Melanoma on the right Hallux: A case report

Abstract

Cutaneous melanoma is a malignant neoplasm originating in the melanocytes of the skin. Primary melanomas are usually darkly pigmented but can be amelanotic, and diagnosis is based on a combination of clinical and histopathological findings. Primary melanoma is treated with a wide excision, with margins determined by tumor thickness. Subsequent treatment depends on the stage of the disease; appropriate surgical management is essential for the diagnosis, staging, and optimal treatment of primary cutaneous melanoma. We present the case of a 68-year-old female patient who, two years prior to admission, suffered trauma with a sharp object (knife) to a mole located on the right hallux. She subsequently developed an ulcerated lesion that progressed in diameter and thickness, accompanied by changes in color toward blackish and reddish tones, in addition to a small amount of blood discharge. Amputation of the right hallux was performed, along with sentinel lymph node and lymph node dissection. The pathological anatomy reported: right hallux: Nodular melanoma with partial ulceration, areas of necrosis and recent hemorrhage, completely resected, Clark level: IV
Breslow: 1.6 mm and lymph node dissection of the external right inguinal group plus deep superior right inguinal lymph node group and medial right inguinal lymph node group, respectively: lymph nodes due to known primary melanoma. The patient was discharged due to satisfactory clinical evolution.