Skip Navigation LinksHome > December 2013 - Volume 35 - Issue 8 > Congenital Malignant Melanoma: A Case Report With Cytogeneti...
American Journal of Dermatopathology:
doi: 10.1097/DAD.0b013e318284a679
Extraordinary Case Report

Congenital Malignant Melanoma: A Case Report With Cytogenetic Studies

Singh, Krishna MD*,†; Moore, Stephen PhD*,‡; Sandoval, Marina MD§; Balzer, Bonnie MD; Frishberg, David MD; Lewin, Sheryl MD; Schreck, Rhona PhD*; Raffel, Leslie MD*

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Abstract

Although rare, congenital malignant melanoma (CMM) should be considered in the differential diagnosis of congenital skin lesions. We report a case of CMM in a 4-month-old infant presenting with an enlarging scalp mass, initially thought to be a hemangioma. Incisional biopsy of the lesion showed a compound congenital nevus with atypical cells suggestive of a proliferative nodule versus malignancy on histopathology. Subsequent excisional biopsy revealed malignant melanoma, and further workup confirmed extensive disease with distant metastases. Cytogenetic analysis of both the tumor sites showed highly abnormal karyotypes including pseudotetraploidy, telomere associations, and evidence of gene amplification, all consistent with malignancy. Fluorescence in situ hybridization demonstrated amplification of the MYC gene, with no copy number changes in CDKN2A (INK4/ARF), PTEN, or Cyclin D1. Our report details the cytogenetic and molecular studies of CMM, which provide insight into the biologic behavior of the lesions and may confirm diagnosis when histopathology is not determinant.

© 2013 Lippincott Williams & Wilkins

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