Multiple Smooth Skin Nodules

Miller, Scott D.; Vinson, Richard P.; McCollough, Martha L.; Keeling, James H.

doi:10.1001/archderm.1997.03890480101016

Cited by 14 publications

(15 citation statements)

References 6 publications

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“…2 Within the last decade, an increase in reported cases and reviews portraying skin involvement have highlighted this presentation. 1,3,5,[8][9][10][11][12] Enhanced awareness of skin involvement and recognition of J AM ACAD DERMATOL VOLUME 55, NUMBER 2 histologic and immunohistologic features associated with chordoma tumors could explain the increased rate of reported cases. Also, while some chordomas are painful, asymptomatic nodules potentially are ignored, which may explain some of the discrepancies in identifying skin involvement.…”

Section: Discussionmentioning

confidence: 99%

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Cutaneous metastatic chordoma with concomitant tuberous sclerosis

Lountzis

Hogarty

Kim

et al. 2006

Journal of the American Academy of Dermatology

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Section: Discussionmentioning

confidence: 99%

“…Lesions are frequently multiple (at least 4 or more). [1][2][3]9 Skin involvement also can occur in the context of direct growth extension and local recurrence. 5,8 The gender distribution of noncutaneous chordoma tumors demonstrates a ratio of approximately 2 to 1 in favor of males.…”

Section: Discussionmentioning

confidence: 99%

Cutaneous metastatic chordoma with concomitant tuberous sclerosis

Lountzis

Hogarty

Kim

et al. 2006

Journal of the American Academy of Dermatology

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“…Coexpression of S100 protein and CK enables distinction from myxoid melanoma. [176][177][178][179][180][181] Histologically identical to chordoma at the light microscopic level is the parachordoma, a benign cutaneous neoplasm that most often is seen in the extremities adjacent to synovia, tendons, or osseous structures. 169 The immunohistochemical profile may be similar to chordoma, which more frequently manifests expression of CK (98 vs 66%) and epithelial membrane antigen (90 vs 20%).…”

Section: Differential Diagnosismentioning

confidence: 99%

Unusual variants of malignant melanoma

2006

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A potential diagnostic pitfall in the histologic assessment of melanoma is the inability to recognize unusual melanoma variants. Of these, the more treacherous examples include the desmoplastic melanoma, the nevoid melanoma, the so-called 'minimal-deviation melanoma,' melanoma with prominent pigment synthesis or 'animal-type melanoma,' and the malignant blue nevus. Also problematic are the unusual phenotypic profiles seen in vertical growth phase melanomas; these include those tumors whose morphological peculiarities mimic cancers of nonmelanocytic lineage and those melanomas that express aberrant antigenic profiles not commonly associated with a melanocytic histogenesis. Metaplastic change in melanoma, balloon cell melanoma, signet-ring cell melanoma, myxoid melanoma, small cell melanoma and rhabdoid melanoma all have the potential to mimic metastatic and primary neoplasms of different lineage derivations. Abnormal immunohistochemical expression of CD 34, cytokeratins, epithelial membrane antigen, and smooth muscle markers as well as the deficient expression of S100 protein and melanocyte lineage-specific markers such as GP100 protein (ie HMB-45 antibody) and A103 (ie Melan-A) also present confusing diagnostic challenges. In this review, we will discuss in some detail certain of these novel clinicopathologic types of melanoma, as well as the abnormal phenotypic expressions seen in vertical growth phase melanoma. Modern Pathology (2006) 19, S41-S70. doi:10.1038/modpathol.3800516Keywords: melanoma; variants; phenotype; immunohistochemistry; morphology Desmoplastic melanoma Introduction and Clinical FeaturesDemoplastic melanoma is a rare variant of malignant melanoma first recognized in 1971.1 Desmoplastic and neurotropic melanoma may be mistaken clinically for a scar, a fibroma, a basal cell carcinoma, or a fibromatosis. Sometimes there is pronounced mucin deposition that imparts a boggy quality to the lesion. 2,3 The clinical clue to the diagnosis, when present, is cutaneous or mucosal pigmentation overlying a palpable dermal or submucosal nodule. That said, only half of desmoplastic melanomas are clinically pigmented. 3 Desmoplastic melanomas tend to occur in the head and neck area and the upper back [4][5][6][7] but are also seen in mucosal sites such as the vulva or gingiva 8 and in acral locations. Typically, they occur in older patients, with mean ages in the larger series falling into the sixth to eighth decades of life. 4,6,[9][10][11][12][13][14][15] Larger series show a male preponderance of 1.75 to 1. 15 Although any given desmoplastic melanoma can be deeply invasive, when matched for depth of invasion, they are associated with a lesser risk of metastatic disease than conventional melanomas of similar depth. The classical clinical finding is that of a pale or fleshy firm nodule reminiscent of a scar, which tends to delay clinical diagnosis and biopsy. Carlson et al,6 who reported an equal distribution in men and women, found most tumors to be located in the head and neck area (75%) and to be nonpigment...

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“…A single case of cutaneous metastases from chordoma has also been reported. 8 Very few cases of spinal dissemination of clival chordoma have been described in the literature; hence, it is difficult to assess its true incidence. In addition, a few reported cases of intradural metastases were asymptomatic, and a few were discovered only on postmortem examination.…”

Section: Discussionmentioning

confidence: 99%