PRIMARY NONCUTANEOUS MELANOMA OF THE BREAST: CASE REPORT AND LITERATURE REVIEW

Case Report: A 44-year-old woman presented with a progressive growth lesion on the right breast in the last 6 months. Initial core biopsy suggesting poor differentiated malignant round cells tumor with immunohistochemistry confirming melanoma diagnosis. Submitted to radical modified right mastectomy with final pathological report describing a 10 × 9 × 7 cm size melanoma tumor, surgical margins free of neoplasia, extensive angiolymphatic invasion and presence of 7 mitoses per 1 mm2. The nipple was infiltrated by melanoma however the dermis and epidermis were not involved. Eighteen axillary lymph nodes were also evaluated, 15 of them had melanoma involvement with 1 presenting capsular leakage. -Discussion: Breast melanomas can be divided into three majors clinical manifestations: cutaneous melanoma overlying the skin of the breast; metastatic melanoma in the breast and primary noncutaneous melanoma of the breast (PNMB), the most rare subtype. PNMB has a poorly described clinical presentation with only a few previous case reports on the literature. Little is known about the therapeutic and prognostic management of this condition. The age of diagnosis in the previous studies was 26-76 years old, mastectomy surgery with axillary dissection (sentinel lymph node biopsy or complete node dissection) was the standard approach and only one previous report presented tumor size larger than 5 cm, which was the case of this study. - Final comments: Extremely rare presentation of melanoma with primary site in the breast parenchyma, material reviewed by an experienced pathologist and subjected to immunohistochemistry, with only 7 similar case reports described in the international literature.

Publication History

Article published online:
23 October 2019