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Case Reports
. 2024 Mar 2;16(3):e55414.
doi: 10.7759/cureus.55414. eCollection 2024 Mar.

A Unique Case of Late Presentation Giant Lower Extremity Malignant Melanoma

Omar Al Zarkali  1 , Amanda Marker  1 , Lakhvir Kaur  1 , Ana VanDerWall  2
Affiliations
Case Reports

A Unique Case of Late Presentation Giant Lower Extremity Malignant Melanoma

Omar Al Zarkali et al. Cureus. .

Abstract

This case describes a unique presentation of a rare malignancy: giant melanoma. Due to the accessibility of healthcare in the United States, it is unusual for melanomas to grow to massive sizes without clinical intervention. In fact, an in-depth literature review elicited only a handful of similar cases. Giant malignant melanomas are typically defined by a cutoff size of no less than 10 cm in diameter. They often present with distant metastases and are highly invasive. Due to limited yet highly variable presentations, there is no standardized approach to treating this class of melanomas. We present a case with unique features not previously documented in similar cases that was ultimately treated with a novel approach.

Keywords: cancer immunotherapy; cutaneous malignancy; giant melanoma; malignant melanoma metastasis; oncology imaging.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Giant melanoma at the time of presentation
Figure 2
Figure 2. Computed tomography angiography (CTA) of the left lower leg
Figure 3
Figure 3. Computed tomography angiography (CTA) of the left leg with 3D reconstruction
Figure 4
Figure 4. Computed tomography angiography (CTA) of the chest. Multiple bilateral pulmonary nodules (red arrows) and large left pleural effusion (blue arrow)
Figure 5
Figure 5. Hematoxylin and eosin stain (H&E), 10x. Sheets of large pleomorphic cells and necrosis. Cells have abundant cytoplasm, large nuclei with prominent nucleoli
Figure 6
Figure 6. Hematoxylin and eosin stain (H&E), 40x. Cells with large pleomorphic nuclei, prominent nucleoli, and abundant amphophilic cytoplasm (arrow). No pigment, no squamous differentiation, and no glandular differentiation
Figure 7
Figure 7. MART1 immunohistochemical stain. 10x. Cytoplasmic staining (arrow). Supports diagnosis of melanoma
Figure 8
Figure 8. S100 immunohistochemical stain, 10x. Predominantly cytoplasmic staining, but some nuclear staining (within marked borders). Supports diagnosis of melanoma
Figure 9
Figure 9. SOX10 immunohistochemical stain, 10x. Nuclear stain. Supports diagnosis of melanoma
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