Multiple synchronous primary melanomas; A case report

Cutaneous melanoma is a highly aggressive form of skin cancer, responsible for >90 % of deaths related to skin tumors, despite accounting for only a small proportion of total cutaneous tumors. Cutaneous melanoma is the fifth most commonly diagnosed cancer in both females and males and there is an annual increase of around 3-7 %. In recent years, survival rates have improved due to health education campaigns, prevention strategies and the development of new treatments for advanced disease. Melanoma patients have an increased risk of developing a new melanoma, although the risk is still low. Most new melanomas are diagnosed within 5 years of the first melanoma. A small fraction of patients are diagnosed with more than one melanoma within 3 months of the first melanoma, referred to as synchronous melanomas. As this is a rare phenomenon, the available literature remains limited. Some studies have shown improved survival in this group and that the subsequent melanoma was significantly thinner; however further research is needed to fully understand this phenomenon. Here we present a case with a patient with six synchronous melanomas diagnosed within 19 days. The patient underwent genetic screening but no pathogenic gene variants were found. This case highlights the importance of thorough skin examination at the time of melanoma diagnosis. To our knowledge, this is the first reported case of six synchronous melanomas in the absence of identifiable genetic predisposition. The case demonstrates the need for further research.