Images in Clinical Medicine

Cutaneous Melanoma Metastases

Martin Pecherstorfer, M.D.

N Engl J Med 1997; 337:1435November 13, 1997

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Figure 1 In 1990, a 55-year-old woman presented with an acral lentiginous melanoma of the left sole. A radical extirpation of the tumor (tumor stage, T2; tumor thickness, 1.5 mm) and an elective dissection of the inguinal lymph nodes were performed. Neither regional nor distant metastases were found, and adjuvant therapy with interferon alfa-2b was started, which lasted for 12 months. Two years later, neoplastic cells had spread to the skin of the lower left leg. The use of isolated cytostatic limb perfusion was rejected because of enlarged pelvic lymph nodes. Despite treatment with interleukin-2 and the cytostatic drug dacarbazine, the metastatic disease involved almost all the skin of the lower left leg by June 1996. With the exception of both suprarenal glands, melanoma metastases were restricted to the skin and the lymph nodes. The patient died in September 1996.

Martin Pecherstorfer, M.D.
Wilhelminenspital, A-1171 Vienna, Austria

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