dermatomal multiple nodular melanomas at thoracal IV-X on the right back and ribs

lestari, sri (2010) dermatomal multiple nodular melanomas at thoracal IV-X on the right back and ribs. dermatomal multiple nodular melanomas at thoracal IV-X on the right back and ribs .

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Abstract

Background : Nodular melanoma (l'it\4) results from the malignant transformation of melanoclte that has vertical growth. Nodular melanorna is difficult to recognize in the early stage that can cause the late of management. Case : A 50 year old Indonesian man with multiple nodular melanomas on the right back and ribs was reported. Initially, there was a blue black tumour on the right back 2 years ago that grow'ing fast became multiple tumours at thoracal IV- X on the right back and ribs in last three months. There were burning sensation, painful and easy bleeding. The rumours \r€Ie grouping papules, noduls and plaque at thoracal IV-X on the right back and ribs, variety colour (blue-black, amelanotic and erytematous), unilateral distribution. variety shape and size, defined border, hard consistency, smooth surface. and some of them had black crusts on top of the lesions. There were enlargement of right colli, supraclavicul4 infraclavicul4 axillae, and inguinal l1mph nodes. Histophatology examination revealed melanocyte cells with vescicular nuclei and coarse chromatin under stratun corneum and granulosum layers. pleomorf. that expanded to papillary and reticular dermis (vertical gror*rh) and bro*n pigments on dermis. This patient was in stage IIIC based on AJCC 2002 melanoma staging. Oncologist suggested chemotherapy, but he refused the therapl and died a month later. Discussion : Nodular melanoma is the higlest number of melanomas in lndonesia. This was the hnt case of dermatomal multiple nodular melanoma in our DeparLment. The enlargement of llmph nodes suggested metastatic. There is no standard therapy for metastatic meianoma. Chemotherapy may be useful.

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