Melanoma with cutaneous melanoma secondaries

Area of Science:

• Dermatology
• Oncology

Background:

• Malignant melanoma is a significant public health concern.
• Early detection and complete excision are crucial for patient outcomes.

Observation:

• A patient presented with a long-standing, changing black lesion on the left loin.
• Histological examination revealed malignant melanoma.
• Multiple melanoma lesions were present, with sub-surface involvement in apparently normal skin.

Findings:

• The primary melanoma was characterized as a deep (Breslow 2.56 mm) Clark 4 lesion.
• Wide surgical excision with a 20 mm margin was performed.
• No adjuvant radiotherapy or chemotherapy has proven effective for advanced primary melanoma.

Implications:

• This case highlights the importance of thorough examination for melanoma, even in seemingly normal skin.
• Management of advanced primary melanoma requires a multidisciplinary approach.
• Patient choice regarding sentinel lymph node biopsy (SLNB) is a key consideration in treatment planning.