Primary Amelanotic Malignant Melanoma of the Parotid Gland: A Case Report

Primary malignant melanoma of the parotid gland, a rare case arising from a duct: a case report and literature review

Malignant melanoma of the parotid gland is an unusual tumor in the head and neck region, and most parotid melanoma is reported as a metastatic lesion of cutaneous malignant melanoma. We report a case of primary malignant melanoma arising in the parotid gland duct with diagnostic challenge. The patient was a 68-year-old man who complained of repeated right facial swelling that presented 3 months prior. Swelling was detected along the Stensen's duct of the cheek, and brown-colored saliva-like fluid was aspirated. On MR and CT images, a fluid-filled duct with small nodule and heterogeneously enhancing mass in the parotid parenchyma was detected. The nodular mass on the ductal wall grew rapidly, and the hyperintense T1 signal became significant on follow-up images. The final diagnosis via histopathologic examination using biopsy and parotidectomy specimen revealed the lesion as malignant melanoma of the duct and pleomorphic adenoma of the parenchyma. Even if the incidence of primary malignant melanoma is very low among tumors occurring in the parotid gland, efforts supporting an early diagnosis using imaging characteristics are important.

Is Primary Poorly Differentiated Sarcomatoid Malignancy of the Parotid Gland Sarcomatoid Undifferentiated/Dedifferentiated Melanoma? Report of Three Unusual Cases Diagnosed by Fine-Needle Aspiration Combined with Histological, Immunohistochemical, and Molecular Analyses

INTRODUCTION

Poorly differentiated primary sarcomatoid parotid malignancies are extremely rare. These tumors have not been consistently studied by morphology, immunohistochemistry, or molecular techniques.

CASE PRESENTATION

We report three unusual cases of parotid gland poorly-differentiated sarcomatoid malignancy investigated by fine-needle aspiration and studied histologically, by immunohistochemistry and molecular investigations. Aspirates showed poorly specific polymorphous sarcomatoid malignancy in all cases. Histologically, all cases were polymorphous high-grade malignancies, and additionally, one case showed epithelial structures and was finally classified as salivary carcinosarcoma. Immunohistochemistry showed classical melanocytic markers negativity but positivity for PRAME, CD10, and WT1 in all three tumors and for CD56 in two tumors, which can potentially be supportive of melanocytic origin. Although not entirely specific, molecular characterization also suggested the melanocytic lineage of these tumors.

CONCLUSION

Although rare, primary malignant melanoma of salivary gland was already described, but undifferentiated/dedifferentiated amelanotic forms are unknown in this localization up today. Further case reports of similar presentations are required to confirm the unequivocal primary origin of these obscure neoplasms in the parotid gland.

Primary Malignant Melanoma in the Parotid Gland: A Case Report and Literature Review

Primary melanoma of the parotid gland is an extremely rare and challenging tumor with a poor prognosis, and its ultrasonic characteristics have yet to be reported. This article presents a case of a 77-year-old man with a left parotid mass that was confirmed as a melanoma following surgery. The ultrasonic features of melanoma were examined in detail, with a particular focus on their diagnostic value. Furthermore, we summarized the clinical characteristics, treatment options, and outcomes associated with primary melanoma of the parotid gland based on a thorough analysis of the available literature.

Surgery, adjuvant immunotherapy plus chemotherapy and radiotherapy for primary malignant melanoma of the parotid gland (PGMM): A case report

Primary malignant melanoma of the parotid gland (PGMM) is extremely rare, with a poor prognosis. Surgery is the main treatment option followed by adjuvant treatments such as radiotherapy, but which adjuvant treatment to be optimal is still controversial. In this case, a 63-year-old male PGMM patient was first misdiagnosed as a "myoepithelial tumor" and then treated with surgery, postoperative immunotherapy (sintilimab), chemotherapy, and radiotherapy successfully. The progression free survival was more than 19 months without signs of metastasis or recurrence to date. To our best knowledge, this is the first report of postoperative immunotherapy combined with chemotherapy and radiotherapy for PGMM. Our case indicated that combination therapy including surgery, adjuvant immunotherapy (sintilimab) combined with chemotherapy and radiotherapy may be a potential treatment option for PGMM, which needs further research.

Malignant melanoma of parotid glands from a neglected lesion: A case report

Observing a metastatic malignant melanoma and its primary lesion at the same time is rare. The histopathological detection of any unusual pigmented lesion is critical.

Primary malignant melanoma of the parotid gland: A case report and review of the literature

INTRODUCTION

Malignant melanomas (MM) of the parotid gland are rather rare and when discovered in the parotid gland without an identifiable primary site, they are considered even rarer.

PRESENTATION OF CASE

We report a case of a 27 years-old woman who was admitted to our department with a complaint of a painless mass in the parotid area. Clinical examination and radiological investigations found a mass compatible with pleomorphic adenoma. Treatment consisted of superficial parotidectomy. The evolution was marked by the appearance of a tumefaction regarding the scar. A total parotidectomy with neck dissection was performed and the histopathological examination found an intraglandular melanoma.

CONCLUSION

Primary malignant melanoma may represent a serious diagnostic challenge. It should be considered in the differential diagnosis of parotid tumors even if it's rare.

Malignant melanoma of parotid gland in a child-our unique experience

Malignant melanoma (MM) of parotid gland is a rare condition. This pathology is often a result of secondary metastasis from primary lesions in the head and neck skin. A MM arising de novo in parotid gland is very rare. This malignant tumour is more prevalent in adults rather than children and it tends to have several distinct features. Treatment options are limited especially for an advanced lesion. Despite best treatments this condition carries a poor prognosis. This case details our experience in treating a child with MM of parotid gland without other primary cutaneous lesions.

Metastatic Malignant Melanoma of Parotid Gland with a Regressed Primary Tumor

Malignant melanoma of the parotid gland is often metastatic and mainly originates from malignant melanomas in the head and neck. Nevertheless, some malignant melanomas may metastasize and subsequently regress. Therefore, it may not be possible to observe a metastatic malignant melanoma and its primary melanoma simultaneously. The investigation of a patient's old photographs may help in the detection of preexisting and regressed pigmented lesions in the facial and neck regions.

Primary Malignant Melanoma of the Esophagus

Primary malignant melanoma of the esophagus is an extremely rare neoplasm arising from the esophageal mucosal melanocytes. We herein describe a patient of primary malignant melanoma of the esophagus, who was managed by thoracolaparoscopic esophagectomy.

Primary malignant melanoma of the esophagus: a study of clinical features, pathology, management and prognosis

Primary malignant melanoma of the esophagus (PMME) is a rare disease that is characterized by aggressive invasion, early metastasis, and poor prognosis. Treatment protocols are not well-established. To understand this condition more precisely, we performed a retrospective review of eight cases of PMME diagnosed at the Thoracic Department of the Cancer Center at Sun Yat-Sen University between 1985 and 2009. Eight PMME patients (five men and three women) with a mean age of 58 years (range: 48 to 72 years) were included. Dysphagia was the most common presenting symptom. All patients underwent an Ivor-Lewis esophagogastrectomy and lymph node dissection with postoperative adjuvant chemotherapy. One patient with stage III/pT4N0M0 underwent postoperative chemotherapy plus radiotherapy. Four patients died of distant metastases. The median survival time was 28 months (range: 11 months to 6 years). Our data confirm that PMME is a highly aggressive disease with a poor prognosis. If the diagnosis is suspected or confirmed as PMME, and the patients have no distal metastases or extensive lymph node enlargement, we suggest that surgery should be the first choice of treatment. With regard to adjuvant therapy, we recommend the addition of chemotherapy. The role of radiotherapy remains questionable and requires further investigation.