[Malignant melanoma masquerading as a neurotrophic ulcer].
METHODS
A 77-year-old female patient with an ulceration of the heel is described, which was treated over a period of 2 years as a neurotrophic ulcer related to diabetes mellitus. After the initial examination in the outpatient wound healing clinic, a malignant melanoma already showing invasive growth with a penetration depth of 4.6 mm was detected in a biopsy. After diagnosis and exclusion of metastases, a phase-adapted complete excision was carried out. Furthermore, an adjuvant immunotherapy was introduced.


CONCLUSIONS
Malignant melanoma is a primary cutaneous malignant tumor. Its thickness at the time of the initial diagnosis is crucial to the prognosis. Ulcerated and amelanotic melanomas still present a considerable clinical challenge due to the likelihood of being mistaken for benign diseases and the occurrence of filiae when diagnosis is made too late. This case report demonstrates the importance of differential diagnostic consideration of neoplasias, for example malignant melanoma, in cases of unclear, therapy-refractory wounds and discusses the relevant aspects in avoiding an unnecessary prolongation of diagnostics.
Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Essen, Essen.
Larissa
L
Schöttler
Andreas
A
Körber
Natalia
N
Denisjuk
Julia
J
Freise
Joachim
J
Dissemond
D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001706:Biopsy; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D017719:Diabetic Foot / Q000175:diagnosis*; D003928:Diabetic Nephropathies / Q000175:diagnosis*; D003937:Diagnosis, Differential; D005260:Female; D006365:Heel / Q000473:pathology; D006801:Humans; D007372:Interferons / Q000627:therapeutic use; D008545:Melanoma / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology / Q000601:surgery; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011379:Prognosis; D021701:Sentinel Lymph Node Biopsy; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology / Q000601:surgery
D000970:Antineoplastic Agents; D007372:Interferons