Difficult to diagnose small cutaneous melanoma metastases mimicking angiomas: utility of dermoscopy

Metastases from melanoma can be found in any organ, while the reported incidence of skin metastases varies between 2 and 20%. Cutaneous melanoma metastases (CMM) can be heterogeneous at clinical examination, and they can simulate other benign and malignant lesions, thus generating major diagnostic troubles for the dermatologist. Dermoscopy is a useful tool that may increase the physician's diagnostic accuracy to this purpose.

Herein, we describe the case of two patients having lesions that can easily be confused with other benign or malignant lesions for their clinical and dermoscopic similarities and for the variability of presentation of skin metastases. The description of the dermoscopy patterns of melanoma metastases may be useful to recognize early metastases, when clinically not suspected, facilitating an early removal and histopathological confirmation.

Diagnoses of melanoma metastases and angiomas were confirmed by histological examination. Melanoma metastases show at dermoscopic examination the angioma-like pattern. The ability to detect CMM between other lesions was good taking into consideration that, without the patient's history and with just the dermoscopy image, it could be very difficult to distinguish CMM from other benign or malignant skin lesions.

The present study confirms that dermoscopy is a useful tool to increase the physician's diagnostic accuracy for CMM and allow its differentiation from other cutaneous lesions, always taking into account the patient's medical record.