Malignant Melanoma
A previously asymptomatic, largeblack plaque on a 65-year-old man’sscalp recently began to bleed. The lesionhad grown considerably since itfirst appeared as
A previously asymptomatic, largeblack plaque on a 65-year-old man'sscalp recently began to bleed. The lesionhad grown considerably since itfirst appeared as a small black macule3 years earlier.A clinical diagnosis of malignantmelanoma was confirmed by an incisionalbiopsy. An excisional biopsy ofthe 3.85-mm thick cancer was performedseveral days later. The patientrefused biopsy of clinically palpablelymph nodes in his neck.Common sites of melanomametastases include the nodes, lungs,liver, brain, and bone. This patientdied 8 months later with metastasesto his brain.(Case and photograph courtesy ofDr Reynold C. Wong.)
Melanoma Within a Congenital Nevus
January 1st 2008A 48-year-old Hispanic man had a tender, bleeding growth within a darkly pigmented plaque on the right flank. The pigmented lesion had been present since birth; it was previously asymptomatic. The tumor arose out of the mainly flat patch 6 months earlier and had slowly enlarged. The patient worked indoors, wore sunscreen daily, and generally avoided outdoor activities. He had no family history of skin cancer.
Small-Bowel Metastatic Melanoma
September 1st 2007An 83-year-old man with a history of hypertension, hyperlipidemia, and diverticulosis was hospitalized because of painless hematochezia of 1 day's duration. Two years earlier, he had undergone surgical excision of a superficial spreading melanoma on his right thigh.
