Superior gluteal lymph node metastasis of melanoma

摘要

A 52-year-old woman visited us for a clearly demarcated, small, elastic hard nodule of 35 mm x 22 mm in size, the surface of which showed bluish-red color on the left upper arm (Fig. 1a). She noticed the nodule 10 years prior and the size had gradually grown to be double in the prior 2 years. There had been no pain or tenderness. Our probable clinical diagnosis was calcifying epithelioma. Ultrasonography for the lesion generally showed a hyperechoic mass with some hypoechoic region (Fig. 1b). Surgical excision was performed with local anesthesia. A histological specimen of the lesion showed a well-demarcated nest of tumor cells in the dermis with the dilated vessels filled with blood (Fig. 2a). Most tumor cells with the stromal infiltration of lymphocytic, mononuclear cells were of two types: (i) small, dark nuclei at the periphery of the lobules; and (ii) large nuclei in the center of the lobules (Fig. 2b).