Balloon cell melanoma: a case report with polarized and non-polarized dermatoscopy and dermatopathology

Balloon cell melanoma is a rare melanoma subtype, with only one previous case with dermatoscopy published. It is often non-pigmented, leading to diagnostic difficulty, and there is a tendency for lesions to be thick at diagnosis. We report a case of balloon cell melanoma on the forearm of a 61-y...

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Autores principales:	James Maher, Alan Cameron, Sharon Wallace, Rafael Acosta-Rojas, David Weedon, Cliff Rosendahl
Formato:	article
Lenguaje:	EN
Publicado:	Mattioli1885 2014
Materias:	dermatoscopy dermoscopy dermatopathology balloon cell melanoma balloon cells chrysalis structures Dermatology RL1-803
Acceso en línea:	https://doaj.org/article/0752f1c7c27149b9894fded9366da176
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spelling	oai:doaj.org-article:0752f1c7c27149b9894fded9366da1762021-11-17T08:32:27ZBalloon cell melanoma: a case report with polarized and non-polarized dermatoscopy and dermatopathology10.5826/dpc.0401a112160-9381https://doaj.org/article/0752f1c7c27149b9894fded9366da1762014-01-01T00:00:00Zhttp://dpcj.org/index.php/dpc/article/view/910https://doaj.org/toc/2160-9381 Balloon cell melanoma is a rare melanoma subtype, with only one previous case with dermatoscopy published. It is often non-pigmented, leading to diagnostic difficulty, and there is a tendency for lesions to be thick at diagnosis. We report a case of balloon cell melanoma on the forearm of a 61-year-old man with both polarized and non-polarized dermatoscopy and dermatopathology. It presented as a firm pale nodule with focal eccentric pigmentation. The clinical images evoke a differential diagnosis of dermatofibroma, dermal nevus, Spitz nevus and basal cell carcinoma as well as melanoma. This melanoma was partially pigmented due to a small, pigmented superficial spreading component on the edge of the non-pigmented balloon cell nodule, prompting further evaluation. In retrospect there was the clue to malignancy of polarizing-specific white lines (chrysalis structures) and polymorphous vessels, including a pattern of dot vessels. The reticular lines exclude basal cell carcinoma, polarizing-specific white lines are inconsistent with the diagnosis of dermal nevus and their eccentric location is inconsistent with both Spitz nevus and dermatofibroma. Excision biopsy was performed, revealing a superficial spreading melanoma with two distinct invasive components, one of atypical non-mature epithelioid cells and the other an amelanotic nodular component, comprising more than 50% of the lesion, characterized by markedly distended epithelioid melanocytes showing pseudo-xanthomatous cytoplasmic balloon cell morphology. A diagnosis of balloon cell melanoma, Breslow thickness 1.9 mm, mitotic rate 3 per square millimeter was rendered. Wide local excision was performed, as was sentinel lymph node biopsy, which was negative. James MaherAlan CameronSharon WallaceRafael Acosta-RojasDavid WeedonCliff RosendahlMattioli1885articledermatoscopydermoscopydermatopathologyballoon cell melanomaballoon cellschrysalis structuresDermatologyRL1-803ENDermatology Practical & Conceptual (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	dermatoscopy dermoscopy dermatopathology balloon cell melanoma balloon cells chrysalis structures Dermatology RL1-803
spellingShingle	dermatoscopy dermoscopy dermatopathology balloon cell melanoma balloon cells chrysalis structures Dermatology RL1-803 James Maher Alan Cameron Sharon Wallace Rafael Acosta-Rojas David Weedon Cliff Rosendahl Balloon cell melanoma: a case report with polarized and non-polarized dermatoscopy and dermatopathology
description	Balloon cell melanoma is a rare melanoma subtype, with only one previous case with dermatoscopy published. It is often non-pigmented, leading to diagnostic difficulty, and there is a tendency for lesions to be thick at diagnosis. We report a case of balloon cell melanoma on the forearm of a 61-year-old man with both polarized and non-polarized dermatoscopy and dermatopathology. It presented as a firm pale nodule with focal eccentric pigmentation. The clinical images evoke a differential diagnosis of dermatofibroma, dermal nevus, Spitz nevus and basal cell carcinoma as well as melanoma. This melanoma was partially pigmented due to a small, pigmented superficial spreading component on the edge of the non-pigmented balloon cell nodule, prompting further evaluation. In retrospect there was the clue to malignancy of polarizing-specific white lines (chrysalis structures) and polymorphous vessels, including a pattern of dot vessels. The reticular lines exclude basal cell carcinoma, polarizing-specific white lines are inconsistent with the diagnosis of dermal nevus and their eccentric location is inconsistent with both Spitz nevus and dermatofibroma. Excision biopsy was performed, revealing a superficial spreading melanoma with two distinct invasive components, one of atypical non-mature epithelioid cells and the other an amelanotic nodular component, comprising more than 50% of the lesion, characterized by markedly distended epithelioid melanocytes showing pseudo-xanthomatous cytoplasmic balloon cell morphology. A diagnosis of balloon cell melanoma, Breslow thickness 1.9 mm, mitotic rate 3 per square millimeter was rendered. Wide local excision was performed, as was sentinel lymph node biopsy, which was negative.
format	article
author	James Maher Alan Cameron Sharon Wallace Rafael Acosta-Rojas David Weedon Cliff Rosendahl
author_facet	James Maher Alan Cameron Sharon Wallace Rafael Acosta-Rojas David Weedon Cliff Rosendahl
author_sort	James Maher
title	Balloon cell melanoma: a case report with polarized and non-polarized dermatoscopy and dermatopathology
title_short	Balloon cell melanoma: a case report with polarized and non-polarized dermatoscopy and dermatopathology
title_full	Balloon cell melanoma: a case report with polarized and non-polarized dermatoscopy and dermatopathology
title_fullStr	Balloon cell melanoma: a case report with polarized and non-polarized dermatoscopy and dermatopathology
title_full_unstemmed	Balloon cell melanoma: a case report with polarized and non-polarized dermatoscopy and dermatopathology
title_sort	balloon cell melanoma: a case report with polarized and non-polarized dermatoscopy and dermatopathology
publisher	Mattioli1885
publishDate	2014
url	https://doaj.org/article/0752f1c7c27149b9894fded9366da176
work_keys_str_mv	AT jamesmaher ballooncellmelanomaacasereportwithpolarizedandnonpolarizeddermatoscopyanddermatopathology AT alancameron ballooncellmelanomaacasereportwithpolarizedandnonpolarizeddermatoscopyanddermatopathology AT sharonwallace ballooncellmelanomaacasereportwithpolarizedandnonpolarizeddermatoscopyanddermatopathology AT rafaelacostarojas ballooncellmelanomaacasereportwithpolarizedandnonpolarizeddermatoscopyanddermatopathology AT davidweedon ballooncellmelanomaacasereportwithpolarizedandnonpolarizeddermatoscopyanddermatopathology AT cliffrosendahl ballooncellmelanomaacasereportwithpolarizedandnonpolarizeddermatoscopyanddermatopathology
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Balloon cell melanoma: a case report with polarized and non-polarized dermatoscopy and dermatopathology

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