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• W4387248905 abstract "SESSION TITLE: Lung Cancer Case Report Posters 8 SESSION TYPE: Case Report Posters PRESENTED ON: 10/09/2023 02:10 pm - 02:55 pm INTRODUCTION: While malignant melanoma is a common skin cancer with frequent metastasis to lungs, primary malignant melanoma of the lung is very rare, with very few cases cited so far. The incidence of malignant melanoma of lung accounts for a mere 0.01% of all lung cancers, and 0.4% of all malignant melanomas. Here, we present one such case. CASE PRESENTATION: 78-year-old male with past medical history significant for transient ischemic attack 10 years ago, presented with complaints of hemoptysis and cough over 1.5 months duration. CT chest on the same day showed a large left hilar mass and a large left pleural effusion, and he underwent thoracentesis the same week, but cytology was negative. He then underwent a bronchoscopy 2 days later, but the tissue was nondiagnostic, because of extensive necrosis. MRI brain was done and was negative for brain metastases. PET-CT scan however showed a 10.9 x 8.8 cm mass in the left lower lung, and a large left pleural effusion. A CT-guided biopsy of the mass showed malignant melanoma. The pathology report showed the tumor cells positive for SOX10, S100, Melan-A (focal) and HMB45 (focal), while they were negative for wide spectrum cytokeratin (AE1/AE3/PCK26), CAM 5.2, CK5/6, p40, Napsin A, TTF-1, synaptophysin, chromogranin and LCA. As the mass seemed unresectable at this stage, after discussion, decision was made to start patient on immunotherapy ipilimumab and nivolumab, with plan to re-evaluate for surgery and radiotherapy after 4 courses of immunotherapy, and follow course of pleural effusion, which appears to be malignant (unilateral, same side as that of mass), although cytology was negative. DISCUSSION: Clinical presentation of PMML varies, from symptoms of cough, hemoptysis and chest pain to incidental findings in asymptomatic patients, with no difference in incidence among males and females. Histopathology is the gold standard for diagnosing this rare cancer. Due to the small number of reported cases, there are no guidelines for treatment yet. Surgical resection has been attempted in most of the reported cases. It may be combined with radiation therapy, chemo or immunotherapy. Prognosis has been poor with post operative recurrence, rapid progression and short survival time – within months from time of diagnosis. CONCLUSIONS: PMML is a very rare and aggressive type of lung cancer, with no set guidelines in place for its treatment due to the low incidence. Case reports such as this help to provide suggestions regarding its treatment and management. REFERENCE #1: Deng S, Sun X, Zhu Z, Lu J, Wen G, Chang X, Gao H, Hua Y, Wang L, Gao J. Primary malignant melanoma of the lung: a case report and literature review. BMC Pulm Med. 2020 Apr 17;20(1):94. doi: 10.1186/s12890-020-1140-z. PMID: 32303211; PMCID: PMC7165392. REFERENCE #2: Peng J, Han F, Yang T, Sun J, Guan W, Guo X. Primary malignant melanoma of the lung: A case report and literature review. Medicine (Baltimore). 2017 Nov;96(46):e8772. doi: 10.1097/MD.0000000000008772. PMID: 29145332; PMCID: PMC5704877. DISCLOSURES: No relevant relationships by Charu Bajracharya No relevant relationships by Sanjeev George No relevant relationships by Suchetha Jagan No relevant relationships by Pooja Jaisawal No relevant relationships by Arjun Narayanan" @default.
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• W4387248905 date "2023-10-01" @default.
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• W4387248905 title "A RARE CASE OF PRIMARY MALIGNANT MELANOMA OF THE LUNG" @default.
• W4387248905 doi "https://doi.org/10.1016/j.chest.2023.07.2923" @default.
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