Inflammatory metastatic melanoma

Flórez, Ángeles; Sánchez‐Aguilar, D.; Peteiro, C.; Peñaranda, José Manuel Suárez; Toribio, Jaime

doi:10.1111/j.1600-0560.1999.tb01811.x

Cited by 12 publications

(14 citation statements)

References 18 publications

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“…Inflammatory metastatic melanoma is rare 3 . It presents as erythematous plaques warm to palpation clinically mimicking cellulitis, and tends to manifest within the first few years of the removal of the primary malignant melanoma 3–7 . The proposed mechanism is invasion and occlusion of the lymphatics by melanoma cells, with resultant edema and vasodilation in and around the affected areas 5–7 …”

Section: Discussionmentioning

confidence: 99%

Ultra‐late erysipeloid angiotropic metastatic malignant melanoma

2001

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In 1998, a 70‐year‐old white man developed a slowly increasing swelling of the right lower extremity of 5 months' duration. During the 3 weeks prior to presentation, the patient noted intensifying erythema accompanied by increasing tenderness and warmth on palpation. A clinical diagnosis of cellulitis was made and the patient underwent a 2‐week course of oral cephalexin, 500 mg four times a day, without improvement. Dermatology was consulted. The pertinent past medical history included: (i) wide local excision of a Clark's level II malignant melanoma from the left lower back in 1980; (ii) metastatic malignant melanoma involving the bladder removed by cystectomy in 1995, together with left inguinal node resection followed by systemic chemotherapy and radiation therapy; (iii) recurrent metastatic malignant melanoma on the right inguinal node, resected, and followed by docetaxel therapy in 1997 with resolution. Physical examination disclosed an ill‐looking, elderly man with a moderately well‐demarcated, elevated, slightly tender, edematous, warm, erythematous, confluent plaque involving the proximal right lower extremity and the right lower flank, suggestive of erysipelas (Fig. 1). Histologic examination revealed infiltration of the superficial and deep dermal vessels (mainly small venules) by highly anaplastic cells (Fig. 2). The vascular lumina were occluded with the neoplastic cells and focal microthrombi formation. Immunohistochemical staining for S‐100 protein, HMB‐45, and vimentin confirmed the diagnosis of metastatic melanoma. CD31 immunostaining decorated the endothelial lining of the dermal vessels. Tissue cultures and special stains for bacteria and fungi were negative. A diagnosis of erysipeloid metastatic malignant melanoma involving the vessels was made. The patient and the family declined further aggressive treatments, and the patient died within a few weeks under hospice care. 1 Moderately well‐demarcated, edematous, erythematous plaque on the right lower flank and proximal right lower extremity with tenderness and warmth on palpation 2 Malignant melanoma cells infiltrating a dermal vessel. The vascular lumen demonstrates occlusion by anaplastic cells

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Section: Discussionmentioning

confidence: 99%

Ultra‐late erysipeloid angiotropic metastatic malignant melanoma

2001

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“…In light of the patient's age and the extent of the area involved, no treatment was done per the family's request. At one month follow up, the patient remained asymptomatic and clinically stable [11]. Importantly, our patient had a negative SLNB at the time of the melanoma diagnosis on his calf.…”

Section: Discussionmentioning

confidence: 85%

“…However, it would be reasonable to assume this presentation is likely a poor prognostic indicator [11]. It is known for instance that inflammatory breast carcinoma portends a worse prognosis than other presentations of breast cancer, so inflammatory ITM may also follow similar suit.…”

Section: Discussionmentioning

confidence: 99%

Metastatic melanoma masquerading as a furuncle

Aslam¹,

Konopinski²,

Aziz³

2017

Our Dermatol Online

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Melanoma metastasizes to the skin in about 10-17% of patients. Although there are reports of metastatic melanoma masquerading as panniculitis and erysipelas, it is very uncommon for it to present as an inflammatory skin lesion. When malignant melanoma cells invade the superficial dermal lymphatic vessels it can result in erythema, edema and induration of the overlying skin. This presentation can be problematic for clinicians if they do not suspect melanoma and choose not to biopsy the lesion. We report a case of an elderly man with a history of invasive melanoma who presented with a furuncle-like lesion that was found to be in-transit metastatic melanoma.

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“…5 These lesions can appear with the acute onset of local signs of inflammation such as progressing erythema, pain, and swelling; they can be clearly demarcated from the surrounding tissue and sometimes are accompanied by fever, chills, nausea, and vomiting, mimicking an infectious event. 6 A diffuse sclerodermiform metastatic lesion with induration of the skin and rapidly lethal course was recently described. 7 Metastases to the lower extremities can look like folliculitis with small red papules with central hairs.…”

Section: Discussionmentioning

confidence: 99%