Amelanotic Malignant Melanoma with Dense Pleural Thickening Mimicking Malignant Mesothelioma

Intern Med. 2019 Apr 1;58(7):969-972. doi: 10.2169/internalmedicine.0867-18. Epub 2018 Nov 19.

Abstract

A 51-year-old man was diagnosed with stage IIC nodular malignant melanoma (T4bN0M0) of the right upper arm. The tumor was treatment-refractory, and left-sided pleural effusion emerged 1.5 years later. Aspiration of pleural fluid revealed abundant amelanotic, atypical cells that resembled epithelial malignant mesothelioma or lung adenocarcinoma cells; these cells were positive for melanoma-associated antigen recognized by T cells (MART-1)/Melan-A, HMB-45, and S-100 on immunocytochemistry. Thoracic computed tomography (CT) revealed marked diffuse pleural thickening in the left hemithorax that mimicked malignant mesothelioma; thus, the present report describes the unique cytological and radiological findings of this case.

Keywords: amelanotic melanoma; malignant melanoma; nodular type; pleural effusion.

Publication types

  • Case Reports

MeSH terms

  • Biopsy
  • Diagnosis, Differential
  • Humans
  • Lung Neoplasms / diagnosis*
  • Male
  • Melanoma, Amelanotic / diagnosis*
  • Melanoma, Amelanotic / surgery
  • Mesothelioma / diagnosis*
  • Mesothelioma, Malignant
  • Middle Aged
  • Pleura / diagnostic imaging*
  • Pleural Neoplasms / diagnosis*
  • Pleural Neoplasms / surgery
  • Tomography, X-Ray Computed