Iranian Journal of Pathology

A Case of Amelanotic Plasmacytoid Melanoma with Strong CD138 Expression, Mimicking Multiple Myeloma – A Case Report

Document Type : Case Reports

Authors

Ery Kus Dwianingsih 1, 2
Yuni Artha Prabowo Putro 2, 3
Sofia Pranacipta 1
Shinta Andi Sarasati 1
Amri Wicaksono 4
Sekar Safitri 1
Eviana Norahmawati 5
Rahadyan Magetsari 2, 3

1 Department of Anatomical Pathology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia

2 Dr. Sardjito General Hospital, Jl Kesehatan No. 1, Sendowo, Yogyakarta, Indonesia

3 Department of Surgery, Orthopaedic and Traumatology Division, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia

4 Department of Radiology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia

5 Department of Anatomical Pathology, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia

https://doi.org/10.30699/ijp.2025.2040460.3354
Abstract
Background & Objective: Melanomas have diverse pathological features that mimic other tumors, such as lymphoma, sarcoma, and even poorly differentiated carcinoma. The most recently identified variant, the plasmacytoid variant, is an uncommon variant that can appear as a solitary tumor or a metastatic disease. Due to its rarity, the epidemiologic profile of this variant is not well characterized. This case report illustrates a diagnostic challenge of plasmacytoid cell mimicker, which is rarely found in daily practice.
Case Presentation: A 49-year-old man presented with multiple subcutaneous soft tissue nodules in the thoracic area and multiple pathological fractures in the left distal humerus and distal ulna. Clinical and radiological findings were suggestive of metastatic bone disease with differential diagnosis of multiple myeloma. Fine needle aspiration biopsy and histopathological findings were suggestive of multiple myeloma with differential diagnoses of metastatic carcinoma, rhabdomyosarcoma, and amelanotic melanoma. Thus, immunostaining for CD138, CK, desmin, vimentin, S-100, and HMB45 were requested and the results were compatible with the final diagnosis of amelanotic plasma melanoma.
Conclusion: It is crucial to consider melanoma as one of the differential diagnoses of a tumor with plasmacytoid feature and CD138 positive staining as it can mimic multiple myeloma as demonstrated in this case report.

Keywords

Cutaneous Malignant
Hematologic Neoplasm
Syndecan-1

Subjects

Iranian Journal of Pathology
Volume 20, Issue 2
Spring 2025
Pages 225-230

  • Receive Date 24 September 2024
  • Revise Date 14 November 2024
  • Accept Date 06 December 2024

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