Hard to face: cutaneous malignant melanoma.

Area of Science:

• Dermatology
• Oncology
• Pathology

Background:

• A patient presented with recurrent skin disease on the nose dorsum.
• The initial lesion, excised in 2002, was suspected to be pigmented basal cell carcinoma.
• The affected skin exhibited actinic damage.

Purpose of the Study:

• To report a case of recurrent melanoma.
• To detail the histological findings and staging of the melanoma.
• To document the management and follow-up of the patient.

Main Methods:

• Histopathological examination of the excised nodule.
• Sentinel lymph node biopsy.
• Radical lymph node dissection.
• Computed tomography (CT) scans for systemic staging.

Main Results:

• Histology revealed superficial spreading melanoma (Clark level IV, Breslow thickness 2.1 mm) arising from a nevus.
• Sentinel lymph node was positive for melanoma micrometastases.
• CT scans showed no evidence of systemic disease.
• No further metastases were found in other lymph nodes after dissection.

Conclusions:

• Recurrence of melanoma can occur even after complete excision.
• Sentinel lymph node biopsy is crucial for staging melanoma.
• Multimodality imaging and surgical intervention are key in managing melanoma patients.