Melanoma arising in a large plaque-type blue nevus with subcutaneous cellular nodules Journal Article


Authors: Yeh, I.; Fang, Y.; Busam, K. J.
Article Title: Melanoma arising in a large plaque-type blue nevus with subcutaneous cellular nodules
Abstract: Melanoma may arise in association with and/or simulate the appearance of a cellular blue nevus. The distinction of a cellular blue nevus with atypical features from blue nevus-like melanoma can be difficult. One rare setting, in which one may face this diagnostic challenge, is nodule formation in a large plaque-type blue nevus. We have previously reported 2 patients with cellular blue nevus-like subcutaneous nodules without overt malignant features and indolent clinical behavior. Herein we report a patient who developed malignant melanoma in association with a large plaque-type blue nevus. A 46-year-old woman with a history of "cellular blue nevus" of the breast that developed 7 years earlier during pregnancy had soft tissue nodules at the prior surgical site. She was found to have melanoma associated with a large plaque-type blue nevus, which involved the skin and subcutis of the chest wall and extended into breast parenchyma. Ten years after mastectomy and axillary node dissection with negative lymph nodes, the melanoma recurred as a subcutaneous chest wall nodule. Cytogenetic analysis revealed a number of aberrations, including deletion of 6q and gains of 6p and 8q. The patient then developed visceral metastases, first to the liver, and died of widely metastatic melanoma. In contrast, the cytogenetic findings of a previously reported cellular blue nevus-like nodule in a patient with a large plaque-type blue nevus were normal. That patient is still alive with no evidence of melanoma 16 years after the surgical excision of the subcutaneous cellular blue nevus-like nodule. © 2012 by Lippincott Williams & Wilkins.
Keywords: middle aged; genetics; case report; melanoma; metastasis; neoplasm recurrence, local; skin neoplasms; cytogenetics; pathology; breast neoplasms; skin tumor; tumor recurrence; breast tumor; fatal outcome; multiple cancer; neoplasms, multiple primary; fatality; blue nevus; nevus, blue
Journal Title: American Journal of Surgical Pathology
Volume: 36
Issue: 8
ISSN: 0147-5185
Publisher: Lippincott Williams & Wilkins  
Date Published: 2012-08-01
Start Page: 1258
End Page: 1263
Language: English
DOI: 10.1097/PAS.0b013e31825b62ec
PROVIDER: scopus
PUBMED: 22790865
DOI/URL:
Notes: --- - "Export Date: 1 August 2012" - "CODEN: AJSPD" - "Source: Scopus"
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  1. Klaus J Busam
    688 Busam
  2. Yuqiang Fang
    23 Fang