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CASE REPORT
Year : 2011  |  Volume : 56  |  Issue : 2  |  Page : 223
Malignant melanoma of scrotal skin


Department of Surgery, Jhalawar Hospital and Medical College, Jhalawar, Rajasthan, India

Date of Web Publication5-May-2011

Correspondence Address:
Rohit Gupta
137, Mahaveer Nagar, Tonk Road, Jaipur
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0019-5154.80427

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   Abstract 

Black/bluish discolored skin tumor without cuticular covering de novo from site of origin could be a diagnostic feature of melanomas.


Keywords: Diagnostic sign, primary melanoma, absent cutis de novo


How to cite this article:
Das Gupta H K, Gupta R. Malignant melanoma of scrotal skin. Indian J Dermatol 2011;56:223

How to cite this URL:
Das Gupta H K, Gupta R. Malignant melanoma of scrotal skin. Indian J Dermatol [serial online] 2011 [cited 2020 Jul 15];56:223. Available from: http://www.e-ijd.org/text.asp?2011/56/2/223/80427



   Case Report Top


A 65-year-old male presented with mulberry bossilated black to bluish tinged scrotal mass which was devoid of cuticular coverage de novo from site of origin. It grew painlessly two of 7 cm Χ 10 cm and abraded at two places which oozed blood on touch and grew painlessly [Figure 1]. This was associated with painless lymphadenopathy in right inguino-femoral and left inguinal region which were of soft consistency and fixed to underlying structures without intervening cuticular nodules.
Figure 1: Mulberry bossilated black to bluish tinged scrotal mass

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Histopathology of biopsied scrotal mass revealed features of malignant melanoma in form of marked cellular atypia, prominent eosinophillic nucleoli with abundant mitotic figures, nuclear grooves with junctional activity, and melanin pigmentation in surrounding tissue [Figure 2].
Figure 2: Histopathology showing prominent eosinophillic nucleoli with abundant mitotic figures (H and E, x400)

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FNAC from lymphadenopathy yielded inguinal lymphadenopathy yielded thin blackish aspirate. Smear showed malignant cells with macrosomal nucleoli and intracytoplasmic pigmentation. Clinical staging of tumor was T4bN3M0 (AJCC.2002). The scrotal mass was excised and patient was advised for systemic chemotherapy with dacarbazine (DTIC).


   Discussion Top


The case is being reported to highlight the observation that tumor was devoid of cuticular coverage de novo even from its site of origin and could not be described as fungating. The other usual tumors of skin do have skin or cutilcular coverage before they fungate. The reason of absent cuticular coverage in melanoma is from melanin pigment cells located in epidermis itself, so could be a diagnostic hallmark of cuticular melanoma.


    Figures

  [Figure 1], [Figure 2]



 

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