Acral Nodular Melanoma Presenting With Rapid Progression.

Area of Science:

• Oncology
• Dermatology
• Surgical Pathology

Background:

• Melanoma, a significant malignancy derived from melanocytes, constitutes a small but deadly percentage of all cancers.
• Nodular melanoma (NM) represents an aggressive subtype requiring prompt diagnosis and management.

Observation:

• A 42-year-old female presented with an 18-month history of a rapidly progressing lesion on her right heel.
• The lesion exhibited ulceration and sloughing, with PET scan revealing an 11mm thick enhancing mass without distant metastasis.

Findings:

• Histopathological examination confirmed the diagnosis of nodular melanoma of the heel.
• The patient underwent successful surgical excision and reconstruction using local flap, sural graft, and split-thickness skin grafting.

Implications:

• This case highlights the importance of recognizing and managing rare melanoma presentations, even in non-sun-exposed areas like the heel.
• Effective surgical strategies are vital for achieving favorable outcomes in localized nodular melanoma.
• Further research into the specific risk factors and optimal treatment for heel melanomas is warranted.