case_images: PMC4061179_01
case_images: Pigmented melanoma metastasis constituted from pleomorphic epithelioid cells; hematoxylin and eosin stain, ob. 40x.. Abbreviation: ob, objective.
case_images: cia-9-929Fig1.jpg
case_images: PMC4061179_01_cia-9-929Fig1.jpg
case_images: f1-cia-9-929
case_images: Moreover, 6 months after the diagnosis, he returned with submandibular lymph node metastasis consistent with a pigmented melanoma with epithelioid cells (Figure 1).
case_images: PMC4061179_02
case_images: Bucopharyngoscopy: oropharyngeal (right palatine tonsil) melanoma.
case_images: cia-9-929Fig2.jpg
case_images: PMC4061179_02_cia-9-929Fig2.jpg
case_images: f2-cia-9-929
case_images: An otolaryngology clinic exam suspected a T2 tumor, approximately 3 cm in largest diameter (Figure 2), and an excision biopsy (right tonsillectomy) was performed.
case_images: Epithelioid malignant melanocytes with high pleomorphic nuclei and large macronucleoli; hematoxylin and eosin stain, ob. 40x.. Abbreviation: ob, objective.
case_images: cia-9-929Fig3.jpg
case_images: PMC4061179_02_cia-9-929Fig3.jpg
case_images: f3-cia-9-929
case_images: Histopathologic exam revealed a malignant tumor composed of epithelioid cells with one or more high pleomorphic nuclei and large nucleoli (Figure 3).
case_images: PMC4061179_03
case_images: Left nasal fossa polypoid mass.
case_images: cia-9-929Fig4.jpg
case_images: PMC4061179_03_cia-9-929Fig4.jpg
case_images: f4-cia-9-929
case_images: Otolaryngology clinical exam revealed a left nasal fossa polypoid mass arising from the level of middle meatus, extending to the choana (Figure 4).
case_images: PMC4061179_04
case_images: 70  rigid hypopharyngolaryngoscopy: laryngeal melanoma.
case_images: cia-9-929Fig5.jpg
case_images: PMC4061179_04_cia-9-929Fig5.jpg
case_images: f5-cia-9-929
case_images: Otolaryngology clinic exam by indirect laryngoscopy and 70  rigid pharyngolaryngoscopy (Figure 5) revealed an infiltrative vegetative tumor that involved the laryngeal vestibule and the hypopharyngeal retrocricoid area, with normal vocal cord mobility and no cervical lymph node involvement.
case_images: PMC4061179_05
case_images: PMC4061179_06
case_images: Melan A positivity in the malignant melanocytes, ob. 40x.. Abbreviation: ob, objective.
case_images: cia-9-929Fig6.jpg
case_images: PMC4061179_06_cia-9-929Fig6.jpg
case_images: f6-cia-9-929
case_images: Further immunohistochemical reactions positive for melanocytic markers established the correct diagnosis (Figure 6).
case_images: PMC4061179_07