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Balloon cell melanoma: a case report with polarized and non-polarized dermatoscopy and dermatopathology
Balloon cell melanoma is a rare melanoma subtype, with only one previous case with dermatoscopy published. It is often non-pigmented, leading to diagnostic difficulty, and there is a tendency for lesions to be thick at diagnosis. We report a case of balloon cell melanoma on the forearm of a 61-year-...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Derm101.com
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3919844/ https://www.ncbi.nlm.nih.gov/pubmed/24520518 http://dx.doi.org/10.5826/dpc.0401a11 |
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author | Maher, James Cameron, Alan Wallace, Sharon Acosta-Rojas, Rafael Weedon, David Rosendahl, Cliff |
author_facet | Maher, James Cameron, Alan Wallace, Sharon Acosta-Rojas, Rafael Weedon, David Rosendahl, Cliff |
author_sort | Maher, James |
collection | PubMed |
description | Balloon cell melanoma is a rare melanoma subtype, with only one previous case with dermatoscopy published. It is often non-pigmented, leading to diagnostic difficulty, and there is a tendency for lesions to be thick at diagnosis. We report a case of balloon cell melanoma on the forearm of a 61-year-old man with both polarized and non-polarized dermatoscopy and dermatopathology. It presented as a firm pale nodule with focal eccentric pigmentation. The clinical images evoke a differential diagnosis of dermatofibroma, dermal nevus, Spitz nevus and basal cell carcinoma as well as melanoma. This melanoma was partially pigmented due to a small, pigmented superficial spreading component on the edge of the non-pigmented balloon cell nodule, prompting further evaluation. In retrospect there was the clue to malignancy of polarizing-specific white lines (chrysalis structures) and polymorphous vessels, including a pattern of dot vessels. The reticular lines exclude basal cell carcinoma, polarizing-specific white lines are inconsistent with the diagnosis of dermal nevus and their eccentric location is inconsistent with both Spitz nevus and dermatofibroma. Excision biopsy was performed, revealing a superficial spreading melanoma with two distinct invasive components, one of atypical non-mature epithelioid cells and the other an amelanotic nodular component, comprising more than 50% of the lesion, characterized by markedly distended epithelioid melanocytes showing pseudo-xanthomatous cytoplasmic balloon cell morphology. A diagnosis of balloon cell melanoma, Breslow thickness 1.9 mm, mitotic rate 3 per square millimeter was rendered. Wide local excision was performed, as was sentinel lymph node biopsy, which was negative. |
format | Online Article Text |
id | pubmed-3919844 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | Derm101.com |
record_format | MEDLINE/PubMed |
spelling | pubmed-39198442014-02-11 Balloon cell melanoma: a case report with polarized and non-polarized dermatoscopy and dermatopathology Maher, James Cameron, Alan Wallace, Sharon Acosta-Rojas, Rafael Weedon, David Rosendahl, Cliff Dermatol Pract Concept Observation Balloon cell melanoma is a rare melanoma subtype, with only one previous case with dermatoscopy published. It is often non-pigmented, leading to diagnostic difficulty, and there is a tendency for lesions to be thick at diagnosis. We report a case of balloon cell melanoma on the forearm of a 61-year-old man with both polarized and non-polarized dermatoscopy and dermatopathology. It presented as a firm pale nodule with focal eccentric pigmentation. The clinical images evoke a differential diagnosis of dermatofibroma, dermal nevus, Spitz nevus and basal cell carcinoma as well as melanoma. This melanoma was partially pigmented due to a small, pigmented superficial spreading component on the edge of the non-pigmented balloon cell nodule, prompting further evaluation. In retrospect there was the clue to malignancy of polarizing-specific white lines (chrysalis structures) and polymorphous vessels, including a pattern of dot vessels. The reticular lines exclude basal cell carcinoma, polarizing-specific white lines are inconsistent with the diagnosis of dermal nevus and their eccentric location is inconsistent with both Spitz nevus and dermatofibroma. Excision biopsy was performed, revealing a superficial spreading melanoma with two distinct invasive components, one of atypical non-mature epithelioid cells and the other an amelanotic nodular component, comprising more than 50% of the lesion, characterized by markedly distended epithelioid melanocytes showing pseudo-xanthomatous cytoplasmic balloon cell morphology. A diagnosis of balloon cell melanoma, Breslow thickness 1.9 mm, mitotic rate 3 per square millimeter was rendered. Wide local excision was performed, as was sentinel lymph node biopsy, which was negative. Derm101.com 2014-01-31 /pmc/articles/PMC3919844/ /pubmed/24520518 http://dx.doi.org/10.5826/dpc.0401a11 Text en Copyright: ©2014 Maher et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Observation Maher, James Cameron, Alan Wallace, Sharon Acosta-Rojas, Rafael Weedon, David Rosendahl, Cliff Balloon cell melanoma: a case report with polarized and non-polarized dermatoscopy and dermatopathology |
title | Balloon cell melanoma: a case report with polarized and non-polarized dermatoscopy and dermatopathology |
title_full | Balloon cell melanoma: a case report with polarized and non-polarized dermatoscopy and dermatopathology |
title_fullStr | Balloon cell melanoma: a case report with polarized and non-polarized dermatoscopy and dermatopathology |
title_full_unstemmed | Balloon cell melanoma: a case report with polarized and non-polarized dermatoscopy and dermatopathology |
title_short | Balloon cell melanoma: a case report with polarized and non-polarized dermatoscopy and dermatopathology |
title_sort | balloon cell melanoma: a case report with polarized and non-polarized dermatoscopy and dermatopathology |
topic | Observation |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3919844/ https://www.ncbi.nlm.nih.gov/pubmed/24520518 http://dx.doi.org/10.5826/dpc.0401a11 |
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