Occurrence of Cutaneous Melanoma in a Patient with Previous History of Uveal Melanoma. Same Embryology, Different Driver Mutation Landscape

Author(s): Erisa Kola, Ina Kola, Migena Brati-Dervishi, Ali Guy, Edlira Horjeti, Violeta Dajci, Juna Musa, Daniela Nakuci

Cutaneous and uveal melanomas originate from melanin-producing neural crest-derived cells. They differ from each other in their genetic background, ways of spreading and prognosis. Worldwide, malignant melanoma is a common skin tumor with poor prognosis and its prevalence is increasing rapidly in fair-skinned populations. Both cutaneous melanoma (CM) and ocular melanoma (OM) arise from melanocyte transformation and represent deadly forms of cancer. Early diagnosis and treatment increase the overall survival. We are reporting a case of a patient with previous history of uveal melanoma (UV) diagnosed with cutaneous melanoma, lentigo maligna type. The coexistence of both melanomas in the same patient is incredibly challenging due to the same embryonic origin; however, the pathogenesis and biological behaviors are quite different. BRAF and NRAS mutations dominate in lesions arising in an epithelial context such as conjunctival melanoma and CM. Histopathological examination remains the gold standard for the confirmation of the diagnosis.