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[Melanoma of soft tissues]
M N Pisani-Moreau1, D Merigou, C Gautier
1Unité de dermatologie-cancérologie, Centre Hospitalier Pellegrin, Bordeaux.
Annales De Dermatologie Et De Venereologie
|January 1, 1997
Summary
Soft tissue melanoma is a rare melanocyte tumor. This case highlights its characteristics, immunohistochemical markers (S100, HMB45), and sarcoma-like prognosis with high recurrence rates.
Area of Science:
- Oncology
- Dermatopathology
- Surgical Pathology
Background:
- Soft tissue melanoma, initially termed clear-cell sarcoma, is a rare melanocyte neoplasm.
- First described in 1965, its nomenclature evolved due to immunohistochemical similarities with cutaneous melanoma.
Observation:
- A 59-year-old woman presented with a 3-year history of pain and a subcutaneous tumor between her toes.
- Histopathological examination revealed a weakly eosinophilic cell proliferation organized in nests (theques), positive for S100 and HMB45.
- The patient experienced local recurrences requiring multiple surgical interventions and adjuvant therapies.
Findings:
- Soft tissue melanoma typically affects young individuals and commonly presents in the limbs, particularly the feet, often near tendons and aponeuroses.
- Pathology shows monomorphic cells with clear or eosinophilic cytoplasm, positive S100 and HMB45 immunohistochemistry are crucial for diagnosis.
- Differential diagnoses include metastatic melanoma and epithelioid sarcoma.
Implications:
- Soft tissue melanoma exhibits a prognosis similar to sarcomas, characterized by frequent local recurrence and distant metastases (lymph nodes, lungs).
- The reported mortality rate is 56%, underscoring the aggressive nature of this tumor.
- Wide surgical excision remains the primary treatment modality.