皮肤转移性结肠恶性黑素瘤

Cutaneous metastatic malignant melanoma: A case report and review of the literature

患者男, 84岁。因左下肢黑色及暗红色丘疹斑块半年余伴疼痛就诊。皮损组织病理:表皮正常,真皮上部见上皮样细胞团块,紧贴表皮,部分区域见气球样细胞,见色素颗粒,真皮下部及皮下组织内见灶状、片状上皮样细胞,免疫组化示:Melan-A、S-100蛋白、波形蛋白(Vim)、HMB45均阳性、CK(pan)、CD31、CD34均阴性,Ki-67约40%~50%。肠镜发现:降结肠处有黑褐色肿物,中央粉色溃疡面,边缘呈蓝黑色,组织病理诊断:恶性黑素瘤。最后诊断:结肠恶性黑素瘤伴广泛皮肤转移。

A 84-year-old male presented with black and dark-red papules and plaques on the left lower extremities with pain for over half a year. Histopathological examination of left crus skin showed sheets and clusters of epithelioid cells in the upper dermis, in close proximity to the normal epidermis. Some dermal cells are balloon-like and pigmented. The epithelioid cells were focally seen in the deep dermis and subcutis. Immunohistochemical examination showed that the tumor cells were positive for Melan-A, S-100, Vim and HMB45. The tumor cells were negative for CK(pan), CD31 and CD34. Ki-67 labeled40-50% of the dermal infiltrate. Colonoscopy revealed malignant melanoma. Diagnosis of colonic malignant melanoma with extensive cutaneous metastasis was made.