A Case of Delayed Diagnosis of Acral Lentiginous Melanoma

Česká verzia

Authors: M. Gottvaldová ¹; H. Jedličková ¹; A. Poprach ²; V. Vašků ¹
Authors place of work: I. dermatovenerologická klinika LF MU a FN U sv. Anny v Brně ¹; Klinika onkologické péče, Masarykův onkologický ústav, Brno ²
Published in the journal: Klin Onkol 2015; 28(6): 439-443
Category: Kazuistiky
doi: https://doi.org/10.14735/amko2015439

Maligní melanom je nádorové onemocnění kůže, které vzniká nekontrolovanou proliferací melanocytů. Nejčastěji se objevuje na kůži, ale může postihnout i sliznice, meningy či oko. Část melanomů se vyvíjí z melanocytárního névu. Akrolentiginózní melanom je typ melanomu lokalizovaný na dlaních, chodidlech, prstech, pod nehty, a je nejčastějším typem melanomu u fototypu VI. Nejdůležitějším faktorem úspěšné léčby je včasná detekce a excize tumoru s histologickým stagingem.

Summary

Background:
Melanoma is a malignant skin disease. The tumor development is caused by an uncontrollable proliferation of melanocytes. The most common occurrence is on the skin, but melanoma may also develop on the mucous membrane, meninges, and eyes. Some melanomas develop from melanocytic nevus. Acral lentiginous melanoma occurs on palms, feet, fingers and under nails, and is the most common type of melanoma for phototype VI. The most important factor for successful treatment of malignant melanoma is an early detection, excision of the primary tumor and histological staging. Surgical treatment of an early-stage melanoma is a key to successful therapy; however, many patients (mostly men) do not seek medical attention before it istoo late.

Case report:
This case study presents a 59-year-old patient, who suffers from white coat syndrome and whose finger was amputated for alleged gangrene. Subsequently, brownish black nodules appeared across his arm. Histological examination proved metastases of malignant melanoma. It was only at this phase, when the patient admitted a nevus at the tip of his amputated finger, from which ulceration and gangrene gradually emerged.

Conclusion:
This case demonstrates a combination of multiple unfavorable factors, which led to delayed diagnosis and therapy.

Key words:
acral lentiginous melanoma – histology – neoplasm metastasis – gene amplifications – white coat syndrome

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers.

Submitted:
4. 9. 2015

Accepted:
1. 10. 2015

Zdroje

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