 47-year-old Asian woman. The tumor sized 10 × 6 × 2 cm on the anterior aspect of right lower leg. On resecting surgery, we also found black pigmented lymph nodes in the groin area on harvesting skin graft. Results: Histological examination showed a typical figure for pigmented epithelioid melanocytoma. In groin area, melanocytes were observed only in the lymph node capsule. Thus, we conclude that melanocytes in the capsule of this case could not be associated with metastasis. The patient is doing well 2 years after the surgery, with no evidence of recurrence or distant metastases. Conclusions: Pigmented epithelioid melanocytoma is a rare, heavily pigmented, borderline, melanocytic tumor with infiltrative borders. It has potential for frequent metastases but shows an indolent clinical course.