We present a rare case of transplacental-transmitted maternal melanoma to the placenta and foetus during the pregnancy of a 34-year-old woman. She was diagnosed with a melanoma at the age of 25, for which she was treated with chemotherapy. During her pregnancy, she presented with a recurrence of the disease and died 3 months after delivery. The 10-month-old female child presented with a recurrent retroauricular oedema on the left side, as in acute mastoiditis. A trephination of mastoid apophysis followed. Multiple fragments of dark-coloured tissue were sent for histological examination, and the immunophenotype showed a melanocytic tumour in the mastoid. A full radiological assessment showed no sign of metastasis. The child remained without treatment. Complete remission of bone metastatic lesion has been confirmed by follow-up; now, the child is 4 years old, alive, and without evidence of disease.
What will audience learn from your presentation?
Foetal metastases are rare. Melanoma is the most common neoplasm with transplacental transmission to the foetus with very poor prognosis. We present a rare case with transplacental-transmitted metastases from maternal melanoma to the mastoid with spontaneous regression. The child presented with the similar clinical characteristics as those in acute mastoiditis.
Melanoma involves 8% of the cases of cancer occurring during pregnancy. Foetal metastases are always associated with neoplastic involvement of placenta. Biological characteristics of foetal metastases from maternal cancer need further investigation. For this reason, in case of malignancy during pregnancy, we recommend immunohistological analysis of the whole placenta.
We cannot exclude the possibility of a delayed presentation of the disease due to lack of long-term follow-up data on unaffected children born from mothers with metastatic melanoma Thus, newborns who do not present melanoma at birth should be considered at high risk and undergo close follow-up.