title: Melanoma-in-transit presenting as panniculitis.
abstract: Malignant melanoma presenting as an inflammatory skin metastasis has been described but is an exceedingly rare phenomenon. We report an unusual case of a patient who developed right leg lesions that were initially thought to be infectious in origin. There was no resolution of these lesions with antibiotic therapy, and the patient subsequently underwent an incisional biopsy that showed atypical S-100 positive cells within dermal vessels. On further questioning, the patient revealed that 20 years earlier she had a pigmented lesion removed from her right posterior calf. Review of that material revealed malignant melanoma, approximately 3.2 mm in depth. Although the patient was subsequently treated with a right groin lymph node dissection and isolated limb perfusion chemotherapy, she has continued to develop locally recurrent disease. This case is unusual both in terms of clinical presentation and interval of disease progression.
authors.affiliation: Department of Pathology, Indiana University School of Medicine, Indianapolis, USA.
authors.forename: J
authors.initials: J
authors.lastname: Cotton
authors.forename: D J
authors.initials: DJ
authors.lastname: Armstrong
authors.forename: R
authors.initials: R
authors.lastname: Wedig
authors.forename: A F
authors.initials: AF
authors.lastname: Hood
mesh_terms: D000368:Aged; D018906:Antineoplastic Agents, Alkylating / Q000008:administration & dosage / Q000627:therapeutic use; D001706:Biopsy; D010478:Chemotherapy, Cancer, Regional Perfusion; D003937:Diagnosis, Differential; D018450:Disease Progression; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis / Q000473:pathology; D008545:Melanoma / Q000188:drug therapy / Q000473:pathology* / Q000556:secondary / Q000601:surgery; D008558:Melphalan / Q000008:administration & dosage / Q000627:therapeutic use; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D015434:Panniculitis / Q000473:pathology*; D009418:S100 Proteins / Q000032:analysis; D012874:Skin Diseases, Infectious / Q000175:diagnosis; D012878:Skin Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D014746:Vimentin / Q000032:analysis
chemical_list: D018906:Antineoplastic Agents, Alkylating; D009418:S100 Proteins; D014746:Vimentin; D008558:Melphalan