A Case of Amelanotic Malignant Melanoma of the Lingual Base That Was Diagnosed Based on a Biopsy of Late Metastasis to a Lumbar Vertebra after Being Misdiagnosed as HPV-Positive Oropharyngeal Anterior Wall Squamous Cell Carcinoma.

IF 0.4 Q4 OTORHINOLARYNGOLOGY
Case Reports in Otolaryngology Pub Date : 2021-09-30 eCollection Date: 2021-01-01 DOI:10.1155/2021/7139280
Takumi Okuda, Shinsuke Ide, Kei Kajihara, Tetsuya Tono
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引用次数: 1

Abstract

We report a case of amelanotic malignant melanoma (AMM) in a 66-year-old female. AMM of the lingual base was diagnosed based on a biopsy of late metastasis to the bone marrow of the L4 lumbar vertebra. The patient was initially treated with chemoradiotherapy after being misdiagnosed with poorly differentiated human papillomavirus- (HPV-) related squamous cell carcinoma of the oropharyngeal anterior wall. p16 immunostaining is used to diagnose HPV-related oropharyngeal cancer. However, while p16 expression is used as a surrogate marker of HPV infection, it is important to be aware that p16 protein overexpression can also be caused by other factors. Malignant melanoma is known to express the p16 protein. Morphologically differentiating between AMM and poorly differentiated squamous cell carcinoma based on hematoxylin-eosin staining is difficult. Therefore, in cases that are pathologically diagnosed as p16-positive poorly differentiated oropharyngeal squamous cell carcinoma, it is important to rule out AMM.

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1例口咽前壁鳞状细胞癌误诊为HPV阳性,经腰椎晚期转移活检诊断为舌根无毛恶性黑色素瘤。
我们报告一例无黑色素瘤恶性黑色素瘤(AMM)在一个66岁的女性。舌底AMM的诊断是基于对L4腰椎骨髓晚期转移的活检。在被误诊为低分化人乳头瘤病毒(HPV)相关口咽前壁鳞状细胞癌后,患者最初接受放化疗。p16免疫染色用于hpv相关口咽癌的诊断。然而,虽然p16表达被用作HPV感染的替代标志物,但重要的是要意识到p16蛋白过表达也可能由其他因素引起。恶性黑色素瘤已知表达p16蛋白。基于苏木精-伊红染色在形态学上区分AMM和低分化鳞状细胞癌是困难的。因此,在病理诊断为p16阳性低分化口咽鳞状细胞癌的病例中,排除AMM很重要。
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来源期刊
Case Reports in Otolaryngology
Case Reports in Otolaryngology OTORHINOLARYNGOLOGY-
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审稿时长
13 weeks
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