Connective tissue tumors in patients with cutaneous melanoma

A possible relation between cutaneous melanoma and connective tissue tumors has been described.

After the observation that a group of our patients had both cutaneous melanoma and a soft tissue sarcoma, we elected to review this formally. Eleven patients with both diagnoses were identified and are described.

A computer search through the Medical Records Department and the Tumor Registry of the Massachusetts General Hospital identified seven men and four women with the diagnoses of melanoma and malignant bone or soft tissue sarcoma. The medical records and pathology specimens of all tumors were reviewed.

In three patients, the two tumors were diagnosed within 1 year of each other, in seven, the diagnosis of melanoma was made first, and in one, melanoma was diagnosed after the connective tissue lesion. The interval between the two diagnoses ranged up to 13 years. Although the locations and types of melanoma were typical, some of the connective tissue tumors were unusual; there were two sacral chordomas. In two instances, the melanoma and connective tissue tumor were anatomically close; the sarcoma developed at the edge of the resection of the prior melanoma in one patient. None of the tumors developed in previously irradiated tissues, and in no instance did the second tumor appear to be caused by the therapy received for the first. None of the patients had a family history of melanoma. Four patients had other cancers in addition to the melanoma and connective tissue tumor.

Although these patients were seen in a referral center, it is our impression (based on the total number of patients with connective tissue tumors seen and the incidence of melanoma in the general population) that observing 11 patients with both types of tumors is greater than would be expected by chance.