患者男,39岁。头部红色结节、斑块2年。2年前患者头部出现一黄豆大红色结节,当地医院以“表皮囊肿”相继予激光和手术治疗,皮损均复发。皮损组织病理示:表皮与真皮交界处和真皮内瘤细胞呈巢状分布,肿瘤细胞大小不等,核深染,具显著异型性,肿瘤细胞内无明显黑素颗粒。免疫组化检查:瘤细胞表达S-100及Melan-A。CT检查示肺转移癌。诊断:无色素性黑素瘤。 Male patient, 39 years old. Head red nodules, plaque 2 years. Two years ago, a big red nodule appeared on the head of the patient. The local hospital treated with “epidermal cyst” successively with laser and surgery, and the lesions were both recurrence. Histopathological examination showed that the junction of epidermis and dermis and neoplasm of neoplasia were nested, the size of tumor cells were different, the nucleus was deeply stained, with significant atypia and no obvious melanin granules in tumor cells. Immunohistochemistry: The tumor cells expressed S-100 and Melan-A. CT examination showed lung metastases. Diagnosis: no pigmented melanoma.