Angiosarcomatous transdifferentiation of metastatic melanoma

Figures

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  FIGURE 1. Skin excision of the right upper leg showing nodular melanoma (hematoxylin and eosin ×10)

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  FIGURE 2. Lymph node with metastatic melanoma. The angiosarcomatous component is visible in the central and upper part of the lymph node (hematoxylin and eosin ×5)

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  FIGURE 3. A close‐up of the angiosarcomatous component shows vascular channels filled with erythrocytes (hematoxylin and eosin ×100)

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  FIGURE 4. Detail of the angiosarcomatous component. Highly atypical endothelial cells can be seen and mitotic figures are present. The vascular spaces contain erythrocytes (hematoxylin and eosin ×200)

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  FIGURE 5. A, close‐up of the melanoma metastasis in the inguinal lymph node showing both components (hematoxylin and eosin ×20). B, immunohistochemistry for SOX‐10 was positive in the conventional melanoma and completely negative in the vascular component (SOX10 ×20). C and D, immunohistochemistry for Erg (C) and CD 31 (D) was positive in the vascular component and completely negative in the conventional melanoma (ERG ×20)

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  FIGURE 6. Next‐generation sequencing result showing the NRAS: c.181_182delinsAG p.(Gln61Arg) mutation. Both the conventional melanoma and the angiosarcomatous component had this identical mutation (molecular analyses performed on the lymph node metastasis and subsequent cutaneous in‐transit metastasis)