| Autor: |
Andrianandrasana, Ny Ony Tiana Florence, Randrianarisoa, Rova Malala Fandresena, Navoly, Patty, Ranaivoson, Mirana Andoniaina Christiana, Vololontiana, Hanta Marie Danielle, Rafaramino, Florine |
| Předmět: |
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| Zdroj: |
Journal of Medical Case Reports; 3/12/2023, Vol. 17 Issue 1, p1-4, 4p |
| Abstrakt: |
Background: Melanoma is usually discovered from an irregular skin patch or a modification of a preexisting patch. Cutaneous and lymph node metastases are common. Muscle metastases are rare. We report a case of melanoma with infiltration of the gluteus maximus, which had normal dermatological examination. Case presentation: A 43-year-old Malagasy man with no history of skin surgery was admitted with progressively worsening dyspnea. On admission, he presented with superior vena cava syndrome, painless cervical lymphadenopathy, and a painful swelling in the right buttock. Skin and mucous membrane examination did not reveal any abnormal or suspicious lesions. The biology was limited to a C-reactive protein of 40 mg/L, a white blood cell count of 23 G/L, and a lactate dehydrogenase level of 1705 U/L. The computed tomography scan showed several lymphadenopathies, compression of the superior vena cava, and a tissue mass at the expense of the gluteus maximus. Cervical lymph node biopsy and cytopuncture of the gluteus maximus were consistent with a secondary melanoma location. A stage IV melanoma of unknown primary origin, and with stage TxN3M1c associated with lymph node metastases and extension to the right gluteus maximus, was suggested. Conclusions: Melanoma of unknown primary origin accounts for 3% of diagnosed melanomas. Diagnosis is difficult in the absence of a skin lesion. Patients are diagnosed with multiple metastases. Muscle involvement is unusual and may suggest a benign pathology. In this context, biopsy remains essential for diagnosis. [ABSTRACT FROM AUTHOR] |
| Databáze: |
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