A solitary subcutaneous nodule as a presenting sign of metastatic malignant melanoma

Two patients were referred because of an innocent-appearing solitary subcutaneous nodule; excision revealed metastasis of malignant melanoma, but comprehensive investigation failed to disclose the primary tumor. In neither patient was there subsequent evidence of local recurrence but both died of disseminated disease--the first 2 years and the second 10 months after the excision.