MEETING No. 24, OCTOBER 18, 2000, MULTIMEDICA PRIVATE HOSPITAL, SESTO S. GIOVANNI

Case 1
Case 2
Case 3
Case 4
Case 5
Case 6
Case 7

Caso 4

"SKIN LESION IN NEWBORN BABY"
D. MERLO - II.CC.P. - Milano
C. CLEMENTE - S. Pio X Private Hospital - Milano
(pict. by dr. Clemente)

Clinical history: a six days male new born baby presents since birth with a polypoid ulcerated skin lesion in hypogastrium.
Macroscopic description: 2 cm, bluish, peduncolate lesion with ulcerated surface (pict. 1). Microscopic description: sections show two components of the lesion: a superficial and a deep one. The superficial component consists of large, often atypical, nevus cells mainly single or arranged in little nests (pict. 2) - (pict. 3) - (pict. 4) in the reticular dermis and at the dermal-epidermal junction (pict. 5).
These cells only occasionally infiltrate the epidermis. The deeper component shows smaller cells, with eosinophilic, finely granular cytoplasm (pict. 6) - (pict. 7) - (pict. 8); they are positive with immunohistochemical staining for S100 (pict. 9). There are mitosis and blood vessels proliferation.

Differential diagnosis:

melanoma? Collision tumor nevus/sarcoma?
This case has been reviewed by dr. Clemente who confirms the two components of the tumor.
He notes that the nests of melanocytes are not continuous along the dermal-epidermal junction and the invasion of the epidermis is not “aggressive”.
The skin ulceration is probably due to decubitus. Both components are positive for S100; only the superficial one is positive for HMB45 whilst the deep one is PAS positive. Melanoma diagnosis is excluded.



Diagnosis

pict. 1	pict. 2
pict. 3	pict. 4
pict. 5	pict. 6
pict. 7	pict. 8
pict. 9

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