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Sebocyte-Like Cell Primary Cutaneous Melanoma: A Rare Cytologic Variant of Malignant Melanoma

Molina-Ruiz, Ana M. MD*; Ortiz-Reina, Sebastián MD; Carranza, Carmen MD*; Kutzner, Heinz MD; Requena, Luis MD*

American Journal of Dermatopathology: November 2015 - Volume 37 - Issue 11 - p 862–865
doi: 10.1097/DAD.0000000000000275
Extraordinary Case Report

Abstract: Although rising incidence rates of cutaneous melanoma have been observed during the last 4 decades in white populations worldwide, the sebocyte-like cell variant has been described only twice in the literature to date. In our case, a 64-year-old man presented for evaluation of a changing pigmented lesion on the left upper back. Excision of the lesion revealed an invasive melanoma with a Breslow depth of 3.3 mm. Microscopic sections showed a predominantly dermal-based tumor composed of sheets and nests of enlarged epithelioid melanocytes, most of which showed an uncommon phenotype with multivacuolated cytoplasms and scalloped nuclei, features that gave them a strong resemblance to mature sebocytes. The lesional cells expressed S100 protein, Melan-A, and p16, whereas adipophilin was positive only within the sebocyte-like component of the neoplasm and showed focal nonspecific staining. The patient's sentinel lymph node biopsy was positive for micrometastases, although a subsequent position emission tomography scan was unremarkable. Sebocyte-like melanocytes are a rare distinctive type of melanocytes that can be found mostly in benign but also in malignant melanocytic lesions. They usually present focally within the lesions and, therefore, do not represent a diagnostic problem in nevus or primary cutaneous melanoma. However, when sebocyte-like melanocytes are the main cellular component of a melanocytic lesion or when they are found in the context of metastatic melanoma, they may create a potential diagnostic pitfall; for this reason, awareness of this cell type is important.

*Department of Dermatology, Fundación Jiménez Díaz, Universidad Autónoma, Madrid, Spain;

Department of Pathology, Hospital Universitario Santa María del Rosell, Murcia, Spain; and

Dermatophatologisches Gemeinschaftslabor, Friedrichshafen, Germany.

Reprints: Ana M. Molina-Ruiz, MD, Department of Dermatology, Fundación Jiménez Díaz, Avd. Reyes Católicos 2, Madrid 28040, Spain (e-mail: amolinar@fjd.es).

The authors declare no conflicts of interest.

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