Abstract
We report a case of pedunculated malignant melanoma of the left-upper arm. A 57-year-old woman consulted our outpatient clinic for a huge, growing tumor she had had for three years. The physical examination revealed an erosive and hemorrhagic, flesh-colored, pedunculated tumor on the left upper arm. The radiological examination, including PET-CT disclosed no metastatic tumor. A total removal of the mass was performed. The tumor measured 120×95×75 mm, and weighed 307 g. Histology showed aggregates of large atypical cells, containing small amounts of melanin, throughout the dermis, and partially infiltrating the subcutaneous tissue. An immunohistochemical study showed positivity to S-100 protein, and HMB-45. A diagnosis of pedunculated type nodular melanoma (tumor thickness = 30.0 mm, pT4b, N0, M0, Stage IIc.) was made. The patient died following multiple metastases to the bone, skin, and brain nine months after the operation. A total of 28 cases of PMM, including the present case, were previously reported since 2000. Among them, 15 cases showed a reddish colored tumor, 17 cases revealed pT4 in the T-classification category, six cases showed metastasis, and seven-cases resulted in death. It seems that PMM are deeply infiltrating tumors, resulting in moderately poor prognosis.
