Acral nodular melanoma presenting with rapid progression

Abstract

Melanoma is a malignant tumor that is derived from melanocytes of the skin and other sites. Melanoma accounts for 1% to 3% of all malignancies and 1% to 2% of all cancer deaths worldwide. We are presenting a case of a 42-year-old female who presented to the surgery department with a growth over the right heel since 18 months, with a history of trauma to the site. The lesion showed rapid progression with a large mass and secondary skin ulceration and sloughing. A PET scan showed an enhancing lesion on the right heel measuring 11 mm in thickness. There was no evidence of any systemic organ or any lymph node metastasis. Surgical excision and reconstruction on the part of the heel by a local flap with sural graft with split-thickness skin grafting was done. The excised growth was sent for histopathology. The histopathological diagnosis of nodular melanoma (NM) of the heel was given. We are presenting this case for its clinical, histopathological, and surgical management.

A Rare Disease Presentation of Malignant Fungating Acral Melanoma of the Hand

“…There are reported cases of nodular melanoma developing at sites of trauma that may yield the etiology of the tumor in this patient. 8 …”

“…Nodular melanoma is characterized by rapid progression and invasive vertical growth patterns through tissue layers, and performing a more proximal amputation was a viable option. 8 Further studies should be performed to specifically quantify treatment options for nodular melanoma of the hand.…”

Acral nodular melanoma at a site of trauma

“…Early detection and diagnosis are necessary to achieve optimal treatment outcomes and avoid progression to metastatic disease [9]. Treatment for melanoma involves surgical excision with reconstruction, and adjuvant chemotherapy and radiation if advanced [10]. However, despite the established diagnosis of melanoma, lack of insurance remains a significant barrier to receiving treatment.…”