A 68-Year-Old Man with Metastatic Melanoma

A CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL by Ryan Sullivan and colleagues.
A 68-year-old man was seen in the cancer center at this hospital because of metastatic melanoma. Eleven years earlier, a superficial spreading melanoma had been excised from the right lower leg. The patient had been well until approximately 5 weeks before presentation. Examination revealed a mass in the right groin, with surrounding erythema. An ultrasound-guided biopsy of a lymph node in the right groin was performed at the other hospital. Pathological examination showed metastatic melanoma.
Masses were present in the right groin and right medial thigh. CT of the chest, abdomen, and pelvis revealed enlarged retroperitoneal, pelvic sidewall, and inguinal lymph nodes on the right side, with the largest lymph node in the right groin.
The diagnostic test in this case was a repeat biopsy of the groin lesion to obtain tissue for genetic testing which was suggest new treatment options for this patient with advanced metastatic disease.