臀部巨大黑素瘤误诊1例

Misdiagnosis of Large Melanoma on the Hip

患者男,69岁。臀部外伤后红肿痛6个月,初诊臀部皮肤软组织感染伴坏死。皮损组织病理示:梭形瘤细胞,呈交错束状排列,部分细胞胞质内含黑素颗粒,真皮层内肿瘤组织似肉瘤样结构,局部与表皮分界不清。免疫组织化学示:HMB45(+),Melan A(弱+),Vimentin(+),CK(-)。诊断:臀部巨大黑素瘤。

A 69-year-old male suffered from post-traumatic swelling and pain on the hip for 6 months. He was diagnosed with soft tissue infection and necrosis. Pathological examination showed spindle cells arranged in interlaced fascicular pattern. Cytoplasm contained melanin granules. Tumor tissue appeared sarcomatoid changes with poor boundaries. Immunostaining showed HMB45（＋）, MelanA weak（＋）, Vimentin（＋）, CK（-）. Diagnosis was large melanoma on the hip.