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Published in: BMC Women's Health 1/2021

Open Access 01-12-2021 | Melanoma | Case report

Nodular malignant melanoma in vulvar skin without pigmentation: a case report

Authors: Jing Nie, Yan Li, Xue Shen, Yan Liu, Haipeng Shi, Yonghong Lu

Published in: BMC Women's Health | Issue 1/2021

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Abstract

Background

Polypoid nodule growing without apparent pigmentation on the vulvar skin usually reminds us of the diagnostic pitfall, which is commonly and mistakenly diagnosed as other types of tumors. Although there are several manifestations of amelanotic melanoma are known, these malignancies are usually pigmented because they are derived from melanocytes containing melanin. However, amelanotic melanomas are easily misdiagnosed or their diagnoses were commonly delayed due to lack of pigmentation. Therefore, a solitary polypoid nodule is worth noting and further reporting. Particularly, the clinical characteristics and outcomes of the solitary polypoid nodule are rare in Asian patients.

Case presentation

We presented an interesting case of a 33-year-old female with a solitary polypoid nodule without apparent pigmentation on her vulvar skin. Her medical history was unclear, no ulcer was seen in the lesion area, and dermatoscopy was indicated a possible tumorous change, which has caught the attention of clinicians, and then further examined by the pathologist. The final diagnosis was nodular malignant melanoma (NM) (Breslow thickness 9.5mm, Clark level 4).

Conclusions

Hence, though reviewing this case record, the relevant literature and NM-related materials, we suggest that the combination of skin imaging technology and histopathological examination could provide us a better understanding and reduce the possibility of misdiagnosis in clinic practice.
Literature
1.
go back to reference Liu W, Dowling JP, Murray WK, McArthur GA, Kelly JW. Rate of growth in melanomas: characteristics and associations of rapidly growing melanomas. Arch Dermatol. 2006;142(12):1551–8.CrossRef Liu W, Dowling JP, Murray WK, McArthur GA, Kelly JW. Rate of growth in melanomas: characteristics and associations of rapidly growing melanomas. Arch Dermatol. 2006;142(12):1551–8.CrossRef
2.
go back to reference Shen S, Wolfe R, McLean CA, Haskett M, Kelly JW. Characteristics and associations of high-mitotic-rate melanoma. Jama Dermatology. 2014;150(10):1048.CrossRef Shen S, Wolfe R, McLean CA, Haskett M, Kelly JW. Characteristics and associations of high-mitotic-rate melanoma. Jama Dermatology. 2014;150(10):1048.CrossRef
3.
go back to reference Kalkhoran S, Milne O, Zalaudek I, Puig S, Malvehy J, Kelly J, et al. Historical, clinical, and dermoscopic characteristics of thin nodular melanoma. Arch Dermatol. 2010;146(3):311–8.CrossRef Kalkhoran S, Milne O, Zalaudek I, Puig S, Malvehy J, Kelly J, et al. Historical, clinical, and dermoscopic characteristics of thin nodular melanoma. Arch Dermatol. 2010;146(3):311–8.CrossRef
4.
go back to reference Faut M, Wevers KP, Ginkel RJ, Diercks GF, Hoekstra HJ, Kruijff S, et al. Nodular histologic subtype and ulceration are tumor factors associated with high risk of recurrence in sentinel node-negative melanoma patients. Ann Surg Oncol. 2017;24(1):142–9.CrossRef Faut M, Wevers KP, Ginkel RJ, Diercks GF, Hoekstra HJ, Kruijff S, et al. Nodular histologic subtype and ulceration are tumor factors associated with high risk of recurrence in sentinel node-negative melanoma patients. Ann Surg Oncol. 2017;24(1):142–9.CrossRef
5.
go back to reference Green AC, Baade P, Coory M, Aitken JF, Smithers M. Population-based 20-year survival among people diagnosed with thin melanomas in Queensland, Australia. J Clin Oncol. 2012;30(13):1462–7.CrossRef Green AC, Baade P, Coory M, Aitken JF, Smithers M. Population-based 20-year survival among people diagnosed with thin melanomas in Queensland, Australia. J Clin Oncol. 2012;30(13):1462–7.CrossRef
6.
go back to reference Chi ZH, Li SM, Sheng XN, Si L, Guo J. Clinical presentation, histology, and prognoses of malignant melanoma in ethnic chinese: a study of 522 consecutive cases. Bmc Cancer. 2011;11(1):85.CrossRef Chi ZH, Li SM, Sheng XN, Si L, Guo J. Clinical presentation, histology, and prognoses of malignant melanoma in ethnic chinese: a study of 522 consecutive cases. Bmc Cancer. 2011;11(1):85.CrossRef
7.
go back to reference Paola C, Iris Z, Giovanni MR, Nicola DM. Improving the early diagnosis of early nodular melanoma: can we do better? Expert Rev Anticancer Ther. 2018;18(10):1007–12.CrossRef Paola C, Iris Z, Giovanni MR, Nicola DM. Improving the early diagnosis of early nodular melanoma: can we do better? Expert Rev Anticancer Ther. 2018;18(10):1007–12.CrossRef
8.
go back to reference Mayer JE, Adams BB. Nodular Melanoma Serendipitously Detected by Airport Full Body Scanners. Dermatology. 2015;230(1):16–7.CrossRef Mayer JE, Adams BB. Nodular Melanoma Serendipitously Detected by Airport Full Body Scanners. Dermatology. 2015;230(1):16–7.CrossRef
9.
go back to reference Yang J, Pan Z, Zhao F, Feng XJ, Liu QQ, Li YJ, et al. A nomogram for predicting survival in patients with nodular melanoma: A population-based study. Medicine. 2019;98(24):e16059–9.CrossRef Yang J, Pan Z, Zhao F, Feng XJ, Liu QQ, Li YJ, et al. A nomogram for predicting survival in patients with nodular melanoma: A population-based study. Medicine. 2019;98(24):e16059–9.CrossRef
10.
go back to reference Brenn T. Histologisches Spektrum des malignen Melanoms. Pathologe. 2015;36(1):53–61.CrossRef Brenn T. Histologisches Spektrum des malignen Melanoms. Pathologe. 2015;36(1):53–61.CrossRef
11.
go back to reference Menzies SW, Moloney FJ, Byth K, Avramidis M, Argenziano G, Zalaudek, Iris, et al. Dermoscopic Evaluation of Nodular Melanoma. JAMA Dermatology. 2013;149(6):699.CrossRef Menzies SW, Moloney FJ, Byth K, Avramidis M, Argenziano G, Zalaudek, Iris, et al. Dermoscopic Evaluation of Nodular Melanoma. JAMA Dermatology. 2013;149(6):699.CrossRef
12.
go back to reference Pizzichetta MA, Kittler H, Stanganelli I, Ghigliotti G, Talamini R. Dermoscopic diagnosis of amelanotic/hypomelanotic melanoma. Br J Dermatol. 2016;177(2):538–40.CrossRef Pizzichetta MA, Kittler H, Stanganelli I, Ghigliotti G, Talamini R. Dermoscopic diagnosis of amelanotic/hypomelanotic melanoma. Br J Dermatol. 2016;177(2):538–40.CrossRef
13.
go back to reference Iris Z, Jürgen K, Jason G, Gerardo F, Caterina C, Giuseppe A. How to diagnose nonpigmented skin tumors: a?review of vascular structures seen with dermoscopy: part ii. nonmelanocytic skin tumors. J Am Acad Dermatol. 2010;63(3):377–86.CrossRef Iris Z, Jürgen K, Jason G, Gerardo F, Caterina C, Giuseppe A. How to diagnose nonpigmented skin tumors: a?review of vascular structures seen with dermoscopy: part ii. nonmelanocytic skin tumors. J Am Acad Dermatol. 2010;63(3):377–86.CrossRef
14.
go back to reference Ohsie SJ, Sarantopoulos GP, Cochran AJ, Binder SW. Immunohisto chemical characteristics of melanoma. J Cutan Pathol. 2008;5(5):433–44.CrossRef Ohsie SJ, Sarantopoulos GP, Cochran AJ, Binder SW. Immunohisto chemical characteristics of melanoma. J Cutan Pathol. 2008;5(5):433–44.CrossRef
15.
go back to reference Pleunis N, Schuurman MS, Van Rossum MM, Bulten J, Massuger LF, De Hullu JA, et al. Rare vulvar malignancies; incidence, treatment and survival in the Netherlands. Gynecol Oncol. 2016;142:440–5.CrossRef Pleunis N, Schuurman MS, Van Rossum MM, Bulten J, Massuger LF, De Hullu JA, et al. Rare vulvar malignancies; incidence, treatment and survival in the Netherlands. Gynecol Oncol. 2016;142:440–5.CrossRef
16.
go back to reference Sugiyama VE, Chan JK, Shin JY, Berek JS, Osann K, Kapp DS. Vulvarmelanoma: a multivariable analysis of 644 patients. Obstet Gynecol. 2007;110:296–301.CrossRef Sugiyama VE, Chan JK, Shin JY, Berek JS, Osann K, Kapp DS. Vulvarmelanoma: a multivariable analysis of 644 patients. Obstet Gynecol. 2007;110:296–301.CrossRef
17.
go back to reference Heinzelmann-Schwarz VA, Nixdorf S, Valadan M, Diczbalis M, Olivier J, Otton G, et al. A clinicopathological review of 33 patients with vulvar melanoma identifies c-KIT as a prognostic marker. Int J Mol Med. 2014;33(4):784–94.CrossRef Heinzelmann-Schwarz VA, Nixdorf S, Valadan M, Diczbalis M, Olivier J, Otton G, et al. A clinicopathological review of 33 patients with vulvar melanoma identifies c-KIT as a prognostic marker. Int J Mol Med. 2014;33(4):784–94.CrossRef
Metadata
Title
Nodular malignant melanoma in vulvar skin without pigmentation: a case report
Authors
Jing Nie
Yan Li
Xue Shen
Yan Liu
Haipeng Shi
Yonghong Lu
Publication date
01-12-2021
Publisher
BioMed Central
Published in
BMC Women's Health / Issue 1/2021
Electronic ISSN: 1472-6874
DOI
https://doi.org/10.1186/s12905-021-01422-1

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