2021 Volume 38 Issue 5 Pages 740-744
A 54-year-old male visited a local internal medicine doctor, complaining of cough and chest pain lasting a few weeks. Computed tomography revealed a pulmonary effusion, multiple tumors on the thoracic wall, and swollen left cervical lymph nodes. He was referred to our hospital, and further studies, including video-assisted thoracic surgery (VATS), were carried out in the surgery department. However, prior to VATS, the patient was referred to us regarding a pale white tumor of 85×70×23 mm on the scalp, including an ulcerated lesion of 30×25×8 mm. A specimen taken from the scalp revealed malignant melanoma (MM), presumably arising from an amelanotic congenital melanocytic nevus, based on histological and immunohistochemical studies. In addition, specimens of thoracic tumors revealed immunoreactive patterns similar to those of the scalp specimen, leading to the diagnosis of the thoracic tumors as metastases from the scalp lesion. Chemotherapy was carried out three times; however, the patient died 4 months later due to disease progression. A giant congenital melanocytic nevus (CMN) with size exceeding 20 cm in diameter has a high-risk of malignant transformation. A medium-sized CMN also has malignancy potential, although the transformation occurs less than that of giant CMN, therefore, should be paid attention.
