Giant inguinal melanoma treated with complex oncological and reconstructive surgery: A case report

A 53-year-old woman came to our attention with a giant inguinal mass that was growing in the last 5 months, so she underwent a total body CT-scan that showed a 25 × 16 × 21cm mass of the right inguinal region which was compressing the femoral vessels and infiltrated the omolateral rectum muscle, pulmonary embolism and thrombosis of the right femoral vein. We performed a tru-cut biopsy that was consistent with an undifferentiated round-cell sarcoma. So, we performed a wide excision of the mass and a reconstruction with a pedunculated muscular flap of the tensor muscle of the fasciae late, a graft of omologous fasciae late and a graft of the great saphena vein onto the superficial femoral artery. The histological examination of the specimen demonstrated instead an "atypical amelanotic sarcomatoid malignant melanoma" with rabdoid aspects. The patient underwent a radicalization surgery and reconstruction with microsurgical great dorsal and anterior serratus flap. To our knowledge, this is the biggest inguinal melanoma treated with surgical excision described so far.