A large metastatic intramammary lesion of an occult melanoma

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COD: 2730_04_09_2017_AOP Categorie: , ,

Eleonora Nacchiero, Stefania Stucci, Paolo Annoscia, Michelangelo Vestita, Rossella Elia,
Paolo Claudio Marannino

Ann Ital Chir, Digital Edition 2017, 6
Epub Ahead of Print – September 4

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OBJECTIVE: Malignant melanomas presenting with unknown primaries are uncommon. In the majority of cases metastases
of occult melanoma were detected in skin or in lymph nodes. Melanoma can rarely occur as a primary or metastatic
intramammary tumor.
CASE REPORT: We report the case of a 58-year-old Caucasian woman who came to our department with a voluminous
mass in her right breast. Histopathological examination found metastasis of epithelioid melanoma with unknown primary
lesion. Our patient underwent a radical enlarged mastectomy, but due to the extension a radical removal was not
possible.
DISCUSSION: In 2.2% of cases, melanoma may present with a metastasis without an identifiable primary lesion; this
case should be considered a stage IV melanoma (Tx; N1; M1) due to the extension of the lesion and the infiltration
of adjacent structures.
CONCLUSIONS: In literature, the presence of a breast metastasis of melanoma with unknown primary origin was reported
just in one case. The execution of histopathological analysis is mandatory for a correct differential diagnosis with primary
carcinoma of the breast. Palliative metastasectomy should be discussed with multidisciplinary melanoma board.

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