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Case Reports
. 2025 Apr 11;17(4):e82076.
doi: 10.7759/cureus.82076. eCollection 2025 Apr.

Malignant Melanoma of the Foot in Five Elderly Patients: Clinicopathologic Features and Treatment Outcomes

Jekin J Sharon  1 , Gokulesh D G  1 , Kamalraj M  1
Affiliations
Case Reports

Malignant Melanoma of the Foot in Five Elderly Patients: Clinicopathologic Features and Treatment Outcomes

Jekin J Sharon et al. Cureus. .

Abstract

Malignant melanoma, an aggressive neoplasm of melanocytes, remains a leading cause of skin cancer-related deaths globally, with rising incidence among elderly populations. Foot melanomas are often diagnosed at advanced stages due to delayed detection and misdiagnosis. They exhibit poorer outcomes compared to melanomas at other sites. This case series presents five elderly patients (ages 58-80) with malignant melanoma of the foot, detailing their clinicopathological features, treatment strategies, and outcomes. All cases presented with advanced disease, emphasizing the challenges of late diagnosis in this demographic. Histopathological evaluation confirmed nodular, superficial spreading, and acral lentiginous subtypes, with Breslow thicknesses ranging from 1.5 mm to 3.5 cm. Management involved wide local excision, lymph node dissection, and adjuvant chemotherapy in high-risk cases. Recurrence occurred in one patient, underscoring the aggressive nature of the disease. The series highlights the necessity of early detection, multidisciplinary care, and tailored adjuvant therapies to improve outcomes in elderly patients with foot melanoma.

Keywords: acral melanoma; adjuvant therapy; breslow thickness; elderly patient care; foot tumors; melanoma recurrence; melanoma surgery; nodular melanoma; plantar melanoma.

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Conflict of interest statement

Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Intraoperative images of patient 1. (a) Nodular melanoma in the dorsolateral aspect of left foot, (b) tumor near the superficial peroneal nerve (indicated by artery forceps) after dissection, (c) left-side ilioinguinal dissection showing femoral triangle, and (d) tumor specimen removed
Figure 2
Figure 2. Intraoperative images of patient 2. (a) Plantar lesion in the lateral border of the right foot and 2-cm margin marked all around, (b) after wide local excision, and (c) excised specimen
Figure 3
Figure 3. Intraoperative images of patient 3. (a) Blackish pigmented, ulcerated, nodular lesion in the heel of right foot and (b) wide local excision of tumor
Figure 4
Figure 4. Clinical images of patient 4. (a) Blackish pigmented, ulcerated, nodular lesion in the third digit of the right foot and (b) delayed primary wound closure after Ray’s amputation of the second and third digits
Figure 5
Figure 5. Clinical images of patient 5. (a) Non-pigmented, nodular lesion in the heel of left foot, (b) wide local excision of the tumor, and (c and d) specimen sent for histopathology
Figure 6
Figure 6. Clinical image of patient 5 showing the recurrent lesion in the lateral aspect of left foot (white arrow) and healed scar at the site of primary lesion (yellow arrow)
Figure 7
Figure 7. Imaging investigations of patient 5. (a) CT image of the left leg with ankle (coronal section) showing the recurrent lesion in the lateral aspect (green arrow), (b) PET scan image showing the corresponding increased metabolic uptake in the recurrent lesion in the lateral aspect of the left foot (red arrow), (c) left iliac lymph node as visualized in CT scan (yellow arrow), and (d) PET scan showing increased metabolic uptake in the corresponding left iliac lymph node (white arrow)
CT, computed tomography; PET, positron emission tomography
See this image and copyright information in PMC

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