Primary Tonsillar Melanoma

    Histopathology of the re-excision shows a mucosal nodule composed of nests of epithelioid cells, pagetoid extension, and mitoses.  Higher power demonstrates significant atypia. The nodule stains positive for HMB45, MART1, and S100.  Melan-A immunostain also highlights melanoma in-situ which extends to the lateral margin.