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CASE REPORT article

Front. Med.
Sec. Dermatology
Volume 11 - 2024 | doi: 10.3389/fmed.2024.1427982

An isolated melanoma metastasis in patient with large congenital nevus without detectable primary melanoma: case report and review of literature

Provisionally accepted
Marta Pabianek Marta Pabianek Ilon Jatczak-Grochala Ilon Jatczak-Grochala Aleksandra Lesiak Aleksandra Lesiak Joanna Narbutt Joanna Narbutt Aleksandra Siekierko Aleksandra Siekierko Magdalena Ciazynska Magdalena Ciazynska *
  • Medical University of Lodz, Łódź, Łódź, Poland

The final, formatted version of the article will be published soon.

    Giant congenital pigmented nevi constitute an extremely diverse group of skin lesions in terms of morphology, which are often associated with many clinical implications such as: development of melanoma or presence of neurocutaneous melanosis, primarily a development of melanoma.We present rare case of a 62-year-old patient with a giant congenital birthmark who reported to oncology department due to a tumor in the lower abdomen detected during an ultrasound examination. Biopsy of the lesion showed the presence of melanoma metastasis. Four independent dermatologists performed a dermoscopic examination of the patient's skin and mucous membranes. In the PET/CT examination, apart from the previously described change in the lower abdomen, no metabolically active foci with features of malignant growth were found. The patient underwent surgical removal of the lesion in the lower abdomen. The postoperative histopathological examination confirmed the presence of metastasis of melanoma of the subcutaneous tissue of the abdomen with no connection to the epidermis. The BRAFV600 mutation was not found in the molecular test.Taking to consideration stage IV R0 melanoma of unknown primary origin, and with stage T0N0M1a, the only adjuvant treatment option in the case of melanoma with distant metastasis after radical resection is treatment with nivolumab. After a rheumatological consultation the patient was qualified for adjuvant treatment with nivolumab.

    Keywords: melanoma of unknown primary origin, Giant congenital melanocytic nevus, Adjuvant treatment, Melanoma, Primary melanoma

    Received: 05 May 2024; Accepted: 26 Aug 2024.

    Copyright: © 2024 Pabianek, Jatczak-Grochala, Lesiak, Narbutt, Siekierko and Ciazynska. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Magdalena Ciazynska, Medical University of Lodz, Łódź, 90-419, Łódź, Poland

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