Giant thick melanomas: a retrospective case series

Giant thick melanomas (GTMs) are rare tumors characterized by extreme size and depth. We aimed to describe their clinical features and outcomes.

We retrospectively reviewed eleven patients diagnosed with GTMs at a tertiary dermatology center. GTMs were defined as primary cutaneous melanomas with diameter > 5 cm and Breslow thickness > 4 mm. Tumor size was measured clinically, and all histopathology was reviewed by two dermatopathologists. Clinical, pathological, treatment, and outcome data were extracted from electronic records.

Eleven patients (median age 69 years) presented with large tumors (median diameter 55 mm; median Breslow thickness 12 mm), most often on the trunk or extremities. Over half (54.5%) had stage III-IV disease at diagnosis, and treatments included surgery and systemic therapy. Median overall survival was 13 months, with two long-term survivors.

GTMs are aggressive and frequently diagnosed at advanced stages. Early recognition and multidisciplinary management are essential. Giant thick melanoma (GTM) is a rare entity characterized by aggressive behavior and poor prognosis. We conducted a retrospective descriptive study defining GTM as lesions with a diameter > 5 cm and Breslow thickness > 4 mm. Eleven cases were analyzed (mean age: 68.5 years), with a female predominance and predominant localization on the trunk. The main reasons for consultation were tumor growth, bleeding, and neurological symptoms. At diagnosis, AJCC stages ranged from IIB to IV. During follow-up, seven patients died -five due to melanoma and two from other causes-, while two remain alive and under active follow-up. Median follow-up was 1 year (range 0-15 years; mean 3.5 years). These findings confirm the severity of GTM and highlight the persistence of diagnostic delay. The main limitation of this study is the small sample size.