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Freja Lund Nielsen1, Mitra Sepehri1
1Afdeling for Plastikkirurgi og Brandsårsbehandling, Københavns Universitetshospital - Rigshospitalet.
Ugeskrift for Laeger
|April 28, 2023
Summary
This case report highlights a rare amelanotic melanoma discovered on the heel after metastasis was found in the groin. It emphasizes the importance of examining unpigmented skin lesions for primary melanoma detection.
Area of Science:
- Dermatology
- Oncology
Background:
- Melanoma metastasis to lymph nodes can occur even when the primary tumor is not apparent.
- Amelanotic melanoma, lacking pigment, presents diagnostic challenges and is associated with poorer prognoses than pigmented melanoma.
Observation:
- A 62-year-old woman presented with groin lymph node metastasis of unknown primary melanoma.
- Thorough skin examination revealed no suspicious pigmented lesions.
- Positron Emission Tomography-Computed Tomography (PET-CT) identified increased activity in the left heel, revealing an amelanotic melanoma.
Findings:
- The primary melanoma was amelanotic, making it clinically difficult to detect.
- Delayed detection of amelanotic melanoma likely contributes to its worse prognosis.
Implications:
- This case underscores the necessity of considering amelanotic lesions during the search for primary melanoma.
- Clinicians should maintain a high index of suspicion for amelanotic melanoma, even with a negative initial skin survey.