Pigmented epithelioid melanocytoma

A 16‐year‐old Hispanic male presented with a nontender purple nodule on the right shoulder that had been present for 1 year. There was no personal or family history of skin cancer. He had no significant past medical history. Physical examination revealed a 10 mm × 5 mm, firm, dark purple nodule on the right anterior shoulder ( Fig. 1 ). The surface was not eroded or crusted. The nodule was not attached to underlying structures. A deep shave excision was performed.

Figure 1 Open in figure viewer PowerPoint Clinical photograph of tumor of the right anterior shoulder     

Pigmented epithelioid melanocytoma: two case reports

Because of indolent course without mortality, the term "pigmented epithelioid melanocytoma" has been suggested as a replacement for "equine" or "animal-type" melanoma and for the epithelioid blue nevus of the Carney type, from which they are histologically indistinguishable. This report reviews this concept and recounts in detail two of eighteen cases occurring in residents of the Central Coast of California. This paper also contains clinical photographs of pigmented epithelioid melanocytoma, unlike prior reports.     

Scrotal glans penis (glans penis plicatum) associated with scrotal tongue (lingua plicata)

Scrotal glans penis (glans penis plicatum), is manifested by thin deep vertical furrows and tiny papillomas of the glans penis. The condition is similar to the changes seen in scrotal tongue (lingua plicata). Both conditions were seen in the same patient. We are unaware of similar cases described previously. A 26 year old Caucasian married man, complained of a two-year history of tenderness of the head of the penis occurring during sexual intercourse, at about the time of ejaculation. The patient had been aware of cracks on the head of the penis since before the age of six and wondered if these were responsible for his recent discomfort.
The patient was aware that his tongue had grooves which did not bother him, but he could not specify when this was first noticed. No family member was known to have a similar penile or tongue condition. On the advice of his general practitioner, he had used on his penis an antifungal cream, ketoconazole (Nizoral), and a topical steroid cream, mometasone furoate (Elocom), without effect. He was otherwise in good health and not on any medication. There was a history of allergy to penicillin.
Physical examination revealed that the penis was circumcised. The glans was of normal size and color and had several parallel, thin furrows running from the urethral opening to the corona. Multiple tiny, skin-colored papillomas were present on the glans with the majority on its dorsal aspect. Separating the furrows by pulling the skin folds apart, revealed no cracks or bleeding (Fig. 1). The scrotum was normal and showed no similar changes.
The tongue showed typical features of scrotal tongue (lingua plicata) (Fig. 2).     

Pigmented epithelioid melanocytoma: Report of a case and review of 173 cases in the literature

Pigmented epithelioid melanocytoma (PEM), or animal-type melanoma, is an unusual variant of melanoma which has been reported to have indolent behavior and a relatively good prognosis. We report a 12-year-old girl with PEM on the third finger web of her right hand. Histopathologically, it was composed of heavily pigmented dermal epithelioid and spindled melanocytic tumor cells. A sentinel lymph node biopsy was negative, and no recurrence was noted 1 year later. We reviewed 173 previously published cases of PEM or so-called animal-type melanoma in the literature. Among the 173 cases and our case, extremities were the most common sites of occurrence (52/129, 40.3%), and most of the depth of invasions were Clark level IV and V [76/114 (66.7%) and 33/114 (28.9%), respectively]. Lymph nodes metastasis was noted in 39/89 (43.8%) of the cases being investigated. Only two cases died of the disease with visceral metastasis. Thus, a more advanced level of invasion and the presence of lymph node metastasis did not imply a definitely malignant clinical course, because spreading beyond lymph nodes was rare (5/174, 2.9%). However, long-term follow-up with more cases and further research are needed to fully delineate the true biological nature of this pigmented melanocytic tumor.     

Pigmented epithelioid melanocytoma: report of first Japanese cases previously diagnosed as cellular blue nevus

Background:  The term 'pigmented epithelioid melanocytoma (PEM)' was recently used for borderline melanocytic tumor/low-grade melanoma including cases previously diagnosed as human animal-type melanoma and epithelioid blue nevus. No Japanese cases have been reported.
Methods:  We reviewed 219 cases previously diagnosed as blue nevus in Japan. Common blue nevus was identified in 154 cases and cellular blue nevus in 65 cases.
Results:  We have found two Japanese cases of PEM previously diagnosed as cellular blue nevus. Two patients were female. The age at presentation was 32 and 28 years. Two lesions were on the buttock. Two cases fulfilled histological criteria proposed for PEM. There is no evidence of recurrence or metastases.
Conclusions:  PEM is a distinct melanocytic tumor and the unifying diagnostic term. PEM is present in Japanese, but these cases may be previously diagnosed as cellular blue nevus. Japanese pathologists should recognize a new concept of PEM, and when they make a diagnosis of PEM, they should be recommended sentinel lymph node sampling.     

Keratoacanthoma of the glans penis

A patient with a solitary keratoacanthoma of the glans penis is presented. Since this area is devoid of hair, this keratoacanthoma could not have arisen from a hair follicle as has been suggested as the cause of keratoacanthoma. Keratoacanthoma should be included in the differential diagnosis of rapidly growing keratotic tumors of the glans penis. Correct diagnosis of this tumor may save patients from needless mutilating surgery of the penis.     

Tinea of the glans penis

A 56-year-old Japanese man with tinea of the glans penis is described. He did not carry any other tinea lesions except that of the glans penis. Mycological examinations revealed that the causative organism was Trichophyton mentagrophytes.     

Cancer of the glans penis

Carcinoma of the glans penis has been diagnosed in a patient aged 84 with a history of treatment for syphilis. The condition has been diagnosed on the basis of histologic studies.