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Case Reports
. 2021 Aug 8;13(8):e16996.
doi: 10.7759/cureus.16996. eCollection 2021 Aug.

Unusual Presentation of Giant Upper Limb Malignant Melanoma

Ooi G Khim  1 , Juzaily F Leong  1 , Mohamed H Sani  1 , Nor Hazla Mohamed Haflah  2
Affiliations
Case Reports

Unusual Presentation of Giant Upper Limb Malignant Melanoma

Ooi G Khim et al. Cureus. .

Abstract

Melanoma is rare among the Asian population. In Malaysia, there is little public awareness of melanoma compared to other types of cancer. Giant melanomas measuring more than 10 cm are rarely encountered and there are limited data available regarding this disease. We would like to report an unusual presentation of giant malignant melanoma of upper limb in a 62-year-old patient who presented with a five-month history of a progressively enlarging, painless mass on his left arm. This mass which measures 10 x 15 cm turned out to be a giant malignant melanoma of the left arm. To our knowledge, this is the largest melanoma of arm reported in Malaysia. Radiological findings were suggestive of soft tissue sarcoma with lung metastasis. Patient underwent wide local excision of left-arm mass and upper limb reconstruction. The diagnosis of malignant melanoma was made based on the final histopathology report. Despite aggressive treatment involving multidisciplinary units, it did not prevent the disease progression and patient succumbed five months after his presentation. Here, we present our experience in the management of this large malignant melanoma of the arm and to stress the sinister nature of melanoma.

Keywords: adjuvant therapy; giant melanoma; metastases; soft tissue sarcoma; upper limb.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Large mass on anteromedial aspect of left arm with areas of pigmentation.
Figure 2
Figure 2. MRI of the arm showed heterogenous mass on the medial aspect of the left arm (blue arrow) and matted axillary lymph nodes (red arrow).
Figure 3
Figure 3. : Microscopic examination shows infiltration by malignant cells arranged in sheets (black arrow) and the surrounding stroma shows dense melanin pigment deposition (red arrow).
Figure 4
Figure 4. A: Exposed neurovascular structures (black arrow) with large skin defect. B: Latissimus dorsi flap. C: Left arm reconstruction with functional latissimus dorsi flap and split skin graft from the left thigh.
Figure 5
Figure 5. A: Left arm mass 9 x 10 x 15 cm (anterior). B: Left arm mass with biceps muscle (posterior).
Figure 6
Figure 6. Left axillary mass.
See this image and copyright information in PMC

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