Ann Dermatol.  2009 May;21(2):178-181. 10.5021/ad.2009.21.2.178.

Vitiligo-like Depigmentation Associated with Metastatic Melanoma of an Unknown Origin

Affiliations
  • 1Department of Dermatology, College of Medicine,The Catholic University of Korea, Seoul, Korea. yymmpark6301@ hotmail.com
  • 2Division of Medical Oncology, Department of Internal Medicine, College of Medicine,The Catholic University of Korea, Seoul, Korea.

Abstract

Although malignant melanoma usually occurs after the diagnosis of vitiligo-like depigmentation, the latter is rarely followed by the former. We herein report on such a case in which recognition of the vitiligo-like depigmentation preceded diagnosing the metastatic melanoma by several months. A 56-year-old woman had first developed vitiligo-like depigmentation on the forehead, eyelids, neck and back 18 months previously and thereafter she detected a hard mass in the left axilla 2 months previously. Based on the histologic findings, the axillary mass was diagnosed as metastatic melanoma. To evaluate the primary tumor focus, thorough examinations that included PET-CT, bone scan and sigmoidoscopy were performed, but we couldn`t find any the original primary tumor. Our case suggests that the vitiligo-like depigmentation could be a sign that heralds metastatic melanoma.

Keyword

Metastatic melanoma; Vitiligo-like depigmentation

MeSH Terms

Axilla
Eyelids
Female
Forehead
Humans
Melanoma
Middle Aged
Neck
Sigmoidoscopy

Figure

  • Fig. 1 Vitiligo-like lesions on the forehead, eyelids and back.

  • Fig. 2 A lobulated lymph node mass 5.4×3.1 cm in dimension with inhomogeneous enhancement in the left axilla.

  • Fig. 3 (A) The biopsy specimen from the axillary lymph node mass shows the tumor nests (H&E, ×100). Inset: The tumor nests are composed of atypical, epitheloid cells with hyperchromatic, pleomorphic nuclei and some mitoses (H&E, ×400). (B) The tumor cells stained positive for S-100 protein (left: S-100, ×200) and they were positive for HMB-45 (right: HMB, ×200).


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