Journal of

Case Reports and Images in Medicine

 
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Case Report
 
Giant malignant melanoma of the anterior chest wall with widespread metastasis
Narjust Duma1, Abdullah M. Khan1, Basil Kasimis2, Victor Chang2
1Internal Medicine Resident, Internal Medicine Department, Rutgers New Jersey Medical School, Newark, New Jersey, United States.
2Medical Oncologist, Hematology/Oncology Department, Veterans Affairs, East Orange VA Hospital, New Jersey, United States.

Article ID: 100001Z09ND2015
doi:10.5348/Z09-2015-1-CR-1

Address correspondence to:
Narjust Duma
MD, 59 Maier Street, Belleville
New Jersey
United States 07109
Phone: 01-206-841-0615
Fax: 973-972-3129

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How to cite this article:
Duma N, Khan AM, Kasimis B, Chang V. Giant malignant melanoma of the anterior chest wall with widespread metastasis. J Case Rep Images Med 2015;1:1–4.


Abstract
Introduction: Giant melanomas are defined as lesions greater than 10 cm; independent of their depth of invasion; these entities are rarely encountered in clinical practice and they represent a real treatment challenge as many patients are diagnosed with advanced disease. Herein, we document our experience with the first reported giant melanoma of the anterior chest wall and the 5th largest melanoma of any anatomic site.
Case Report: A 63-year-old Caucasian male presented with an irregular, pigmented, non-healing ulcer, measuring 1.5x1.5 cm on his chest. He was referred for a skin biopsy but was lost to follow-up. He returned one year later complaining of fatigue, night sweats, and unintentional weight loss in addition to further growth of the skin lesion. His skin lesion was now a large, fungating mass, fixed to the chest wall and measuring 15x13x2.5 cm. There were multiple satellite lesions on the chest wall and palpable left axillary lymphadenopathy. Skin biopsy confirmed the diagnosis of malignant melanoma. Computed tomography scan demonstrated innumerable pulmonary nodules, retroperitoneal and peri-splenic lymphadenopathy with hepatic and bone metastasis. The patient's clinical course was later complicated by lower extremities arterial and venous thrombosis. Patient expired 15 months after the initial visit.
Conclusion: Metastatic melanoma portends a long-term survival of less than 10%. Treatment depends on whether the disease is limited or disseminated; the latter is generally managed by systemic therapy or supportive care. Given the rarity of giant melanomas there is not a general consensus regarding the management of this subgroup of patients.

Keywords: Chest wall tumor, Giant melanoma, Metastatic melanoma, Skin cancer


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Author Contributions
Narjust Duma – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Abdullah M. Khan – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Basil Kasimis – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Victor Chang – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of submission
The corresponding author is the guarantor of submission.
Source of support
None
Conflict of interest
Authors declare no conflict of interest.
Copyright
© 2015 Narjust Duma et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.



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