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Angiosarcomatous transdifferentiation of metastatic melanoma
Author(s) -
Kilsdonk Melvin J.,
Romeijn Tonnis R.,
Kelder Wendy,
Kempen Léon C.,
Diercks Gilles F.
Publication year - 2020
Publication title -
journal of cutaneous pathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 75
eISSN - 1600-0560
pISSN - 0303-6987
DOI - 10.1111/cup.13857
Subject(s) - melanoma , pathology , medicine , transdifferentiation , dissection (medical) , neuroblastoma ras viral oncogene homolog , lymph node , metastasis , cancer , biology , cancer research , anatomy , stem cell , genetics , colorectal cancer , kras
Melanoma is known to show considerable variation in its histopathological presentation. In exceptional cases, heterologous or divergent differentiation (metaplastic melanoma) can be observed. We report a case of a 69‐year‐old man who was diagnosed with nodular melanoma on the right upper leg. One year later, the patient presented with an inguinal lymph node metastasis and a lymph node dissection was carried out. In two out of five positive lymph nodes, an angiosarcomatous component was found next to a conventional melanoma component. Shortly after, the patient developed two in‐transit metastases in which again an angiosarcomatous component was seen. The vascular component stained positive for ERG and CD31 and negative for melanocytic markers (Mart‐1, S100, SOX‐10), while the conventional melanoma had an opposite staining pattern. Molecular analysis on both components showed an identical mutation in the NRAS gene, which in our opinion proves the divergent differentiation. To the best of our knowledge, this is the first case report describing angiosarcomatous transdifferentiation of melanoma.