RESUMO
ABSTRACT Balloon cell melanoma is a rare presentation of malignant melanoma, usually on the skin, with less than 100 cases reported. Mucosal BCM is even rarer, with only one case of anorectal BCM reported in English literature. The diagnosis is based on the histopathologic findings of a tumor composed of large, foamy melanocytes, with or without pigmentation, and confirmed by immunohistochemical studies showing expression for melanocytic markers. The foam cell appearance of the tumor cells and the lack of melanin pigment lead to a diagnostic dilemma, mostly when presented at an unusual location. Herein, we report a case of balloon cell melanoma at the anorectal junction in a 73-year-old male patient complaining of constipation and bleeding per rectum. Surgical resection was performed with no evidence of recurrence after three years of close follow-up. We believe this case will raise awareness among the medical community to consider this tumor a differential diagnosis in rectal masses.
RESUMO
Balloon cell melanoma, an uncommon histopathological variant of malignant melanoma, was first described by Gardner and Vazquez in 1970. This condition is histopathologically characterized by the presence of balloon cells with varying sizes and atypical nuclei. An 84-year-old woman presented with a solitary, dome-shaped, walnut-sized, brownish nodule on the posterior aspect of the left ear with bleeding, having only detected the nodule 2 weeks prior. Histopathologically, the lobulated tumor mass revealed copious melanin pigment and many balloon cells with clear cytoplasm, atypical nuclei, and variable size. Immunohistochemically, the tumor mass showed positive reaction to S-100 protein and HMB 45 staining. We herein report a typical case of balloon cell melanoma, which developed primarily on the skin.