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Review
. 2022 Mar 28;9(2):100-110.
doi: 10.3390/dermatopathology9020013.

Balloon Cell Melanoma: Presentation of Four Cases with a Comprehensive Review of the Literature

Gerardo Cazzato  1 , Eliano Cascardi  2 , Anna Colagrande  1 , Antonietta Cimmino  1 , Giuseppe Ingravallo  1 , Lucia Lospalluti  3 , Paolo Romita  3 , Aurora Demarco  3 , Francesca Arezzo  4 , Vera Loizzi  4 , Miriam Dellino  4   5 , Irma Trilli  6 , Emilio Bellitti  1 , Paola Parente  7 , Teresa Lettini  1 , Caterina Foti  3 , Gennaro Cormio  4 , Eugenio Maiorano  1 , Leonardo Resta  1
Affiliations
Review

Balloon Cell Melanoma: Presentation of Four Cases with a Comprehensive Review of the Literature

Gerardo Cazzato et al. Dermatopathology (Basel). .

Abstract

Background: balloon cell melanoma represents less than 1% of all histological forms of malignant melanoma and represents a diagnostic challenge for the dermatopathologist.

Methods: in this paper we present our cases of BCM found in our daily practice from 1 January 2008 to 31 December 2021, and we conduct a review of the literature relating to this entity in the period from the first description, 1970, to early 2022.

Results: four cases of melanoma balloon cell have been extrapolated from our electronic database, while in the review of the literature we have identified 115 cases of patients with primary and/or metastatic BCM.

Conclusions: we believe that future studies with numerous case series are essential not only to increase the knowledge of the pathophysiology of this neoplasm but also to correctly evaluate the response of BCM patients to new oncological therapies.

Keywords: balloon cell; dermatopathology; differential diagnosis; malignant melanoma.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
(A) Photomicrograph of the first case (F, 76 years old), showing the pseudolipoblastic/balloon cell aspects of the melanocytes, characterized by a swollen histological appearance and the disintegration of disordered and abundant melanic pigment (Hematoxylin-Eosin, Original Magnification 4×). (B) Histological micrograph of patient number two (M, 75), showing two different neoplastic parts: on the right, the more properly “balloon cell” part, while in the center and on the left, there is a part with spindle cells of malignant melanoma. Additionally, in this case, there was an abundant and irregular presence of melanic pigment (Hematoxylin-Eosin, Original Magnification 4×). (C) Histological preparation of sections from the third patient (F, 36 years old) showed very similar morphological characteristics to those in case number two (Hematoxylin-Eosin, Original Magnification: 10×). (D) Balloon cell melanoma photomicrograph of the lesion in patient number four (M, 51 years old). Note the balloon-shaped appearance of melanocytes with histological characteristics that sometimes resemble pseudolipoblasts (Hematoxylin-Eosin, Original Magnification: 20×). (E) Histological micrograph showing the cytological detail of melanocytes with balloon cell characteristics of the cytoplasm (Hematoxylin-Eosin, Original Magnification: 40×).
Figure 2
Figure 2
(A) Immunohistochemical preparation with S-100 protein antibody: note the intense positivity of the marker at the level of the melanoma component with spindle cells and a more tenuous positivity at the level of the balloon cell component. (Immunohistochemistry, Original magnification: 10×). (B) Photomicrograph showing immunostaining with anti-Melan-A antibody: note that the positivity of staining is almost entirely comparable to the previous one. (Immunohistochemistry anti-Melan-A, Original Magnification: 10×).
Figure 3
Figure 3
PRISMA 2020 Flow chart utilized for this systematic review related to balloon cell melanoma.
See this image and copyright information in PMC

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