Pescarini Elena, Spanikova Gabriela, Mbaidjol Zacharia, De Antoni Eleonora, Vindigni Vincenzo, Bassetto Franco
Clinic of Plastic and Reconstructive Surgery, Padova University-Hospital, Italy.
Clinic of Paediatric Surgery, Jessenius Faculty of Medicine, Comenius University in Bratislava, Slovakia.
Case Rep Surg. 2020 Oct 30;2020:2938236. doi: 10.1155/2020/2938236. eCollection 2020.
The incidence of cutaneous malignant melanoma has shown a drastic increase over recent decades, and approximately 70% of newly diagnosed melanoma are tumors with a Breslow thickness less or equal to 1 mm. In the literature, there are well-documented rare cases of late metastasis of thin melanoma, and given their growing incidence, it is expected in the future to see more cases of late recurrence. We present a case report of a metastatic cutaneous melanoma 25 years from diagnosis and a review of the literature. A 61-year-old female patient presented with a newly discovered asymptomatic nodule on her thigh. Her relevant past medical history included a completely excided lesion with Breslow 1.4 mm thickness in 1989 for which she was followed up according to the guidelines and subsequently declared cured after 10 years of surveillance. Fine-needle aspiration and cytological analysis of the lesion proved to be a subcutaneous localization of malignant melanoma. The lesion was completely excised, and the patient has remained disease free since her surgery. The aim of this case report is to emphasize that late metastasis remains uncommon but a definitive cure from melanoma cannot always be considered a disease-free interval of 10 years. Physicians should always be aware of previous melanoma diagnosis with newly discovered suspicious lesions. Better patient education could improve the detection of recurrence and secondary melanomas without any need for more frequent follow-up visits and a prolonged follow-up time.
近几十年来，皮肤恶性黑色素瘤的发病率急剧上升，新诊断的黑色素瘤中约70%是 Breslow厚度小于或等于1毫米的肿瘤。文献中有关于薄型黑色素瘤晚期转移的罕见病例的详细记载，鉴于其发病率不断上升，预计未来会出现更多晚期复发病例。我们报告一例诊断后25年发生转移的皮肤黑色素瘤病例并进行文献复习。一名61岁女性患者大腿上出现一个新发现的无症状结节。她的相关既往病史包括1989年有一个 Breslow厚度为1.4毫米的病变被完全切除，之后她按照指南进行随访，在10年的监测后被宣布治愈。对该病变进行细针穿刺和细胞学分析，结果证实为恶性黑色素瘤的皮下定位。病变被完全切除，自手术以来患者一直无病生存。本病例报告的目的是强调晚期转移仍然不常见，但黑色素瘤的彻底治愈不能总是以10年的无病间期来衡量。医生应始终对新发现的可疑病变警惕既往黑色素瘤诊断史。更好的患者教育可以提高复发和继发性黑色素瘤的检出率，而无需更频繁的随访就诊和延长随访时间。
