Metastatic breast cancer of skin may be seen in a number of forms. It is rare to find it in association with a benign melanocytic nevus. We describe a patient with metastatic adenocarcinoma of breast within a benign melanocytic nevus and delineate this occurrence within the context of reviewing cutaneous breast metastatic disease.

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Seborrheic keratoses (SKs) are common benign nonmelanocytic epidermal tumors with characteristic clinical features, which are thought to allow a straightforward diagnosis in most situations. As a result, it is an accepted practice to destroy them without histopathologic confirmation. However, systematic reviews of histologic specimens reveal an erroneous clinical diagnosis or associated malignant tumors in a number of cases, including malignant melanomas. We describe a patient with a clinically typical-appearing SK, which was biopsied and histologically proven to be a malignant melanoma arising in the SK. Our report is a reminder that the reliability of clinical diagnosis of SKs needs to be questioned. In addition, a biopsy of SKs is not only warranted but necessary in order to identify a malignant melanoma that would otherwise be misdiagnosed or even completely missed.

We describe a 64-year-old man with a primary nodular melanoma showing unusual histologic features. It consisted entirely of markedly atypical melanocytes arranged in a well-structured glandular pattern. These atypical melanocytes were positive for S-100. This is only the second report of such histology in melanoma, and to our knowledge, the first such case consisting entirely of these features. We review the literature on this rare variant of melanoma.

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