Amelanotic nodular malignant melanoma in a patient with a family history of skin cancers

Amelanotic skin melanoma is the amelanotic or hypomelanotic subtype of nodular melanoma. Amelanotic melanoma accounts for almost 60% of completely unrecognized melanoma. Amelanototic melanomas may not have the classic features of other melanomas and are usually red or skin-colored and more symmetrical, so superficially spreading melanomas are more easily recognized by most healthcare professionals and even patients.

Today, the path of melanoma development associated with genetic predisposition is being considered, in particular, with an unfavorable oncological family history, which is characterized by the development of melanoma in areas of the body periodically exposed to insolation, such as the trunk and limbs. The mechanism underlying amelanosis is not fully understood. As in pigment analogs, amelanotic melanoma cells retain their melanin-producing ability due to the expression of tyrosinase and microphthalmia-associated transcription factor.

We present our own clinical case of the development of a rare amelanocytic nodular melanoma on the leg in a patient with a family history of cancer. The complexity of the presented clinical case lies in the clinical picture atypical for nodular melanoma, since the formation was not pigmented, which did not cause concern for the patient and doctors, since the clinical picture was more consistent with a typical pyogenic granuloma. The patient underwent a wide excision of the formation. Further examination ruled out tumor metastases. The patient received a course of prophylactic therapy with recombinant interferon alfa. There was no recurrence of the disease during 3 years of follow-up. No metastasis has been observed so far.