The Clinical Features and Autopsy Findings of Multiple metastatic Nodular Melanoma / 대한피부과학회지

ABSTRACT

We have experienced a 50-year-old male patient, who died of multiple metastatic nodular melanoma which had the primary lesions on the right hallux and forefoot with eventual involvement of skin and internal organs. An autopsy was performed for the evidence of metastatic features of the internal organs and their spreading routes, with concurrent histopathologic findings. The autopsy findings revealed diffuse metastases to the ipsilateral femoral and inguinal lymph nodes via ascending vascular channels and to the internal organs 1. The heart had multiple metastatic lesions on the pericardium and right ventricular wall. And the mediastinal, periaortic and periesophageal lymph nodes were also involved. 2. The both lungs were moderately indurated and focally discolored, and showed metastatic lesions in the right lower lobe and hilar areas, Melanoma cells were diffusely invaded to the interstitia and alveoli. 3. The right 5th and 6th ribs showed the invsion of melanoma cells on their bone marrows, periostia, and Haversians canals. 4. The liver was enlarged and showed multiple various sized nodules on the surface with adesion to the parts of peritoneum, omentum and diaphragm. Melanoma cells were seen mostly on and around the sinusoidal spaces and parenchyma. 5. The stomach wall had an ulcerated metastatic lesion and the melanoma cells invaded deeply into the muscle layer. 6. The pancreas was normal in its size and shape but had multiple metastatic lesions on the head and body with melanoma celi infiltration. 7. The both kidneys were grar ular surfaced and showed two metastatic lesions on the right renal cortex and two on the left. Renal tubules and parenchyma were widely invaded by melanoma cells but the glomerular tufts were intact. 8. The adreral and thyroid glands showed four and two metastatic lesions respectively and diffuse invasion of melanoma cells into the parenchyma. 9. The brain was normal in gross appearance, but the cortex was edematous and showed settered melanoma cell infiltration.