mart-1-antigen and Melanoma--Amelanotic

We herein describe the case of a 77-year-old Japanese man who presented with progressive thrombocytopenia. No lymphadenopathies, bone lesions, hepatosplenomegaly or masses within any internal organs were detectable. Bone marrow smears revealed diffuse infiltration of large atypical cells morphologically resembling mature lymphoid neoplasms. A flow cytometric analysis showed that the tumor cells strongly expressed CD56 without myeloid or lymphoid antigens, suggesting that they were non-hematologic in origin. Ultimately, amelanotic malignant melanoma of unknown primary origin was diagnosed based on positive immunostaining for S100 proteins, HMB-45 and Melan-A. This case illustrates the usefulness of flow cytometric analyses for making such diagnoses. We also review the available literature on similar cases.

Topics: Aged; Bone Marrow Neoplasms; CD56 Antigen; Fatal Outcome; Flow Cytometry; gp100 Melanoma Antigen; Humans; Immunohistochemistry; Male; MART-1 Antigen; Melanoma-Specific Antigens; Melanoma, Amelanotic; Neoplasms, Unknown Primary; S100 Proteins

A rare case of amelanotic vulvar melanoma is presented. The patient was a 71-year-old woman complaining of vulvar itching and yellowish vaginal discharge who underwent a complete gynecological evaluation during which a suspicious grey-whitish mass on her vulva was observed. The tumor presented superficial ulceration and was located in the upper half of the labia minora and clitoris. Initially it was suspected to be a vulvar carcinoma. A biopsy was taken and a histopathological suspicion of amelanotic melanoma was rendered. The mass was radically excised and the diagnosis was confirmed using HMB-45, Melan-A and anti-S-100 protein antibodies. Malignant melanoma is readily diagnosed by the presence of melanin granules. Although amelanotic melanoma contains a few melanin granules, it is often difficult to differentiate it from other non-epithelial malignant tumors. This report describes a case of amelanotic melanoma of the vulva, which was correctly diagnosed by immunohistochemical staining with the HMB-45, Melan-A antibody and for the S-100 protein.

Topics: Aged; Antigens, Neoplasm; Female; Humans; MART-1 Antigen; Melanoma-Specific Antigens; Melanoma, Amelanotic; Neoplasm Proteins; S100 Proteins; Vulvar Neoplasms

Topics: Biomarkers, Tumor; Conjunctival Neoplasms; Cryotherapy; Diabetic Retinopathy; Glaucoma, Open-Angle; Humans; Hypertension; Male; MART-1 Antigen; Melanoma, Amelanotic; Middle Aged; Ophthalmologic Surgical Procedures; S100 Proteins

A 60-year Brazilian woman, presented with an enlarged lymph node in the neck for one year, and a superficial nonulcerated lesion was observed in the scalp. Fine needle aspiration and biopsy of the lymph node revealed amelanocytic metastasis, and immunohistochemistry study showed Melan-A/ Mart-1 antigen (clone A103 and S-100 protein). The entire suspected area of the scalp was further resected and an amelanotic melanoma without angiolymphatic invasion was diagnosed. Ultrasonography and PET-computed tomography showed hypermetabolic cystic area in the right parotid. Furthermore, aspiration biopsy and surgical samples from parotid cyst confirmed the malignant amelanotic melanoma. Cystic metastases are scarcely reported in parotid gland, and can pose diagnostic challenges.

Topics: Antigens, Neoplasm; Biopsy, Fine-Needle; Female; Humans; Immunohistochemistry; Lymph Nodes; Lymphatic Metastasis; MART-1 Antigen; Melanoma, Amelanotic; Middle Aged; Neoplasm Proteins; Parotid Gland; Parotid Neoplasms; Positron Emission Tomography Computed Tomography; S100 Proteins; Scalp; Skin Neoplasms; Treatment Outcome; Ultrasonography

Topics: Aged; Bone Marrow; Bone Marrow Neoplasms; Calcium-Binding Proteins; Female; gp100 Melanoma Antigen; Humans; MART-1 Antigen; Melanoma-Specific Antigens; Melanoma, Amelanotic; Neoplasm Proteins; Proto-Oncogene Proteins c-kit

Conjunctival melanoma is a relatively rare malignancy. It is presented as pigmented nodule in any area of conjunctiva, amelanotic tumors are pink with smooth appearance. The authors describe an amelanotic melanoma of the conjunctiva in an 82-year-old female patient. Cytological, histopathological and immunohistochemical studies revealed an invasive amelanotic melanoma exhibiting S-100 and MART-1 positivity. The patient undervent surgical and chemotherapy treatment and three years after the initial treatment is in the terminal stage of metastatic disease. Absence of pigmentation delayed early clinical detection and treatment. Awareness of this nonpigmented melanoma is crucial for early recognition and appropriate management.

Topics: Aged, 80 and over; Biomarkers, Tumor; Biopsy; Brain Neoplasms; Conjunctival Neoplasms; Female; Humans; MART-1 Antigen; Melanoma, Amelanotic; S100 Proteins; Tomography, X-Ray Computed

Amelanotic vulvar melanoma is a rare type of malignant melanoma. This paper describes a case of an asymptomatic ulcerated nodule 20 mm in size. The tumor cells from the nodular lesion showed positive staining immunohistochemically for Melan-A, but negative staining with HMB-45. The cells showed negative reactivity to S-100 except in one region. The melanoma cells in the epidermis were detected in one of the specimens from the excised tumor nodule. The cells in the epidermis showed positive staining for Melan-A and S-100 and partial staining with HMB-45. The tumor was diagnosed as malignant melanoma of the vulva and immunohistochemically shown to have intratumor histological heterogeneity. This case suggests the importance of viewing non-pigmented nodules on the vulva of elderly females as potentially malignant melanoma, and that a combination of immunohistochemical stains may be useful for recognizing the stage of the melanosomes in the melanoma cells.

Topics: Aged, 80 and over; Antigens, Neoplasm; Female; Humans; Immunohistochemistry; MART-1 Antigen; Melanoma, Amelanotic; Neoplasm Proteins; Vulva; Vulvar Neoplasms

Small cell melanoma is a recognized rare variant of malignant melanoma. We report a case of a brown, ulcerated papule on the left third finger of an 80-year-old woman. Microscopic examination revealed the presence within the epidermis of diffuse sheets of monomorphic small to medium-sized cells. The nuclei were round or oval, and hyperchromatic with inconspicuous nucleoli. Melanin pigment was either absent or minimal. This case report draws attention to the difficulties encountered in the histological diagnosis of this rare variant of malignant melanoma.

Topics: Aged; Amputation, Surgical; Antigens, Neoplasm; Biomarkers, Tumor; Female; Fingers; Humans; Lymphatic Metastasis; MART-1 Antigen; Melanoma-Specific Antigens; Melanoma, Amelanotic; Neoplasm Proteins; Skin Neoplasms

Tyrosinase-related protein-2 (TRP-2) is a highly conserved melanogenic enzyme expressed in both pigmented and unpigmented melanomas of the mouse. To determine whether TRP-2 would be a good diagnostic marker for amelanotic melanomas of the dog, we performed immunohistochemistry for TRP-2, S-100, and Melan A on 21 canine tumors identified as amelanotic melanomas based on routine histopathologic examination. Thirteen of the tumors were TRP-2 positive, 10 were Melan A positive, and 19 were S-100 positive. TRP-2 was expressed in the cytoplasm of tumor cells in both primary and metastatic melanomas. S-100 staining was positive in all of three schwannomas and two of three gastrointestinal stromal tumors (one fibrosarcoma and one leiomyosarcoma) tested. Neither Melan A nor TRP-2 antibodies reacted with these tumors. Our findings indicate that staining for TRP-2 is a sensitive and specific method for confirming the diagnosis of amelanotic melanoma in dogs.

Topics: Animals; Antigens, Neoplasm; Dog Diseases; Dogs; Immunohistochemistry; Intramolecular Oxidoreductases; MART-1 Antigen; Melanoma, Amelanotic; Neoplasm Proteins; S100 Proteins; Sensitivity and Specificity; Skin Neoplasms

Topics: Antigens, Neoplasm; Biomarkers, Tumor; Cartilage; Diagnosis, Differential; Epithelioid Cells; Humans; MART-1 Antigen; Melanoma-Specific Antigens; Melanoma, Amelanotic; Neoplasm Proteins; Nerve Sheath Neoplasms; Neurilemmoma; Soft Tissue Neoplasms

To report a rare case of endometrial metastasis of cutaneous malignant melanoma, mimicked by histologically xanthomatous lesion. Only about ten other cases of endometrial metastasis of this malignancy have been reported previously. -. Case report. -. A 60 year old female. -. Fractionated curettage and immunohistologically examination of the tissue. -. Due to xanthomatous regressive changes of the metastatic tissue, difficulties in the histological confirmation as a metastasis of an unpigmented malignant melanoma occurred. But immunohistological staining showed positivity for S-100 and MART-1, as did the primary tumour. -. If atypical bleeding in patients with known malignant melanoma of the skin occur endometrial metastasis should be excluded by gynaecologists.

Topics: Antigens, Neoplasm; Diagnosis, Differential; Dilatation and Curettage; Endometrial Neoplasms; Endometrium; Fatal Outcome; Female; Humans; Immunohistochemistry; MART-1 Antigen; Melanoma, Amelanotic; Middle Aged; Neoplasm Proteins; S100 Proteins; Skin Neoplasms; Uterine Hemorrhage

Topics: Aged; Antigens, Neoplasm; Facial Neoplasms; Humans; Male; MART-1 Antigen; Melanoma-Specific Antigens; Melanoma, Amelanotic; Melanosomes; Neoplasm Proteins

The presence or absence of melanoma cells in human peripheral blood has recently been shown to be associated with disease prognosis, including overall survival. The detection of tyrosinase mRNA-positive circulating melanoma cells by reverse transcription-polymerase chain reaction (RT-PCR) has been limited to disseminated tumours expressing measurable amounts of this melanocyte-specific enzyme. To biologically classify both melanotic and amelanotic melanomas and to evaluate the clinical and prognostic relevance of tumour cell microcontamination, we examined autologous peripheral blood stem cell (PBSC) harvests from patients with advanced malignant melanoma prior to dose-escalated chemotherapy. To assay heterogeneous melanoma cell antigen expression, we developed a highly sensitive RT-PCR using four melanoma- and one tumour-associated antigen as molecular markers. Expression of the melanocyte-associated transcripts of tyrosinase, MART1/Melan-A, tyrosinase-related protein-1 (TRP-1) and tyrosinase-related protein-2 (TRP-2) as well as the tumour-specific transcript of MAGE-3 was analysed by RT-PCR in PBSC harvests from 31 patients. Seven of the 31 PBSC harvests tested positive for one or more molecular markers: two patients for tyrosinase only, and one patient for MAGE-3 only, one patient for tyrosinase and MAGE-3, one for tyrosinase and MART1/Melan-A, and two patients for tyrosinase, MART1/Melan-A, TRP-2 and MAGE-3. mRNA-positive patients exhibited a significantly impaired overall survival (P = 0.0032), with a median survival of 3 months as opposed to 10 months in PBSC mRNA-negative patients. In conclusion, the use of this multiple-marker microcontamination assay allowed for molecular and prognostic classification of advanced malignant melanoma.

Topics: Adult; Antigens, Neoplasm; Biomarkers, Tumor; Female; Hematopoietic Stem Cells; Humans; Immunohistochemistry; Interferon Type I; Intramolecular Oxidoreductases; Male; MART-1 Antigen; Melanoma; Melanoma, Amelanotic; Middle Aged; Neoplasm Proteins; Neoplastic Cells, Circulating; Pregnancy Proteins; Prognosis; RNA, Messenger; RNA, Neoplasm; Sensitivity and Specificity; Tumor Cells, Cultured

The authors retrospectively tested the potential value of paraffin-reactive monoclonal antibodies (A103 against melan-A, T311 against tyrosinase) and antibody KBA62 as immunohistochemical markers for amelanotic metastatic melanomas. The study cases included 72 amelanotic metastases of known cutaneous melanomas, 59 poorly differentiated carcinomas, 73 sarcomas of varying histogenesis, 4 Leydig cell tumors, 10 high-grade lymphomas, and 6 plasmoblastic/anaplastic myelomas. The results were compared with immunostainings for S-100 protein and HMB-45. HMB-45, antimelan-A, and antityrosinase showed almost identical staining results, with a sensitivity of 0.85 for HMB-45 and of 0.86 for both antimelan-A and for antityrosinase. HMB-45 and antityrosinase both had a specificity of 1.00; the specificity of antimelan-A was 0.95 as a result of a positive reaction in three of three adrenocortical carcinomas and four of four Leydig cell tumors. KBA62 stainings resulted in a sensitivity of 0.86 for melanomas. A positive immunoreactivity of KBA62 alone had a specificity of only 0.83, but in conjunction with anti-S-100 protein (sensitivity, 1.00; specificity, 0.87) and anticytokeratin 8/18/19 (CK), a KBA62+/S-100+/CK- immunophenotype identified all except one of the melanoma cases that were negative for the three melanocyte-specific markers with a specificity of 0.99. In conclusion, we found comparable immunohistochemical sensitivities of HMB-45, antityrosinase, and antimelan-A for a highly specific identification of approximately 85% of amelanotic metastatic melanomas on paraffin sections. Melanomas that were negative for all of these specific markers might be sensitively and specifically detected with anti-S-100 protein and KBA62.

Topics: Antibodies, Monoclonal; Antigens, Neoplasm; Biomarkers, Tumor; Humans; Immunohistochemistry; Keratins; MART-1 Antigen; Melanoma-Specific Antigens; Melanoma, Amelanotic; Monophenol Monooxygenase; Neoplasm Proteins; Paraffin; S100 Proteins; Staining and Labeling