
Melanoma of Unknown Primary Presenting as a Single Back Mass
Abstract
In this report, we present a case involving the discovery of metastatic melanoma within a mid-right back mass with the clinical presentation of an epidermoid cyst, but the histological qualities of a lymph node. A 43-year-old male presented with a 5 cm x 5 cm cyst-like mass on his mid-right back that had become painful over the last year and consequently underwent three surgical procedures. First, initial excision of the back mass and histological examination resulted in a diagnosis of metastatic melanoma without epidermal involvement. This was followed by re-excision of the back mass site and sentinel node excision, and finally, lymph node dissection of the right axilla. Of the lymph nodes examined, the sentinel node in the right axilla alone showed evidence of melanoma. The absence of a primary lesion or any histological evidence of regression in a presumed primary site resulted in a diagnosis of melanoma of unknown primary, or occult primary melanoma. To our knowledge, this is the first documented case of an occult primary melanoma presenting as a single mass representing a lymph node in the back.
Keywords
Full Text:
PDFReferences
Bailey EC SA, Tsao H, Mihm MC, Jr., Johnson TM, Jr. In: Katz SI GL, Gilchrest BA, Paller AS, Leffell DJ, Wolff K, ed. Fitzpatrick's dermatology in general medicine. McGraw-Hill; 2012
Kamposioras K, Pentheroudakis G, Pectasides D, Pavlidis N. Malignant melanoma of unknown primary site. To make the long story short. A systematic review of the literature. Crit Rev Oncol Hematol. 2011, 78:112-126
Vijuk G, Coates AS. Survival of patients with visceral metastatic melanoma from an occult primary lesion: A retrospective matched cohort study. Ann Oncol. 1998, 9:419-422
Margaritescu I, Chirita AD, Vasilescu F. Completely regressed primary cutaneous melanoma - difficulties in diagnosis and classification. Rom J Morphol Embryol. 2014, 55:635-642
Uren RF, Howman-Giles R, Thompson JF. Patterns of lymphatic drainage from the skin in patients with melanoma. J Nucl Med. 2003, 44:570-582
Rastrelli M, Pigozzo J, di Maggio A, Tosi AL, Sileni VC, Rossi CR. Neoadjuvant treatment with dabrafenib of unresectable localizations from occult melanoma. Melanoma Res. 2014, 24:413-414
Network NCC. Nccn clinical practice guidelines in oncology: Melanoma. 2016
Swetter SM, Ecker PM, Johnson DL, Harvell JD. Primary dermal melanoma: A distinct subtype of melanoma. Arch Dermatol. 2004, 140:99-103
Teow J, Chin O, Hanikeri M, Wood BA. Primary dermal melanoma: A West Australian cohort. ANZ J Surg. 2015, 85:664-667
Refbacks
- There are currently no refbacks.