Case Report
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 26, 2020; 8(24): 6373-6379
Published online Dec 26, 2020. doi: 10.12998/wjcc.v8.i24.6373
Primary pulmonary malignant melanoma diagnosed with percutaneous biopsy tissue: A case report
Jian-Min Xi, Huan Wen, Xue-Bing Yan, Jin Huang
Jian-Min Xi, Huan Wen, Jin Huang, Department of Pathology, Hunan Academy of Traditional Chinese Medicine Affiliated Hospital, Changsha 410006, Hunan Province, China
Xue-Bing Yan, Department of Radiology, Hunan Academy of Traditional Chinese Medicine Affiliated Hospital, Changsha 410006, Hunan Province, China
Author contributions: Xi JM analyzed and interpreted the patient data and drafted the article; Wen H collected the data and contributed to manuscript writing; Huang J performed the histological examination; Yan XB was in charge of the imaging data analysis; All authors read and approved the final version of the manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no competing interests.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jian-Min Xi, Department of Pathology, Hunan Academy of Traditional Chinese Medicine Affiliated Hospital, No. 58 Lushan Road, Changsha 410006, Hunan Province, China. xijianmin@qq.com
Received: July 30, 2020
Peer-review started: July 30, 2020
First decision: September 24, 2020
Revised: September 30, 2020
Accepted: October 26, 2020
Article in press: October 26, 2020
Published online: December 26, 2020
Processing time: 142 Days and 11.4 Hours
Abstract
BACKGROUND

Primary malignant melanoma of the lung (PMML) is a rare and highly malignant tumor with a poor prognosis. Here, we report a PMML case diagnosed by computed tomography (CT)-guided percutaneous biopsy, describe its pathological features and review relevant literature to improve our understanding of this tumor.

CASE SUMMARY

A 64-year-old Chinese female presented with productive cough for 7 mo. A chest CT scan showed a large and space-occupying lesion in Lingual lobe. Positron emission tomography-CT revealed multiple nodules located in the superior lobe apicoposterior segment of her left lung. Brain magnetic resonance imaging showed numerous enhancing nodules, suggesting brain metastasis. Abdominal CT scan did not show any abnormalities. By CT-guided percutaneous biopsy, four pieces of gray and taupe tissues (1 cm length and 0.1 mm in diameter) were obtained. After pathologic examination, the tumor was found to consist of epidermal and nested small round cells, fibrosis and thin-walled blood vessels. The finding was suggestive of malignant melanoma. To confirm the diagnosis, pathological morphology and immunophenotypic features of the biopsy specimens were observed. The patient denied any history of skin tumors. No abnormal lesions were detected in other sites of the body. Molecular testing was positive for wild-type EGFR and KIT gene mutations. Finally, the clinical and pathological findings suggested PMML.

CONCLUSION

PMML is very rare, and the percutaneous biopsy tissue is limited. Therefore, comprehensive consideration of histology, immunohistochemistry, imaging, and clinical information is important for the diagnosis of PMML.

Keywords: Biopsy; Primary malignant melanoma of the lung; Malignant melanoma; Positron emission tomography-computed tomography; Pathology; Diagnosis; Case report

Core Tip: Malignant melanoma is a refractory malignancy with a dismal prognosis. Primary malignant melanoma of lung is rare, accounting for only 0.01% of all primary lung tumors. This case highlights that comprehensive consideration of histology, immunohistochemistry, imaging, and clinical information is important for the diagnosis of primary malignant melanoma of the lung.