Diffuse melanosis in a patient with multifocal liver and thyroid metastases of a malignant melanoma

Jantke, Maren Elisabeth; Schön, Michael P.; Kretschmer, Lutz; Thoms, Kai‐Martin

doi:10.1111/j.1610-0387.2012.07988.x

Cited by 3 publications

(5 citation statements)

References 7 publications

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“…Multiple lines of evidence suggest that specific growth factors, such as alpha-melanocyte stimulating hormone, hepatocyte growth factor and endothelin-1 released by cancer cells stimulate normal melanocyte proliferation, ultimately resulting in increased skin pigmentation 10. Other sources report that melanin precursors released into the bloodstream during cell lysis of internal tumour cells after anticancer therapy leads to the skin darkening seen in DMC 11 12. On the other hand, case reports have also hypothesised that dermal MM micrometastases producing melanin is the root cause behind DMC 4.…”

Section: Discussionmentioning

confidence: 99%

Diffuse melanosis cutis: a rare manifestation of metastatic melanoma

et al. 2019

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Diffuse melanosis cutis (DMC) is an extremely rare and late complication of metastatic melanoma (MM). It involves the progressive blue-grey discolouration of the skin and mucous membranes, occurring approximately 1 year after diagnosis of MM. The pathogenesis of DMC is unknown, although specific growth factors, such as alpha-melanocyte stimulating hormone, hepatocyte growth factor and endothelin-1, released by cancer cells, along with release of melanin precursors in the bloodstream and dermal MM micrometastases producing melanin have been attributed. Even with appropriate therapy, DMC seems to be a poor prognostic factor, with a mean survival time of 4–5 months. Here, we report a case of BRAF-mutated MM who presented with DMC. The patient underwent BRAF/MEK inhibition followed by anti-PDL1 therapy, yet passed away approximately 1 year after diagnosis.

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Section: Discussionmentioning

confidence: 99%

Diffuse melanosis cutis: a rare manifestation of metastatic melanoma

et al. 2019

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“…[9] On the other hand, other reports indicate that the main cause of the skin darkening is melanin precursors which are liberated into the bloodstream during the rapid lysis of MM metastatic tumors in the internal organs, a phenomenon triggered by anticancer therapy. [3,6,10] Subsequently, in the dermis and urine melanin, precursors undergo spontaneous oxidation and are transformed into the melanin. This theory has been supported by the documented observations of melanin precursors, melanin, melanosomes, and melanophages in patients’ serum.…”

Section: Discussionmentioning

confidence: 99%

“…This theory has been supported by the documented observations of melanin precursors, melanin, melanosomes, and melanophages in patients’ serum. [3,6,11] …”

Section: Discussionmentioning

confidence: 99%

“…In the literature, approximately 70 cases of DMC have been described until now, most of them being associated with multiple organ metastases or chemotherapy treatment such as dacarbazine. [3,6] The average time from MM diagnosis to the development of DMC is 1 year, and the survival time from the onset of this symptom is approximately 4–5 months. [2] Herein, we present a case of DMC in the course of MM micrometastases to the skin.…”

Section: Introductionmentioning

confidence: 99%

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Diffuse melanosis cutis related to dermal micrometastases as the first clinical symptom of distant metastatic malignant melanoma

Maj

Jankowska‐Konsur²,

Gruber³

et al. 2017

Medicine

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Rationale:Diffuse melanosis cutis (DMC) is a very rare sign of malignant melanoma progression. The condition usually develops after approximately one year from melanoma diagnosis in a patient with metastatic tumors and after anticancer treatment with cytostatic medications.Patient concerns:A 72-year old Caucasian man was admitted to the Department of Dermatology with DMC for 4 months and the history of two melanomas treated surgically 30 years and 9 months before present hospitalization.Diagnosis:Histological and immunohistochemical examinations of DMC biopsy indicated melanoma metastatic cells as well as free deposits of melanin and melanophage presence in the dermis.Interventions:The patient refused to the treatment.Outcomes:The patient died eight months after DMC appeared.Lessons:DMC is a rare presentation of advanced MM and is a bad prognostic factor. The pathomechanisms of the discoloration of the skin are not fully explained. The role of micrometastases, as well as melanin precursors, released during lysis of MM metastases, and growth factors may play a role in the development of the symptom.

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“…It consists of an increasing diffuse gray pigmentation affecting the entire skin, frequently accompanied by melanuria. It usually develops in patients with metastatic melanoma, sometimes after initiation of chemotherapy [13].…”

Section: Clinical Lettermentioning

confidence: 99%