[Metastatic cutaneous hematoma variant from melanoma: five cases]

Melanoma is an aggressive tumor with high metastatic potential. We described herein five patients with metastatic cutaneous hematoma variant from melanoma.

Patients were four men and one woman, four were already known for melanoma. In one case, the occurrence of hematoma leads to the diagnosis of metastatic melanoma. These hematomas were true hematomas, which had appeared spontaneously and in some cases a nodule or lymphadenopathy was clinically found. A biopsy was performed in two cases, showing the sub-cutaneous metastasis with hemorrhages (histological hematoma) and vascular proliferation within tumor cells. Patients were not treated by anti-coagulants or antiagregants and biological tests were not exhibiting any coagulation trouble. Evolution was rapidly dramatic with generalized metastatic disease and death.

Metastatic cutaneous hematoma is a particular type of cutaneous metastasis, poorly reported in the literature. This phenomenon could be explained by local tumoral neoangiogenesis and hematogenous metastatic spread.

We report five cases of metastatic cutaneous hematomas of melanoma. This clinical presentation doesn't seem to be so rare. This clinical variant should be known from oncologists in order to perform a biopsy looking for a metastatic cutaneous involvement from melanoma.