MALIGNANT MELANOMA IN TURNER'S SYNDROME

A 45-year-old woman presented with a 2-week history of weakness with rapidly progressing abdominal distention. Two weeks previously she had an abdominal ultrasound that showed no evidence of ascites or malignant changes.
The patient was known to suffer from Turner's syn-drome 45XO/46XX and Hashimoto's thyroiditis for which she was treated with L-thyroxine. She also had numerous nevi, some of which were biopsied recently and interpreted as having no malignant features.
On admission, the patient complained of weakness and abdominal discomfort. She was of short stature and was pale. Her secondary sexual characteristics were fully devel-oped. Many pigmented nevi were scattered over her skin, without clinical signs of malignant transformation. Fundo-scopy showed no signs of malignancy in the choroid layer. The abdomen was tense and edematous. Breast examina-tion was normal. An ECG and chest x-rays were also within normal limits. Computerized tomography showed a large amount of fluid with small masses spreading in the peri-toneal cavity. Aspiration of the abdominal fluid revealed ma-lignant cells that stained positively with S-100, melanoma-specific antigens, and with Masson-Fontana (Fig. 1).