Pathology of liver biopsy tissue: appearance: black, under the microscope: a malignancy with pigmentation (Figure 3); immunohistochemical (IHC) of paraffin section: Melan-A (++), HMB45 (++), S-100 (++), P16 (scattered+), Ki67 (about 25%), CgA (−), Syn (−), CK-P (−), BRAF (V600E) (+), indicating MM. Here, MLANA is linked to Miyoshi myopathy.