Gallegos‑Sierra C, Villarreal‑Salgado JL, García‑Lagarda DJ, Ramos‑Guerrero JA, Cabral‑García G

Language: Spanish
References: 11
Page: 130-136
PDF size: 346.47 Kb.

ABSTRACT

Melanoma, which according to United States statistics, comprises almost 2% of deaths from cancer, may have an unusual morphology, with amelanotic or very small lesions, and therefore present a diagnostic challenge, which is why clinically subtle or hidden melanomas also can be overlooked at the time of skin grafting. We present a case of a 62-year-old female with a nodular tumor of 2 months of evolution in the central area of the skull, with a traumatic history of a burn 18 years ago with reconstruction with a full-thickness graft. Tumor resection was performed with flap rotation and partial thickness graft placement for reconstruction. The definitive histopathological report showed malignant melanoma with Clark V infiltration, and a positive immunohistochemistry. This case describes the appearance of a primary melanoma in situ that evolves within the 18 year old skin graft. The appearance of primary melanoma in the recipient site of a skin graft is an extremely rare event with few cases reported. The relationship between the development of secondary cutaneous melanoma to a partial or total skin graft has been considered viable from three possible main mechanisms: lymphatic, by contamination or hematogenous. We concluded that this clinical case establishes an entity that is uncommon and to some extent rare, but possible. In the case of similar lesions, there must be great suspicion and they should be handled in accordance with the management guidelines. Although it is true, that this case is rare and with few reports, it contributes to the clinical archives and provides a possible diagnosis when a primary or secondary neoplasm occurs on a graft.

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