Neurotropic melanoma arising from a neurocristic hamartoma

• Published in: Journal of cutaneous pathology Vol. 50; no. 3; pp. 197 - 200
• Main Authors: Clements, Stephanie Ann, Kelley, Benjamin Franklin, Rivera, Louis, Greenway, Hubert T.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.03.2023; Wiley Subscription Services, Inc
• Subjects: Aged; congenital nevus; desmoplastic neurotropic melanoma; Hamartoma - pathology; Humans; Male; Melanoma; Melanoma - pathology; Melanoma, Cutaneous Malignant; Neoplasia; Neural crest; neurocristic hamartoma; neurotropic melanoma; Nevus; Nevus, Pigmented - pathology; Skin Diseases - pathology; Skin Neoplasms - pathology; congenital nevus; desmoplastic neurotropic melanoma; neurotropic melanoma; neurocristic hamartoma
• ISSN: 0303-6987; 1600-0560
• DOI: 10.1111/cup.14378

Neurotropic melanoma is a rare type of malignant melanoma with nerve invasion or neural differentiation. Neurocristic cutaneous hamartoma is a rare, benign tumor of the skin and superficial soft tissue that arises from aberrant migration of neural crest cells. We report a rare case of a 74‐year‐old man with a clinically diagnosed giant congenital nevus of the right mid‐back, histopathologically confirmed to be a neurocristic cutaneous hamartoma, who developed neurotropic spindle cell melanoma within the lesion. The patient was treated with serial re‐excisions until clear margins were achieved. We report a rare case of a 74‐year‐old man with a known giant congenital nevus of the right mid‐back who developed a neurotropic spindle cell melanoma arising from a neurocristic cutaneous hamartoma, all within the congenital nevus. Histopathology revealed two distinct cell populations, one with SOX10‐positive spindled cells consistent with neurotropic melanoma and the other with cytologically bland spindle cells consistent with benign neurocristic hamartoma. This case highlights the pertinent histopathologic findings of this rare entity.