PMC7007043_01
Tumoral lesion approximately 4cm in diameter, located on the lower back, with surrounding erythema
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f1
Male patient, 60 years old, with diagnosis of schizophrenia, presented a tumoral lesion approximately 4cm in diameter, pedunculated, in the lumbar region, with a peritumoral erythematous area (Figure 1).
Histopathology: Confluence of nests of large, atypical mela nocytes. The cells are irregular in size, shape, and spacing. Many have hyperchromatic and pleomorphic nuclei and pigmented cytoplasm (Hematoxylin & eosin, x100)
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f2
The cells exhibited intense hyperchromasia and pleomorphism, with numerous typical and atypical mitotic figures, evident nucleoli and eosinophils, and presence of brownish pigment (Figure 2).
Immunohistochemistry: expression of HMB45 (HMB45, x100)
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f3
Immunohistochemistry was positive for Melan A, S100, SOX10, and HMB45, confirming the diagnosis of malignant melanoma, nodular type, with Breslow thickness 1.5cm and mitotic index of 15 mitoses/mm (Figure 3).