Ganglionic melanoma without cutaneous localization: primitive, or metastasis?

Abstract

The ganglionic melanoma without cutaneous primitive is a rare entity, and that constitutes a challenge for the dermatologist, which pushes him to repeat his dermatological examination several times while searching for the primitive. Case report: We describe the case of a patient aged 73 years, with asymptomatic left inguinal swelling. Dermatologic examination found vitiligo-like leukoderma with a 2% body surface, and 2 cm left inguinal lymphadenopathy, with no inflammatory signs. Histology and immunohistochemistry favored ganglionic melanoma. The complete assessment did not reveal other metastases. the patient benefited from extensive excision with radiotherapy and then chemotherapy without recurrence. Conclusion: ganglionic melanoma without mucocutaneous primitive suggests a high probability of cutaneous regression of a metastatic melanoma, especially if the patient presents a vitiliginous reaction.