PMEL and mesenchymal cell neoplasm: Salient examples of such neoplasms include PEComa, endometrial stromal tumors, and myopericytoma.3,8 PEComas are neoplasms with malignant potential of pericyte lineage composed of epithelioid cells commonly with clear to eosinophilic granular cytoplasm growing radially around adjacent vessels.2,19 Importantly, PEComas stain for melanocytic markers such as HMB45 and MART1, allowing them to be differentiated from other mesenchymal tumors such as uterine angioleiomyoma.