Department of Plastic Surgery, Ninewells Hospital and Medical School, Dundee, UK
Department of Plastic Surgery, Ninewells Hospital and Medical School, Dundee, UK.
BMJ Case Rep. 2023 Aug 27;16(8):e255819. doi: 10.1136/bcr-2023-255819.
A man in his 50s presented to plastic surgery again with a lesion on his left upper arm. He had previously been treated for a malignant melanoma (MM) on his right arm over 5 years earlier. Sentinel lymph node biopsy (SLNB) had been negative, and he had completed the recommended 5 years follow-up period. Imaging was suspicious for an intramuscular soft tissue malignancy within the triceps muscle. After discussion with the regional sarcoma service, a core biopsy was performed. Histopathology suggested a diagnosis of metastatic MM, which was confirmed after surgical excision. This case highlights a rare example of an isolated muscular metastasis of MM, which presented at a distant site, over 5 years from the original treatment. This case highlights the unpredictable nature of MM, reminding clinicians of the need for a low threshold for investigation of soft tissue masses in patients with a history of cutaneous malignancy.
一位 50 多岁的男性因左上臂的病变再次到整形外科就诊。他曾在 5 年前的右臂上患有恶性黑色素瘤 (MM) ，并接受了治疗。前哨淋巴结活检 (SLNB) 为阴性，他已完成了建议的 5 年随访期。影像学检查怀疑肱三头肌内有肌肉内软组织恶性肿瘤。在与区域肉瘤服务部门讨论后，进行了核心活检。组织病理学提示转移性 MM 的诊断，经手术切除后得到证实。本例罕见地出现了 MM 的孤立性肌肉转移，在原始治疗后 5 年以上，出现在远处部位。本例突出了 MM 的不可预测性，提醒临床医生在有皮肤恶性肿瘤病史的患者中，对软组织肿块进行检查的门槛要低。
