Rare Nipple Melanoma Mimics Other Skin Lesions
A 93-year-old woman's case highlights why persistent nipple lesions require precise diagnostic testing.
Updated on Oct. 26, 2026 in Cancer
A medical team recently reported the case of a 93-year-old woman diagnosed with primary invasive melanoma of the nipple after initial tests suggested a sarcoma. Following a mastectomy, the patient has remained disease-free for over two years.
Why it matters
Nipple melanoma is extremely rare and can be easily misdiagnosed, highlighting the importance of precise immunohistochemical testing for ulcerated lesions in older adults. Accurate identification remains critical for determining appropriate surgical interventions in elderly patients.
This case report details a single patient with a 60 mm Breslow thickness tumor confirmed via immunohistochemical markers. While the patient remained disease-free 26 months post-surgery, this remains a solitary, highly advanced clinical presentation.
The details
Clinicians initially suspected sarcoma before immunohistochemical testing for markers including S100, Melan-A, and tyrosinase confirmed the presence of invasive superficial spreading melanoma. Because the lesion had ulcerated and reached a thickness of 60 mm, the patient underwent a modified radical mastectomy and axillary lymph node dissection. Although the tumor was advanced, all 15 sampled lymph nodes tested negative, and doctors opted against adjuvant therapy due to the patient's age.
Timeline
26 months after the initial surgery, the patient remains disease-free.
Health Landscape
Primary melanoma of the nipple is an exceedingly rare diagnostic challenge that frequently mimics other malignancies like sarcoma or Paget's disease. This case underscores the necessity of high-sensitivity marker testing in elderly populations to avoid diagnostic delays.
Persistent ulcerated lesions on the nipple that do not heal should be evaluated by a dermatologist or breast specialist to rule out rare malignancies. Discuss any new or changing nipple masses with your doctor, especially if they are accompanied by bleeding or visible skin changes.
The takeaway
This case demonstrates that invasive melanoma must be considered even when initial biopsies suggest other rare tissue cancers in the nipple area. Always request comprehensive diagnostic testing from your physician if an ulcerated lesion does not resolve after standard initial assessments.
Further reading
For more on the latest research and diagnostic approaches for rare skin malignancies, visit Cancer.
