Malignant melanoma of the skin can rarely metastasize to the trachea. Even less frequent is a malignant melanoma primary in the trachea, with only about 4 cases reported in the literature so far.57 An additional case of multiple tracheobronchial melanoma has also been published, in which the primary site could have been either the trachea or bronchi.58
Pathology. Grossly, most of these tumors have been polypoid, one of them with a long, narrow stalk (Figure 3-33 [Color Plate 5]).59 Another of the tumors had a flat subepithelial location.60 This flat melanoma had metastasized to the adjacent lymph node. Pulmonary metastasis was present in one case.59
Microscopically, the tumor classically consists of large cells with atypical vesicular nuclei and prominent nucleoli. The cells are arranged in nests and sheets (Figure 3-34 [Color Plate 5]) and contain melanin. If no melanin is seen, one can prove melanocytic differentiation by immunohistochemical or ultrastructural analyses. Intraepithelial location of malignant melanoma suggests that the tumor has arisen at that site. Differential diagnosis is broad, and includes various tumor categories such as carcinomas, sarcomas, and lymphomas. The most important ones to differentiate in this location are large cell carcinoma and large cell neuroendocrine carcinoma.
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Complete Guide to Preventing Skin Cancer. We all know enough to fear the name, just as we do the words tumor and malignant. But apart from that, most of us know very little at all about cancer, especially skin cancer in itself. If I were to ask you to tell me about skin cancer right now, what would you say? Apart from the fact that its a cancer on the skin, that is.