Key result
PRAME immunohistochemistry shows diagnostic utility for trans-differentiated melanoma metastatic to the left atrium.
Why the study?
Diagnosing metastatic melanoma can be challenging when melanocytic markers are negative or when tumors display divergent differentiation and aberrant immunoreactivity.
Case Report (n=1)
No
PRAME is a useful ancillary immunohistochemical marker for diagnosing metastatic melanoma to the heart, especially when traditional melanocytic markers are negative due to trans-differentiation.
PRAME IHC may aid diagnosis of marker-negative metastatic melanoma; leaves open need for larger validation studies.
The diagnosis of metastatic melanoma may be challenging, particularly in tumors where all melanocytic markers are negative. In addition, de-differentiated, trans-differentiated, and undifferentiated melanomas may show divergent differentiation and aberrant immunoreactivity. PRAME is an antigen that has been described in primary cutaneous and metastatic melanomas and has become a useful ancillary immunohistochemical marker, particularly when all others are negative. We present a patient with metastatic melanoma to the left atrium with loss of melanocytic differentiation, gain of a rhabdomyosarcomatous differentiation, and a diffuse and strong positivity for PRAME.
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Stephan et al. (2026) conducted a case report in Metastatic melanoma to the heart (n=1). PRAME immunohistochemical marker was evaluated on Diagnostic utility of PRAME. PRAME immunohistochemistry showed diffuse and strong positivity, demonstrating its diagnostic utility in a patient with trans-differentiated melanoma metastatic to the left atrium.
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