Cutaneous Perivascular Epithelioid Cell Tumor of Gynecologic Origin Metastatic to Skin, Lung, Stomach, and Brain
Artículo de revista
Wolters Kluwer Health
The American Journal of dermatopathology
Regarding the first case report recently published by Navale et al1 about a skin perivascular epithelioid cell tumor (PEComa) with focal melanin pigmentation, we wish to present another exceptional case of a malignant uterine PEComa metastatic to skin and lung, gastric lymph-vascular invasion, and brain dissemination, which was also initially misdiagnosed as skin melanoma because of the presence of epithelioid features and the expression of some melanocytic markers. Our patient was a 62-year-old woman, who presented with abnormal uterine bleeding that prompted hysterectomy 3 years ago. An extrainstitutional pathology report on the surgical specimen revealed a lesion compatible with a uterine leiomyosarcoma that was managed with adjuvant radiotherapy. At the 2-year clinical follow-up, the patient presented with a mass on the posterior region of the neck, which required undergoing surgical excision. The pathology study features were compatible with a malignant melanoma. Other reassessment and follow-up studies evidenced a compromise of the lung, with histopathological diagnosis of metastatic melanoma. A year ago, the patient presented with a new pigmented lesion on the right cheek. Once again, the biopsy study revealed a melanoma.
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