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BREAST IMAGING Table of Contents   
Year : 2006  |  Volume : 16  |  Issue : 4  |  Page : 919-920
Malignant melanoma of male breast: A case report


Prathima Institute of Medical Sciences, Nagunur Road, Karimnagar (A.P.), India

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Date of Submission15-Jun-2006
Date of Acceptance10-Oct-2006
 

Keywords: Malignant melanoma, Breast, Male

How to cite this article:
Phatak S V. Malignant melanoma of male breast: A case report. Indian J Radiol Imaging 2006;16:919-20

How to cite this URL:
Phatak S V. Malignant melanoma of male breast: A case report. Indian J Radiol Imaging [serial online] 2006 [cited 2019 Aug 24];16:919-20. Available from: http://www.ijri.org/text.asp?2006/16/4/919/32384

   Introduction Top


The breast is associated with a large number of diseases. The incidence of malignant melanoma is increasing in southern European countries including Turkey.Cutaneous Malignant Melanoma and breast can be interrelated in various contexts Primary melanoma of breast skin, Melanoma metastasis to breast, intransit metastasis to breast, and finally primary breast melanoma. [1] Malignant Melanoma is a neoplasm of melanocytes or of the cells that develop from melanocytes. Once considered uncommon disease the annual incidence is dramatically increasing over last few decades. Early stage melanoma is curable but if melanoma has metastasized prognosis is grim with median survival of 6-9 m0nths. Prognosis is also related to type of melanoma. [2]


   Case Report Top


A fifty-four year old gentleman presented with a left pigmented ulcerative breast mass of five months duration. Radiograph of chest indicated possibility of metastatic nodules (Fig 1), which was confirmed by CT Chest(Fig 2). Biopsy report from the breast mass was Malignant Melanoma.


   Discussion Top


Melanoma originates from melanocytes, which arise from neural crest and migrate, to uvea, meninges, epidermis and ectodermal mucosa. Melanomas may develop in healthy appearing skin or near a previously existing precursor lesion. A malignant melanoma developing in healthy skin is said to arise de novo. Many of the melanomas are induced by solar irradiation. The greatest risk of sun exposure induced melanoma is associated with acute, intense and intermittent blistering sunburns. The risk is different from squamous and basal cell skin cancers, which are associated with, prolonged long term sun exposure. Certain lesions are considered precursor lesions of melanoma including dysplastic nevus, common acquired nevus, congenital nevus and cellular blue nevus. Melanomas have two-growth phases radial and vertical. During the radial phase malignant cells grow in radial fashion.in the epidermis. With time most melanomas progress to vertical growth phase when the malignant cells invade the dermis and develop the ability to metastasize. Many genes are implicated in the development of melanomas including CDKN2A (p 16), CDK4, RB1, CDKN2A (p 19), PTEN/MMAC1 and ras. CDKN2A (p 16) appears to be especially important in both sporadic and hereditary melanomas. This tumor supressor gene is located on band 9p21 and its mutation plays a role in various cancers. Five different histological types of melanomas exist. Superficial spreading melanomas, nodular melanomas which are specially found on trunk of males and rapidly advances to verticval growth signifying it a high risk melanoma. Lentigo maligna melanomas, Acral lentiginous melanomas and mucosal lentigenous melanomas. [2]Studies have confirmed that extensive radiological studies such as CT, MRI and PET scanning have an extremely low yield in asymptotic patients with primary cutaneous melanoma. [3] CHEST RADIOGRAPH for patients with stage I or II disease chest radiograph is obtained although its result will likely to be negative .To date no studies support obtaining a radiograph in these patients but a normal chest radiograph finding at diagnosis provides a base line for future comparison. Patients with stage III disease,in- transit disease or local recurrence should have a chest radiograph ot CT chest because the lungs are often the first site of metastatic disease.CT scan or MRI Brain should be obtained during work up of a patient with known distant metastasis to detect additional asymptomatic metastatic disease CT scan or MRI brain in patient without known metastatic disease should be reserved for those patients who are symptomatic.[2]Although several recent reports have described the usefulness of contrast enhanced CT for visualizing lesions in dense breast tissue located adjacent to the chest wall or identifying the extent of breast carcinoma,CT is not primary method of evaluating specific breast disease.CT scans of chest and abdomen frequently includes all or parts of breasts,breast abnormalities can also be identified on CT.[4]CHEST CT should be the part of staging work up of a patient of stage IV disease.that is patients with known distant metastasis to detect asymptomatic metastatic disease.If patients with stage I,II, or III disease a chest CT scan should be performed only if clinically indicated.CT abdomen is often obtained when evaluating a patient with stage III,locally recurrent or intransit disease.Although yield is ;low a negative CT scan provides a base line study for future comparison.CT Pelvis is indicated only if a patient has local regional recurrence below the waist,is symptomatic or has known metastatic disease. With a history of primary tumor below the waist. [2]

 
   References Top

1.Sidika Kurul et al Breast melanoma Japanese Journal of clinical oncology35 (4); 2005:202-206.  Back to cited text no. 1    
2.Wendy Brick et al Malignant melanoma www.emedicine.com/med/topic1386 last updated October 27,2004.  Back to cited text no. 2    
3.Susan M.Swetter et al Malignant melanoma www.emedicine.com/derm/topic257Last updated November 24,2005.  Back to cited text no. 3    
4.Sun Mikim et al Computed Tomography of the Breast Abnormal findings with mammographic and sonographic correlation J of Comp. Asst.Tomography vol27, No.5 Sept-October 2003:761-770.  Back to cited text no. 4    

Top
Correspondence Address:
S V Phatak
Consultant Radiologist, Prathima Institute of Medical Sciences, Nagunur Road, Karimnagar (A.P.)
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0971-3026.32384

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    Figures

  [Figure - 1], [Figure - 2]

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[Pubmed] | [DOI]



 

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    Introduction
    Case Report
    Discussion
    References
    Article Figures

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