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J Thorac Cardiovasc Surg 2003;126:1215-1217
© 2003 The American Association for Thoracic Surgery

Brief communication

Primary malignant melanoma of the bronchus intermedius

Pier Luigi Filosso, MDa,*, Giovanni Donati, MDa, Enrico Ruffini, MDa, Sabrina Croce, MDb, Mauro Papotti, MDb, Alberto Oliaro, MDa, Maurizio Mancuso, MD,a

a Department of Thoracic Surgery, University of Torino Italy San Giovanni Battista Hospital, Torino, Italy
b Department of Oncology and Biomedical Sciences, University of Torino, Italy, San Giovanni Battista Hospital, Torino, Italy

Received for publication November 5, 2002; accepted for publication December 27, 2002.

* Address for reprints: Pier Luigi Filosso, MD, University of Torino, Italy, San Giovanni Battista Hospital, Department of Thoracic Surgery, Via Genova, 3 10126, Torino, Italy
pierluigifilosso@tiscalinet.it

The first 20% of the full text of this article appears below.

Melanoma is widely known as the most lethal of all skin cancers, and pulmonary metastases are the most common presentation of advanced disease.1 Melanoma of the eye, oral mucosa, genital and perineal areas, subungual and plantar surfaces, scalp, and palms are described, and although rare, they together make up about 10% of melanomas.2 Primary pulmonary melanoma is the rarest type of visceral melanoma: only 20 cases have been previously reported in the English literature. We describe the case of a patient in whom a primary melanoma of the bronchus was diagnosed and radically resected, and we discuss the cause and outcome of this rare pathology.

Clinical summary

A 55-year-old white male smoker (40 pack-years) was referred to us for an endobronchial lesion discovered after complaints of chest pain, cough, and hemoptysis (Figure 1). Bronchoscopy revealed a large polylobulated lesion originating from the intermediate bronchus; histology at bronchial biopsy revealed a malignant melanoma. A preoperative brain and abdomen computed tomographic scan did not show any pathologic lesion. A thorough clinical examination of the body was performed by an experienced dermatologist: 2 suspect skin lesions (the first in the anterior left hemithorax and the second in the ipsilateral arm) were resected, but histology showed normal dermal nevi in both lesions. The patient underwent an accurate evaluation of other sites at which melanoma occasionally might occur: no oral and nasopharyngeal mucosa, anal and rectal mucosa, or eye lesions were detected. Furthermore, no family history for melanoma was documented. The patient underwent a right posterolateral thoracotomy, and a right pneumonectomy was performed; limited resection (sleeve) was not feasible because of tumor site and . . . [Full Text of this Article]






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