PMC7747011_01
Amelanotic Melanoma. Raised, red lesion on the right helical ear. The close-up inset photograph reveals an exophytic vascular-appearing papule with a lobulated surface.
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F1
A man in his 20s with MEN-1 since his teens manifesting as hyperparathyroidism, status post parathyroidectomy, presented with a possible angiofibroma on the helix of the right ear (Figure 1) of 1 year's duration.
Hematoxylin-Eosin-Stained Histopathologic Sections From Shave Biopsy Specimen. A, In this composite of 2 images, prominent papillary dermal edema is seen with superficial dermal vascular and fibroblastic proliferation; atypical melanocytes in a vertical growth pattern are also apparent (original magnification x1).. B, Higher magnification (x20) shows a nodular proliferation of atypical melanocytes with epithelioid morphology; the melanocytes have atypical to pleomorphic nuclei with occasional multinucleated forms, mitotic figures, and abundant cytoplasm consistent with malignant melanoma.
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F2
The atypical cells extended into the dermis consistent with malignant melanoma, nodular type, with at least Clark level IV invasion (Figure 2).