Clinical features of 4 cases of primary pulmonary malignant melanoma and literature review_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

WANG Yinyan ¹ , WU Xiongting ¹ , SONG Ye ² , HUANG Zhengtong ³ , TAN Guiyan ¹ ,  HE Mengzhang ¹

1. The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510260, P. R. China;
2. Guangzhou Medical University Affiliated Cancer Hospital, Guangzhou, Guangdong 510000, P. R. China;
3. Guangzhou Panyu Central Hospital, Guangzhou, Guangdong 511400, P. R. China;

Corresponding?author：

HE Mengzhang, Email: 13600486496@139.com

Keywords：

Primary pulmonary melanoma; clinical features; survival time

DOI：

10.7507/1671-6205.202203017

Video：

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Objective To investigate and analyze the clinical features of primary pulmonary malignant melanoma. Methods The medical records, imaging examinations, pathological results, treatment and prognosis of four primary pulmonary malignant melanoma (PMML) patients were retrospectively collected. In combination with 96 cases reported in the literature, a total of 100 patients with PMML were analyzed. Results Among the 100 PMML patients, there were 60 males (60.0%) and 40 females (40.0%), with an average age of 56.9±10.3 years. Common clinical symptoms were cough (60.0%), chest tightness or pain (18.0%), hemoptysis (16.0%), and dyspnea (11.0%). Distant metastasis was found in 30 cases (30.0%) at the time of consultation. The clinical stage of the first diagnosis and evaluation of the patients was stage Ⅰ in 7 cases (7.0%), stage Ⅱ in 24 cases (24.0%), stage Ⅲ in 13 cases (13.0%), stage Ⅳ in 39 cases (39.0%), and 17 cases (17.0%) did not mention a clear tumor stage. Thirty patients (30.0%) received comprehensive anti-tumor therapy, 53 patients (53.0%) received surgical resection, and 17 patients among them (17.0%) received postoperative adjuvant comprehensive therapy. The overall median survival time of PMML patients was 8.0 (2.0 - 14.4) months. The median survival time of stage Ⅳ PMML patients was 5.0 (3.1 - 6.9) months, which was significantly lower than 24.0 (6.0 - 32.0) months of stage Ⅱ patients (P<0.05) and 15.0 (0.6 - 29.4) months of stage Ⅲ patients (P<0.05). Further analysis showed that different treatment regimens had no significant effect on the median survival time of patients with stage Ⅳ PMML (P>0.05). Conclusions PMML has a high degree of malignancy and no specific clinical symptoms. It is mainly diagnosed by pathology. Surgical resection, postoperative adjuvant chemoradiotherapy or immunotherapy are the main treatment methods, but its overall prognosis is poor.

Citation： WANG Yinyan, WU Xiongting, SONG Ye, HUANG Zhengtong, TAN Guiyan, HE Mengzhang. Clinical features of 4 cases of primary pulmonary malignant melanoma and literature review. Chinese Journal of Respiratory and Critical Care Medicine, 2023, 22(4): 262-268. doi: 10.7507/1671-6205.202203017 Copy

1.	Kamaleshwaran KK, Natarajan S, Parthiban J, et al. Rare case of extradural spinal metastasis from primary lung malignant melanoma detected with fluorine-18 fluorodeoxyglucose-positron emission tomography/computed tomography. Indian J Nucl Med, 2014, 29(1): 57-58.
2.	Wilson RW, Moran CA. Primary melanoma of the lung: a clinicopathologic and immunohistochemical study of eight cases. Am J Surg Pathol, 1997, 21(10): 1196-1202.
3.	Maeda R, Isowa N, Onuma H, et al. Primary malignant melanoma of the lung with rapid progression. Gen Thorac Cardiovasc Surg, 2009, 57(12): 671-674.
4.	Hwang KB, Hwang KE, Jung JW, et al. Primary pulmonary malignant melanoma: an unexpected tumor. Tuberc Respir Dis, 2015, 78(3): 272-275.
5.	Bagwell SP, Flynn SD, Cox PM, et al. Primary malignant melanoma of the lung. Am Rev Respir Dis, 1989, 139(6): 1543-1547.
6.	Bernal L, Restrepo J, Alarcón ML, et al. Primary BRAF mutant melanoma of the lung treated with immunotherapy and pulmonary bilobectomy: a case report. Am J Case Rep, 2021, 18(22): e927757.
7.	Hibiya T, Tanaka M, Matsumura M, et al. An NRAS mutation in primary malignant melanoma of the lung: a case report. Diagn Pathol, 2020, 15(1): 11.
8.	Xi JM, Wen H, Yan XB, et al. Primary pulmonary malignant melanoma diagnosed with percutaneous biopsy tissue: a case report. World J Clin Cases, 2020, 8(24): 6373-6379.
9.	Watanabe M, Yamamoto H, Sato H, et al. Primary pulmonary melanoma: a report of two cases. World J Surg Oncol, 2016, 10(9): S463-S463.
10.	Kyriakopoulos C, Zarkavelis G, Andrianopoulou A. Primary pulmonary malignant melanoma: report of an important entity and literature review. Case Rep Oncol Med, 2017, 2017: 8654326.
11.	dos Santos CL, Fernandes LR, Meruje M. Primary pulmonary melanoma: the unexpected tumour. BMJ Case Rep, 2013, 2013: bcr2013200706.
12.	Yamamoto Y, Kodama K, Maniwa T, et al. Primary malignant melanoma of the lung: a case report. Mol Clin Oncol, 2017, 7(1): 39-41.
13.	Shi YQ, Bing ZX, Xu XH, et al. Primary pulmonary malignant melanoma: case report and literature review. Thorac Cancer, 2018, 9(9): 1185-1189.
14.	Yabuki H, Kuwana K, Minowa M. Resection of primary malignant lung melanoma: a case report. Asian Cardiovasc Thorac Ann, 2018, 26(9): 710-712.
15.	Peng J, Han FF, Yang TY, et al. Primary malignant melanoma of the lung: a case report and literature review. Medicine, 2017, 96(46): e8772.
16.	Filippini A, Zorzi F, Bna' C, et al. Dark sputum: an atypical presentation of primary pulmonary malignant melanoma. Respir Med Case Rep, 2015, 15: 118-120.
17.	?ekin E, Cincik H, Yilmaz I, et al. Primary malignant melanoma of the trachea: case report. Ear Nose Throat J, 2010, 89(7): E18-E20.
18.	王愛蘭, 陸作為, 宋現讓, 等. 肺原發性惡性黑色素瘤一例報告—附細胞學特點分析. 腫瘤防治雜志, 2001, 8(6): 697-698.
19.	Mahowald MK, Aswad BI, Okereke IC, et al. Long-term survival after pneumonectomy for primary pulmonary malignant melanoma. Ann Thorac Surg, 2015, 99(4): 1428-1430.
20.	張強, 杜俊煒, 楊文鵬, 等. 皮膚黑色素瘤基因突變類型及基因拷貝數變異分析. 中國腫瘤臨床, 2022, 49(17): 874-879.

1. Kamaleshwaran KK, Natarajan S, Parthiban J, et al. Rare case of extradural spinal metastasis from primary lung malignant melanoma detected with fluorine-18 fluorodeoxyglucose-positron emission tomography/computed tomography. Indian J Nucl Med, 2014, 29(1): 57-58.
2. Wilson RW, Moran CA. Primary melanoma of the lung: a clinicopathologic and immunohistochemical study of eight cases. Am J Surg Pathol, 1997, 21(10): 1196-1202.
3. Maeda R, Isowa N, Onuma H, et al. Primary malignant melanoma of the lung with rapid progression. Gen Thorac Cardiovasc Surg, 2009, 57(12): 671-674.
4. Hwang KB, Hwang KE, Jung JW, et al. Primary pulmonary malignant melanoma: an unexpected tumor. Tuberc Respir Dis, 2015, 78(3): 272-275.
5. Bagwell SP, Flynn SD, Cox PM, et al. Primary malignant melanoma of the lung. Am Rev Respir Dis, 1989, 139(6): 1543-1547.
6. Bernal L, Restrepo J, Alarcón ML, et al. Primary BRAF mutant melanoma of the lung treated with immunotherapy and pulmonary bilobectomy: a case report. Am J Case Rep, 2021, 18(22): e927757.
7. Hibiya T, Tanaka M, Matsumura M, et al. An NRAS mutation in primary malignant melanoma of the lung: a case report. Diagn Pathol, 2020, 15(1): 11.
8. Xi JM, Wen H, Yan XB, et al. Primary pulmonary malignant melanoma diagnosed with percutaneous biopsy tissue: a case report. World J Clin Cases, 2020, 8(24): 6373-6379.
9. Watanabe M, Yamamoto H, Sato H, et al. Primary pulmonary melanoma: a report of two cases. World J Surg Oncol, 2016, 10(9): S463-S463.
10. Kyriakopoulos C, Zarkavelis G, Andrianopoulou A. Primary pulmonary malignant melanoma: report of an important entity and literature review. Case Rep Oncol Med, 2017, 2017: 8654326.
11. dos Santos CL, Fernandes LR, Meruje M. Primary pulmonary melanoma: the unexpected tumour. BMJ Case Rep, 2013, 2013: bcr2013200706.
12. Yamamoto Y, Kodama K, Maniwa T, et al. Primary malignant melanoma of the lung: a case report. Mol Clin Oncol, 2017, 7(1): 39-41.
13. Shi YQ, Bing ZX, Xu XH, et al. Primary pulmonary malignant melanoma: case report and literature review. Thorac Cancer, 2018, 9(9): 1185-1189.
14. Yabuki H, Kuwana K, Minowa M. Resection of primary malignant lung melanoma: a case report. Asian Cardiovasc Thorac Ann, 2018, 26(9): 710-712.
15. Peng J, Han FF, Yang TY, et al. Primary malignant melanoma of the lung: a case report and literature review. Medicine, 2017, 96(46): e8772.
16. Filippini A, Zorzi F, Bna' C, et al. Dark sputum: an atypical presentation of primary pulmonary malignant melanoma. Respir Med Case Rep, 2015, 15: 118-120.
17. ?ekin E, Cincik H, Yilmaz I, et al. Primary malignant melanoma of the trachea: case report. Ear Nose Throat J, 2010, 89(7): E18-E20.
18. 王愛蘭, 陸作為, 宋現讓, 等. 肺原發性惡性黑色素瘤一例報告—附細胞學特點分析. 腫瘤防治雜志, 2001, 8(6): 697-698.
19. Mahowald MK, Aswad BI, Okereke IC, et al. Long-term survival after pneumonectomy for primary pulmonary malignant melanoma. Ann Thorac Surg, 2015, 99(4): 1428-1430.
20. 張強, 杜俊煒, 楊文鵬, 等. 皮膚黑色素瘤基因突變類型及基因拷貝數變異分析. 中國腫瘤臨床, 2022, 49(17): 874-879.

Chinese Journal of Respiratory and Critical Care Medicine

Clinical features of 4 cases of primary pulmonary malignant melanoma and literature review

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