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Abstract
Primary malignant melanoma arising from the ovarian mature cystic teratoma is extremely rare, with only 31 cases have been described in the literature. It is one of the rarest forms of malignant transformation of ovarian mature cystic teratoma and usually develops unilaterally after menopause. Recently, we experienced a case of primary malignant melanoma arising from ovarian mature cystic teratoma in 71-year-old woman. The diagnosis was confirmed by positive immunohistochemical results of S-100 protein and HMB 45. Here we report the rare case with review of literature.
Figures and Tables
Figure 1
Seventy one year old female with primary malignant melanoma arising from ovarian mature cystic teratoma. (A) Contrast-enhanced computed tomography (CT) image shows septated cystic mass with calcification (arrow head) and fat (asterisk), suggesting teratoma. (B) Note solid portion on anterior wall of the mass (arrow).
Figure 2
(A) Gross appearance of cystic tumor of left ovary. Cystic tumor contains solid tumor with sebaceous material and hairs. (B) There are melanin pigment containing melanoma tumor cells in the background of mature cystic teratoma (multiple hair shafts in the cyst wall, arrows, H&E stain, ×40). (C) The solid tumor reveals spindle shape of brown melanin pigment containing melanoma cells (arrow) with several prominent nucleoli (H&E, ×200). (D) The tumor cells reveal diffuse strong positivity for HMB 45. (E) The tumor cells reveal focal immunopositivity for S-100 protein.
References
1. Vimla N, Kumar L, Thulkar S, Bal S, Dawar R. Primary malignant melanoma in ovarian cystic teratoma. Gynecol Oncol. 2001. 82:380–383.
2. Suneja A, Yadav P, Sharma A, Vaid NB, Singh B, Grover RK. Primary malignant melanoma in cystic teratoma of ovary. Indian J Cancer. 2009. 46:340–342.
3. McNeilage LJ, Morgan J, Constable J, Jobling TW. Metastatic malignant melanoma arising in a mature ovarian cystic teratoma: a case report and literature review. Int J Gynecol Cancer. 2005. 15:1148–1152.
4. Zarbo R, Scibilia G, Conoscenti G, Scollo P. Ovarian cystic teratoma with primary epithelial cell melanoma. Eur J Gynaecol Oncol. 2005. 26:71–74.
5. Kim YK, Yoon KW, Sohn WK, Yoon J, Ko JS, Jeon DJ, et al. A case of metastatic malignant melanoma of the ovary. korean J Obstet Gynecol. 2002. 45:492–496.
6. Choi YS, Jung CW, Kim J, Park GW, Seo YL, Park SH, et al. A case of the primary ovarian malignant melanoma arising from a cystic teratoma. Korean J Med. 2004. 66:644–648.
7. Ki KD, Ha CW, Seo SG, Huh CY, Yang MH, Lee JH, et al. A case of ovarian malignant melanoma showing peritoneal dissemination with unknown primary origin. Korean J Obstet Gynecol. 2006. 49:1578–1583.
8. Ariel IM. Amelanotic melanomas: an analysis of 77 patients. Curr Surg. 1981. 38:151–155.
9. Marcial-Rojas RA, Ramirez De Arellano GA. Malignant melanoma arising in a dermoid cyst of the ovary; report of a case. Cancer. 1956. 9:523–527.
10. McKee PH. Pathology of the skin with clinical correlations. 1989. Philadelphia, PA: JB Lippincott;13.28–13.42.
11. Clark WH Jr, Elder DE, Guerry Dt, Epstein MN, Greene MH, Van Horn M. A study of tumor progression: the precursor lesions of superficial spreading and nodular melanoma. Hum Pathol. 1984. 15:1147–1165.
12. Carlson JA Jr, Wheeler JE. Primary ovarian melanoma arising in a dermoid stage IIIc: long-term disease-free survival with aggressive surgery and platinum therapy. Gynecol Oncol. 1993. 48:397–401.
13. Legha SS, Ring S, Eton O, Bedikian A, Plager C, Papadopoulos N. Development and results of biochemotherapy in metastatic melanoma: the University of Texas M.D. Anderson Cancer Center experience. Cancer J Sci Am. 1997. 3:Suppl 1. S9–S15.
14. Kirkwood JM, Strawderman MH, Ernstoff MS, Smith TJ, Borden EC, Blum RH. Interferon alfa-2b adjuvant therapy of high-risk resected cutaneous melanoma: the Eastern Cooperative Oncology Group Trial EST 1684. J Clin Oncol. 1996. 14:7–17.
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