# Metastatic Intraparotid Balloon Cell Melanoma: A Diagnostic Challenge

## TL;DR

A rare case of metastatic balloon cell melanoma in the parotid gland is reported, highlighting the challenges in diagnosing this condition without a known primary tumor.

## Contribution

This case report adds to the limited literature on metastatic balloon cell melanoma in the parotid gland.

## Key findings

- The patient presented with a parotid gland mass that was diagnosed as metastatic balloon cell melanoma.
- Immunohistochemical staining confirmed the diagnosis with positive results for BRAF, HMB45, Melan-A, PRAME, S100, and SOX-10.
- No primary tumor site was identified despite extensive evaluation.

## Abstract

BCM is an uncommon cytomorphologic variant with the potential to mimic unrelated neoplastic conditions, especially in the absence of a known cutaneous primary lesion or limited access to immunohistochemical stains.

A 28-year-old male patient presented with recent onset parotid gland mass. The mass was excised, and the subsequent workup elicited an interpretation of metastatic balloon cell melanoma (BCM). Despite an extensive evaluation, no evidence of a primary tumor site was identified.

The diagnosis was confirmed based on positive staining for BRAF, HMB45, Melan-A, PRAME, S100, and SOX-10 in the malignant cells.

Familiarity with the histologic and immunophenotypic findings may help to ensure an accurate diagnosis.