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Signet-ring cell melanoma: a potential diagnostic pitfall.
[liposarcoma]
:
Malignant
melanoma
is
commonly
known
as
the
great
mimicker
and
can
present
in
various
clinical
manifestations
and
with
diverse
morphological
variants
.
One
of
the
rare
histological
variants
is
the
signet-ring
cell
type
.
The
signet-ring
morphology
has
been
reported
in
numerous
other
neoplasms
including
adenocarcinoma
,
lymphoma
,
liposarcoma
,
squamous
cell
carcinoma
,
and
basal
cell
carcinoma
.
We
report
a
rare
case
of
primary
signet-ring
cell
malignant
melanoma
in
a
62
-
year
-old
man
.
He
initially
presented
with
an
enlarging
nevus
on
his
right
flank
with
surrounding
erythema
.
A
biopsy
showed
atypical
epithelioid
and
signet
cells
with
prominent
nucleoli
and
occasional
mitoses
.
Initial
diagnosis
favored
metastatic
signet-cell
carcinoma
of
gastrointestinal
origin
.
Review
of
the
biopsy
and
immunohistochemical
analysis
revealed
the
malignant
signet-ring
cells
stained
with
S
100
,
vimentin
,
and
melanoma
cocktail
,
in
keeping
with
melanoma
.
The
signet-cell
morphology
can
be
found
in
a
variety
of
other
malignancies
.
To
prevent
potential
misdiagnoses
,
thorough
histological
examination
should
be
aided
by
an
appropriate
immunohistochemical
panel
to
confirm
melanoma
and
exclude
erroneous
differentials
.
Diseases
Validation
Diseases presenting
"erythema"
symptom
acute rheumatic fever
cowden syndrome
cutaneous mastocytosis
epidermolysis bullosa simplex
erythropoietic protoporphyria
familial mediterranean fever
harlequin ichthyosis
inclusion body myositis
kindler syndrome
lamellar ichthyosis
legionellosis
liposarcoma
malignant atrophic papulosis
neuralgic amyotrophy
omenn syndrome
pyomyositis
thoracic outlet syndrome
This symptom has already been validated