PMC4334432_01
Giant black-brown pigmented nevus, one covering nearly the entire right thoracodorsal region and the other on the left thigh. Note also satellite nevi on the trunk and extremities.
CRIM2015-545603.001.jpg
PMC4334432_01_CRIM2015-545603.001.jpg
fig1
Physical examination revealed many brownish-black nevi on the trunk, including a giant one covering nearly the entire right thoracodorsal region (32 cm x 20 cm) and another on the left thigh (25 x 18 cm) (Figure 1).
Cerebral magnetic resonance imaging revealing a large expansive lesion in the left frontal region. The lesion is heterogeneous on T1 with iso- and hyperintense areas, hypointense on FLAIR, and heterogeneous and markedly hypointense on T2.
CRIM2015-545603.002.jpg
PMC4334432_01_CRIM2015-545603.002.jpg
fig2
This lesion was heterogeneous on T1 with iso- and hyperintense areas, hypointense on FLAIR, and heterogeneous and markedly hypointense on T2 (Figure 2).
Marked cellular pleomorphism and numerous mitotic figures. Immunohistochemical examination showed S100(+), HMB45(+), MelanA(+), and MiTF(+).
CRIM2015-545603.003.jpg
PMC4334432_01_CRIM2015-545603.003.jpg
fig3
Postsurgically pathological diagnosis showed brain involvement of neoplastic cells with characteristics of melanoma (Figure 3).
Reflecting widespread leptomeningeal infiltration, contrast capture was documented in the subarachnoid space from the level of C2-C3.
CRIM2015-545603.004.jpg
PMC4334432_01_CRIM2015-545603.004.jpg
fig4