Giant axillary lymph node metastasis from a regressed and undiagnosed cutaneous melanoma
Medical Review (Med. pregled), 2023, 59(4), 50-55.
M. Aleksieva1, I. Serkedzhiev2, E. Mekov3, S. Yankova4, G. Yankov1
1 Thoracic Surgery Department, UMHAT “Sv. Ivan Rilski” – Medical University of Sofia
2 Department of Anesthesiology and Intensive Care Unit – UMHAT “Sv. Ivan Rilski” – Medical University of Sofia
3 Department of Occupational Diseases, Medical University of Sofia
4 Department of Pediatrics, SHATPD „Prof. Dr. Ivan Mitev“ – Medical University of Sofia
Abstract. Malignant melanoma (MM) of the skin is among the most aggressive malignancies with a poor prognosis. Axillary lymphadenomegaly as the first manifestation of metastatic MM without a known or regressed primary tumor is a rare pathology, usually with a wrong preoperative diagnosis, requiring a complex treatment approach. This manuscript presents a case of a 53-year-old man with a giant axillary lesion, in whom a subtotal resection of the tumor was performed with a histological result of metastasis from malignant melanoma. Clinical regression of the primary skin lesion was established. Rapid disease progression followed, and administration of Pembrolizumab therapy and radiosurgery resulted in remission.
Key words: malignant cutaneous melanoma, axillary lymphadenopathy, surgery, clinical regression
Address for correspondence: Assoc. Prof. Dr Evgeni Mekov, MD, UMHAT „Sv. Ivan Rilski“, 15 “Akademik Ivan Geshov” Blvd., Bg-1431 Sofia, e-mail: evgeni.mekov@gmail.com