[Late metastasis of malignant cutaneous melanoma]

Late recurrence of malignant melanoma, defined as the occurrence of metastases after a disease-free interval of 10 or more years, is a rare but well-known clinical phenomenon. We report on three female patients who developed in transit metastases 26, 15 and 10 years after excision of the primary tumour. All three patients are disease-free 8 and 9 years after resection of the metastases. Reports in the literature also indicate a favourable prognosis for patients with local recurrence or in transit or regional lymph node metastases. The prognosis for patients with late distant metastases, however, is generally poor. For the first group, an early therapeutic intervention is indicated. This and the occurrence of second and multiple primary melanomas make lifelong aftercare desirable. On the other hand, long-term aftercare of the constantly increasing number of melanoma patients will soon exceed the capacity of existing facilities. A high-risk group for late recurrence that would profit by long-term aftercare cannot be defined at the moment.