Melanoma: a devastating evolution

Abstract

Melanoma incidence ranges from 10-15 cases/100000 inhabitants, representing the 5th most common cancer in men. In 30%
of cases, it may present distant metastases, assuming a gloomy
prognosis. The authors describe a case of a 41 year-old man presenting a painful and friable tumefaction on the left foot that had
appeared six months before, followed by progressively worsening
anorexia, weight loss, dysphagia and hoarseness. Physical exam
revealed an ulcerated swelling tumor, approximately 9cmx8cm,
with irregular and friable surface in the left foot and multiple pigmented painful nodules in the scalp and ipsilateral leg. Analytical
data: anemia, leukocytosis, thrombocytosis and alterations of liver
function tests. Imaging study revealed: pulmonary, pleural, liver
and bone metastases with D11 fracture; mediastinal adenopathies; pre-vertebral mass with invasion of the right internal jugular
vein and cranial bones. Upper gastrointestinal Endoscopy showed
gastric ulcers and duodenal brown stain. Biopsies of gastric and
skin lesions: melanoma metastases. Diagnosis of melanoma
was made, stage IV, M1c. Patient was submitted to analgesic
radiotherapy and died before starting palliative chemotherapy