Primary cutaneous malignant melanoma of the breast: A case report

Abstract

Cutaneous malignant melanoma (CMM) of the breast may be classified in two categories as primary and metastatic lesions. CMM represents less than 5% of all malignant melanomas (MM). Clinical findings and diagnostic tools are similar to other MM developed in various areas of skin. Treatment should provide adequate surgical border with wide local excision. Since the presence of lymph node metastasis is a very crucial prognostic factor, lymph node status should also be evaluated. In this article, we presented a 40 year old female patient with cutaneous MM of the breast, who presented with a congenital, blue colored, raised nevus, over the right breast lower lateral quadrant periareolar area, which has been growing in recent years with color darkening and non-healing ulcer development. We aimed to present the clinical, radiologic, pathologic findings and treatment modalities of CMM of the breast with literature review.

Keywords

• Breast
• Cutaneous
• Malign melanoma
• Primary

References

1. Alzaraa, A., Sharma, N., 2008. Primary cutaneous melanoma of the breast: A case report. Cases J. 1, 212. doi: 10.1186/1757-1626-1-212.
2. Balch, C.M., Buzaid, A.C., Soong, S.J., Atkins, M.B., Cascinelli, N., Coit, D.G., Fleming, I.D., Gershenwald, J.E., Houghton, A, Jr., Kirkwood, J.M., McMasters, K.M., Mihm, M.F., Morton, D.L., Reintgen, D.S., Ross, M.I., Sober, A., Thompson, J.A., Thompson, J.F., 2001. Final version of the American Joint Committee on Cancer staging system for cutaneous melanoma. J. Clin. Oncol. 19, 3635-3648.
3. Balch, C.M., Gershenwald, J.E., Atkins, M.B., Buzaid, A.C., Cascinelli, N., Cochran, A.J., 2010. Chapter 31. Melanoma of the skin. In: Edge, S.B., Byrd, D.R., Compton, C.C., Fritz, A.G., Greene, F.L., Trotti, A., editors. AJCC cancer staging manual. 7th ed. New York: Springer, pp. 325-344.
4. Bassi, F., Gatti, G., Mauri, E., Ballardini, B., De Pas, T., Luini, A., 2004. Breast metastases from cutaneous malignant melanoma. Breast. 13, 533-535.
5. Biswas, A., Goyal, S., Jain, A., Suri, V., Mathur, S., Julka, P.K., Rath, G.K., 2010. Primary amelanotic melanoma of the breast: Combating a rare cancer. Breast Cancer. 2, 236-240. doi: 10.1007/s12282-010-0231-8.
6. Bono, A., Baldi, M., Maurichi, A., Tomatis, S., 2003. Distribution of melanoma on breast surface suggests its etiology. Int. J. Cancer. 105, 434.
7. Desmond, R.A., Soong, S.J., 2003. Epidemiology of malignant melanoma. Surg. Clin. North Am. 83, 1-29.
8. English, D.R., Armstrong, B.K., Kricker, A., Fleming, C., 1997. Sunlight and cancer. Cancer Causes Control. 8, 271-283.

9. Essner, R., 2003. Surgical treatment of malignant melanoma. Surg. Clin. North Am. 83, 109-156.
10. Kadison, A.S., Morton, D.L., 2003. Immunotherapy of malignant melanoma. Surg. Clin. North Am. 83, 343-370.
11. Kirkwood, J.M., Strawderman, M.H., Ernstoff, M.S., Smith, J.J., Borden, E.C., Blum, R.H., 1996. Interferon alfa-2b adjuvant therapy of high- risk resected cutaneous melanoma: The Eastern Cooperative Oncology Group trial EST 1684. J. Clin. Oncol. 14, 7-17.
12. Kurul, S., Tas, F., Buyukbabani, N., Mudun, A., Baykal, C., Camlica, H., 2005. Different manifestations of malignant melanoma in the breast: A report of 12 cases and a review of the literature. Jpn J. Clin. Oncol. 35, 202-206.
13. Lee, Y.T., Sparks, F.C., Morton, D.L., 1977. Primary melanoma of skin of the breast region. Ann. Surg. 185, 17-22.
14. Mitchell, S., Lachica, R., Randall, M.B., Beech, D.J., 2006. Paget’s disease of the breast areola mimicking cutaneous melanoma. Breast J. 12, 233-236.
15. Papachristou, D.N., Kinne, D.W., Rosen, P.P., Ashikari, R., Fortner, J.G., 1979. Cutaneous melanoma of the breast. Surgery. 85, 322-328.
16. Tavakkolizadeh, A., Whang, E.E., Ashley, S.W., Zinner, M.J., 2010. Small intestine. In: Brunicardi, F.C., Anderson, D.K., Billiar, T.R., Dunn, D.L., Hunter, J.G., Matthews, J.B., Pollock, R.E., editors. Schwartz’s Principles of Surgery, 9th ed. New York: McGraw-Hill, pp. 979.