Conjunctival Melanoma with Rhabdomyosarcomatous Differentiation
A Case Report
DOI:
https://doi.org/10.21141/PJP.2024.12Keywords:
malignant melanoma, eye, rhabdomyosarcomatous differentiation, rhabdomyosarcomaAbstract
This is a case of malignant melanoma with rhabdomyosarcomatous differentiation presenting as a conjunctival mass in a 50-year-old male. Melanoma cells were seen to react with desmin, myogenin and vimentin, indicating rhabdomyosarcomatous differentiation. This condition is very rare, with less than twenty cases reported in the literature, which contributes to the limitations in molecular characterization and standard treatment protocols for this entity. This condition has an aggressive course with a poor prognosis.
Downloads
References
Banerjee SS, Eyden B. Divergent differentiation in malignant melanomas: a review. Histopathology. 2008;52(2):119-29. https://pubmed.ncbi.nlm.nih.gov/17825057 https://doi.org/10.1111/j.1365-2559.2007.02823.x DOI: https://doi.org/10.1111/j.1365-2559.2007.02823.x
Gupta A, Wagman R, Kuwadekar A, Scoppetuolo M, Dardik M, Smith F. Use of immunotherapy and radiation treatment in the management of metastatic melanoma with rhabdomyosarcomatous differentiation. Adv Radiat Oncol. 2019;5(1):134-9. https://pubmed.ncbi.nlm.nih.gov/32051900 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7004934 https://doi.org/10.1016/j.adro.2019.07.019 DOI: https://doi.org/10.1016/j.adro.2019.07.019
Antonov NK, Niedt GW. Malignant melanoma with rhabdomyosarcomatous differentiation. Am J Dermatopathol. 2016;38(6):456-60. https://pubmed.ncbi.nlm.nih.gov/27205908. https://doi.org/10.1097/DAD.0000000000000478. DOI: https://doi.org/10.1097/DAD.0000000000000478
Chang E, Demirci H, Demirci FY. Genetic aspects of conjunctival melanoma: a review. Genes (Basel). 2023;14(9):1668. https://pubmed.ncbi.nlm.nih.gov/37761808 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10530751 https://doi.org/10.3390/genes14091668 DOI: https://doi.org/10.3390/genes14091668
Lin AY. Tumors of the conjunctiva. In: McKee’s pathology of the skin. 5th ed. Elsevier; 2020.
Koç İ, Kıratlı H. Current management of conjunctival melanoma part 1: clinical features, diagnosis and histopathology. Turk J Ophthalmol. 2020;50(5):293-303. https://pubmed.ncbi.nlm.nih.gov/33342197 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7610047 https://doi.org/10.4274/tjo.galenos.2020.38096 DOI: https://doi.org/10.4274/tjo.galenos.2020.38096
Moulin, A, Verdijk, R, Jager, M, Brouwer, N, Ferreira, T. Conjunctival melanoma. In: WHO Classification of Tumours Editorial Board, eds. Eye tumours. Lyon (France): International Agency for Research on Cancer; 2023 [beta version ahead of print].
Reilly DJ, Volchek M, Ting JW, Allan P, Findlay MW. Rhabdomyoblastic differentiation in metastatic melanoma: making sense of a rare but complex form of mimicry. Int J Surg Pathol. 2014;22(6):520-4. https://pubmed.ncbi.nlm.nih.gov/24275885 https://doi.org/10.1177/1066896913510031 DOI: https://doi.org/10.1177/1066896913510031
Gharpuray-Pandit D, Coyne J, Eyden B, Banerjee SS. Rhabdomyoblastic differentiation in malignant melanoma in adults: report of 2 cases. Int J Surg Pathol. 2007;15(1):20-5. https://pubmed.ncbi.nlm.nih.gov/17172493 https://doi.org/10.1177/1066896906295775 DOI: https://doi.org/10.1177/1066896906295775
Shenjere P, Fisher C, Rajab R, Patnaik L, Hazell S, Thway K. Melanoma with rhabdomyosarcomatous differentiation: two further cases of a rare pathologic pitfall. Int J Surg Pathol. 2014;22(6):512-9. https://pubmed.ncbi.nlm.nih.gov/24788528 https://doi.org/10.1177/1066896914531817 DOI: https://doi.org/10.1177/1066896914531817
Kuwadekar A, Allard J, Dardik M, Smith F. Melanoma with rhabdomyosarcomatous differentiation. BMJ Case Rep. 2018. https://pubmed.ncbi.nlm.nih.gov/29880623 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6011467. https://doi.org/10.1136/bcr-2018-224263 DOI: https://doi.org/10.1136/bcr-2018-224263
Campbell K, Kumarapeli AR, Gokden N, Cox RM, Hutchins L, Gardner JM. Metastatic melanoma with dedifferentiation and extensive rhabdomyosarcomatous heterologous component. J Cutan Pathol. 2018;45(5):360-4. https://pubmed.ncbi.nlm.nih.gov/29405341 https://doi.org/10.1111/cup.13122 DOI: https://doi.org/10.1111/cup.13122
Baltres A, Salhi A, Houlier A, Pissaloux D, et al. Malignant melanoma with areas of rhabdomyosarcomatous differentiation arising in a giant congenital nevus with RAF1 gene fusion. Pigment Cell Melanoma Res. 2019;32(5):708-13. https://pubmed.ncbi.nlm.nih.gov/30945443 https://doi.org/10.1111/pcmr.12785 DOI: https://doi.org/10.1111/pcmr.12785
Tran, T, Linos, K, de Abreu, F, Carlson J. Undifferentiated sarcoma as intermediate step in the progression of malignant melanoma to rhabdomyosarcoma: histologic, immunohistochemical, and molecular studies of a new case of malignant melanoma with rhabdomyosarcomatous differentiation. Am J Dermatopathol. 2019;41(3):221-229. https://pubmed.ncbi.nlm.nih.gov/30085960 https://doi.org/10.1097/DAD.000000000000123 DOI: https://doi.org/10.1097/DAD.0000000000001236
Abbott JJ, Amirkhan RH, Hoang MP. Malignant melanoma with a rhabdoid phenotype: histologic, immunohistochemical, and ultrastructural study of a case and review of the literature. Arch Pathol Lab Med. 2004;128(6):686-8. https://pubmed.ncbi.nlm.nih.gov/15163228 https://doi.org/10.5858/2004-128-686-MMWARP DOI: https://doi.org/10.5858/2004-128-686-MMWARP
Ferreira I, Droop A, Edwards O, et al. The clinicopathologic spectrum and genomic landscape of de-/trans-differentiated melanoma. Mod Pathol. 2021;34(11):2009-19. https://pubmed.ncbi.nlm.nih.gov/34155350 https://doi.org/10.1038/s41379-021-00857-z DOI: https://doi.org/10.1038/s41379-021-00857-z
North J, Bastian B, Lazar A. Melanoma. In: McKee’s pathology of the skin, 5th ed. Elsevier; 2020.
Agaimy A, Specht K, Stoehr R, et al. Metastatic malignant melanoma with complete loss of differentiation markers (undifferentiated/dedifferentiated melanoma): analysis of 14 patients emphasizing phenotypic plasticity and the value of molecular testing as surrogate diagnostic marker. Am J Surg Pathol. 2016;40(2):181-91. https://pubmed.ncbi.nlm.nih.gov/26448190 https://doi.org/10.1097/PAS.0000000000000527 DOI: https://doi.org/10.1097/PAS.0000000000000527
Nahon-Estève S, Bertolotto C, Picard-Gauci A, et al. Small but challenging conjunctival melanoma: new insights, paradigms and future perspectives. Cancers (Basel). 2021;13(22):5691. https://pubmed.ncbi.nlm.nih.gov/34830847 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8616295 https://doi.org/10.3390/cancers13225691 DOI: https://doi.org/10.3390/cancers13225691
Lally SE, Milman T, Orloff M, et al. Mutational landscape and outcomes of conjunctival melanoma in 101 patients. Ophthalmology. 2022;129(6):679-93. https://pubmed.ncbi.nlm.nih.gov/35085662 https://doi.org/10.1016/j.ophtha.2022.01.016 DOI: https://doi.org/10.1016/j.ophtha.2022.01.016
Koç İ, Kıratlı H. Current management of conjunctival melanoma part 2: treatment and future directions. Turk J Ophthalmol. 2020;50(6):362-70. Phttps://pubmed.ncbi.nlm.nih.gov/33389937 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7802095 https://doi.org/10.4274/tjo.galenos.2020.22567 DOI: https://doi.org/10.4274/tjo.galenos.2020.22567
Gattenlöhner S, Brocker EB, Muller-Hermelink HK. Malignant melanoma with metastatic rhabdomyosarcomatoid transdifferentiation. N Engl J Med. 2008;358(6):649-50. https://pubmed.ncbi.nlm.nih.gov/18256407 https://doi.org/10.1056/NEJMc0707079 DOI: https://doi.org/10.1056/NEJMc0707079
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2022 Angeline Llemit, Xavier George Cardos, John Patrick Padilla
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
The Philippine Journal of Pathology is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. Based on works made open access at http://philippinejournalofpathology.org
@philippinepathologyjournal