Case reportNeurotropic Melanoma of the Trigeminal Nerve: A Case of Atypical Facial Pain
Section snippets
History
The patient is a 41-year-old white woman with a history of malignant melanoma diagnosed in 1995 from a lesion on her lower lip. The patient underwent several excisions of the lesion but with problems obtaining tumor-free margins. She eventually underwent plastic surgery and reconstruction of her lower lip, after which she remained lesion free for a period of approximately 4 years. After this period, a recurrence was noted on the inner aspect of the left lower lip, and the lesion was
Histological Examination
Tissue sections were processed and stained with hematoxylin and eosin (H & E). Immunohistochemical studies for S-100, neurofilament protein, and Melan A were accomplished using a standard automated protocol (Ventana, Tuscon, AZ). The S-100 antibody (polyclonal) was purchased from DAKO (Carpinteria, CA), and the neurofilament antibody was from BioGenex (San Ramon, CA; clone NE14). Immunoperoxidase staining was performed using diaminobenzidine (DAB) as the chromogen. The Melan A antibody is from
Discussion
Neurotropic melanoma is a rare malignant variant of desmoplastic melanoma. It represents a neuroid cutaneous lesion that may be preceded by lentigo maligna melanoma or minimal deviation melanoma. Reed has more recently considered neurotropic melanoma to be a separate clinicopathological entity due to its greater propensity of local invasion and recurrences when compared with other variants. Additionally, Reed has emphasized cranial neuropathies and brain involvement by direct extension along
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