Nodular melanoma presenting with rapid progression and widespread metastases: a case report

Abstract

Introduction: Melanoma is responsible for 1% to 2% of all cancer deaths around the world. Nodular melanoma often carries a poor prognosis because of no prodromal radial growth phase, early distant metastasis and significant tumor volume.

Case presentation: We present a case of progressive melanoma. A 51-year-old man was admitted to our hospital with dyspnea and skin lesions. These were multiple, dark colored, firm, and nodular and varied in size. He was diagnosed with melanoma. Temozolomide was administered, but he died of respiratory failure within a week after diagnosis.

Conclusion: Nodular melanoma tends to spread rapidly and eventually metastasize to vital organs. It may be fatal within months of recognition.

Figure 1

(A) Clinical image shows a blue red nodule on the skin over the trunk. (B) Clinical image shows multiple, dark colored, firm, nodular skin lesions varying in size.

Figure 2

(A) Computed tomography image shows a lobulated, irregularly shaped mass 7 × 4.5 cm in diameter with central hypodensity in the right atrium. (B) Computed tomography image shows a brain metastasis.

Figure 3

A cluster of melanin pigment containing melanoma cells is observed in the fine needle aspiration cytology (hematoxylin and eosin staining, 100×).