Ann Dermatol.  2009 May;21(2):171-173. 10.5021/ad.2009.21.2.171.

Giant Acral Melanoma on the Left Thumb of a Korean Patient

• Kim JH
• Jeong SY
• Shin JB
• Ro KW
• Seo SH
• Son SW
• Kim IH

• KMID: 2219389
• DOI: http://doi.org/10.5021/ad.2009.21.2.171

Abstract

The acral regions of the limbs of Asians are predisposed to develop malignant melanoma, but giant-sized acral melanoma has not been previously reported in the Asian population. Giant-sized melanoma implies aggressive tumor invasion and so it is more difficult to achieve a therapeutic cure. A 56-year-old woman presented with a giant acral melanoma of the left thumb with concomitant bone destruction and axillary lymph node metastasis. The initial lesion was a subungual black macule on the left thumb that had grown into a giant 7.0*4.0*3.5 cm-sized melanoma over a 3 year period. The left thumb was amputated and the axillary lymph nodes were completely dissected. During the ensuing 3 months, she underwent adjuvant treatment with interferon-alpha-2a. The interesting feature of this case is that the large melanoma mass of this patient, which was accompanied with adjacent bone destruction and lymph node metastasis, had developed rapidly from a small black macule in the nail matrix, and this black macule was suspected to be a subungual melanoma.

Keyword

Bone invasion; Interferon-alpha-2a; Lymph node metastasis; Melanoma

MeSH Terms

Asian Continental Ancestry Group
Extremities
Female
Humans
Lymph Nodes
Melanoma
Middle Aged
Nails
Neoplasm Metastasis
Thumb

Figure

• 

  Fig. 1 A melanoma measuring 7.0×4.0×3.5 cm is surrounding the left thumb. Ulceration and spontaneous bleeding can be observed.

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  Fig. 2 Atypical epithelioid melanocytes with heavy melanin pigmentation are present at the dermo-epidermal junction and in the dermis (H&E, ×100).

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  Fig. 3 The distal phalangeal bone has largely been destroyed. There are also signs of tumor invasion on the dorsal radial aspect of the proximal phalanx. (A) X-ray image. (B) MRI image.

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