A case of amelanotic spindle-cell melanoma presenting as metastases to breast and axillary lymph node: Diagnosis by FNA cytology
✍ Scribed by Gregory Kobayashi; Camilla Cobb
- Publisher
- John Wiley and Sons
- Year
- 2000
- Tongue
- English
- Weight
- 155 KB
- Volume
- 22
- Category
- Article
- ISSN
- 8755-1039
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✦ Synopsis
Metastatic neoplasms to the breast are relatively rare. Spindle-cell lesions of the breast are also uncommon. Here we present a case of fine-needle aspiration (FNA) of an amelanotic, spindle-cell melanoma metastatic to the breast and axillary lymph node. The patient was a 47-yr-old female who presented with a right breast mass, left axillary adenopathy, and a pigmented skin lesion on the back. FNA of the right breast and left axilla showed malignant, nonpigmented spindle cells that were weakly positive for HMB-45 on immunocytochemistry. The skin biopsy showed a pigmented malignant melanoma with epithelioid features, and also weak positivity for HMB-45. Although malignant melanoma is one of the more common tumors to metastasize to the breast, this is the first known case that showed exclusive spindle-cell morphology. History and physical examination were crucial in making the correct FNA diagnosis. The cytologic differential diagnosis of spindle-cell tumors of breast and the discordant morphology between the primary and metastatic melanotic lesions observed in this case are discussed.