Autopsy and Case Reports
https://www.autopsyandcasereports.org/article/doi/10.4322/acr.2023.459
Autopsy and Case Reports
Clinical Case Report and Review

Anorectal balloon cell melanoma: a rare variant

Priyanka Sameer; Pallavi Srivastava; Saumya Shukla; Nuzhat Husain

Downloads: 0
Views: 307

Abstract

Balloon cell melanoma is a rare presentation of malignant melanoma, usually on the skin, with less than 100 cases reported. Mucosal BCM is even rarer, with only one case of anorectal BCM reported in English literature. The diagnosis is based on the histopathologic findings of a tumor composed of large, foamy melanocytes, with or without pigmentation, and confirmed by immunohistochemical studies showing expression for melanocytic markers. The foam cell appearance of the tumor cells and the lack of melanin pigment lead to a diagnostic dilemma, mostly when presented at an unusual location. Herein, we report a case of balloon cell melanoma at the anorectal junction in a 73-year-old male patient complaining of constipation and bleeding per rectum. Surgical resection was performed with no evidence of recurrence after three years of close follow-up. We believe this case will raise awareness among the medical community to consider this tumor a differential diagnosis in rectal masses.

Keywords

Rectal neoplasms, Immunohistochemistry, Abdomen, Balloon Cell Melanoma

References

1 Longo WE, Vernava AM 3rd, Wade TP, Coplin MA, Virgo KS, Johnson FE. Rare anal canal cancers in the U.S. veteran: patterns of disease and results of treatment. Am Surg. 1995;61(6):495-500. PMid:7762897.

2 Hillenbrand A, Barth TF, Henne-Bruns D, Formentini A. Anorectal amelanotic melanoma. Colorectal Dis. 2008;10(6):612-5. http://dx.doi.org/10.1111/j.1463-1318.2007.01400.x. PMid:17944970.

3 Zhang S, Gao F, Wan D. Effect of misdiagnosis on the prognosis of anorectal malignant melanoma. J Cancer Res Clin Oncol. 2010;136(9):1401-5. http://dx.doi.org/10.1007/s00432-010-0793-z. PMid:20130908.

4 Chavez-Alvarez S, Villarreal-Martinez A, Miranda-Maldonado I, Ocampo-Candiani J, Garza-Rodriguez V. Balloon cell melanoma and its metastasis, a rare entity. Am J Dermatopathol. 2017;39(5):404-11. http://dx.doi.org/10.1097/DAD.0000000000000794. PMid:27984232.

5 Gardner WA Jr, Vazquez MD. Balloon cell melanoma. Arch Pathol. 1970;89(5):470-2. PMid:4191044.

6 Bal MM, Ramadwar M, Deodhar K. Balloon cell melanoma of the anal canal: a wolf in sheep’s clothing? J Cancer Res Ther. 2013;9(4):706-8. http://dx.doi.org/10.4103/0973-1482.126457. PMid:24518721.

7 Jakobiec FA, Shields JA, Desjardins L, Iwamoto T. Balloon cell melanomas of the ciliary body. Arch Ophthalmol. 1979;97(9):1687-92. http://dx.doi.org/10.1001/archopht.1979.01020020255014. PMid:475640.

8 McComiskey M, Iavazzo C, Datta M, et al. Balloon cell urethral melanoma: differential diagnosis and management. Case Rep Obstet Gynecol. 2015;2015:919584. http://dx.doi.org/10.1155/2015/919584. PMid:26257971.

9 Adamek D, Kaluza J, Stachura K. Primary balloon cell malignant melanoma of the right temporo-parietal region arising from meningeal naevus. Clin Neuropathol. 1995;14(1):29-32. PMid:7729077.

10 Khalil MK. Balloon cell malignant melanoma of the choroid: ultrastructural studies. Br J Ophthalmol. 1983;67(9):579-84. http://dx.doi.org/10.1136/bjo.67.9.579. PMid:6882713.

11 Kao GF, Helwig EB, Graham JH. Balloon cell malignant melanoma of the skin. A clinicopathologic study of 34 cases with histochemical, immunohistochemical, and ultrastructural observations. Cancer. 1992;69(12):2942-52. http://dx.doi.org/10.1002/1097-0142(19920615)69:12<2942::AID-CNCR2820691213>3.0.CO;2-0. PMid:1591688.

12 Søndergaard K, Henschel A, Hou-Jensen K. Metastatic melanoma with balloon cell changes: an electron microscopic study. Ultrastruct Pathol. 1980;1(3):357-60. http://dx.doi.org/10.3109/01913128009141437. PMid:7233589.

13 Clevenger J, Joseph C, Dawlett M, Guo M, Gong Y. etal.reliability of immunostaining using pan- melanoma cocktail, SOX10, and microphthalmia transcription factor in confirming a diagnosis of melanoma on fine-needle aspiration smears. Cancer Cytopathol. 2014;122(10):779-85. http://dx.doi.org/10.1002/cncy.21458. PMid:24954720.

14 Belli F, Gallino GF, Lo Vullo S, Mariani L, Poiasina E, Leo E. Melanoma of the anorectal region: the experience of the National Cancer Institute of Milano. Eur J Surg Oncol. 2009;35(7):757-62. http://dx.doi.org/10.1016/j.ejso.2008.05.001. PMid:18602790.

15 Malaguarnera G, Madeddu R, Catania VE, Bertino G, Morelli L, Emanuele R. Anorectal mucosal melanoma. Oncotarget. 2018;9(9):8785-800. http://dx.doi.org/10.18632/oncotarget.23835. PMid:29492238.
 


Submitted date:
09/17/2023

Accepted date:
10/20/2023

Publication date:
12/15/2023

657c15d7a9539540030654f4 autopsy Articles
Links & Downloads

Autops Case Rep

Share this page
Page Sections