Isolated ovarian metastasis from a spindle cell malignant melanoma of the choroid 14 years after enucleation - Prognostic implication of the keratin immunophenotype

A 47-year-old woman developed metastatic melanoma to the right ovary 14 yea rs after the enucleation of the right eye for a choroidal spindle cell mela noma. An immunohistochemical study was performed on paraffin sections of bo th primary and metastatic melanoma specimens to identify markers of both ag gressive phenotype and metastatic potential with particular attention to th e anomalous expression of cytokeratin intermediate filament proteins. Neopl astic cells of both primary and metastatic tumors immunostained positively for S-100, HMB45, MART-1, and vimentin antibodies, but they were negative f or cytokeratins 1-19, 8, 18, and 8,18; <10% of neoplastic cells in both the primary and the metastatic melanomas immunostained for Ki-67 proliferating antigen using MIB-1 antibody. We speculate that the indolent behavior of t his ovarian metastasis is reflected by the absence of coexpression of cytok eratins 8 and 18 with vimentin. This case supports the practical value of u sing this panel of antibodies to evaluate the aggressive potential of uveal melanomas.