Tonsil metastasis from cutaneous melanoma: first clinical sign of recurrence after complete lymph node dissection.
BACKGROUND
The development of melanoma metastasis to the palatine tonsil is a very rare event, generally associated with advanced-stage disease and poor prognosis.


METHODS
A 29-year-old man presented with a melanoma metastasis to the right palatine tonsil 6 months after the surgical excision of an ulcerated nodular melanoma (tumor thickness 1.8 mm, Clark level IV) on the left shoulder. A metastatic sentinel lymph node had been removed from the left axilla, and a subsequent complete lymph node dissection had disclosed no further metastatic lymph nodes. Although staging tests had revealed multiple visceral metastases, a palliative tonsillectomy was performed. The patient died of metastases 5 months later.


CONCLUSIONS
The case presentation suggests that careful examination of the head and neck should be part of the routine follow-up visit in all melanoma patients.
Department of Dermatology, Pistoia Hospital, Pistoia, Italy. r.cecchi@usl3.toscana.it
Roberto
R
Cecchi
Mario
M
Pavesi
Pierantonio
P
Calamandrei
Valentina
V
Rapicano
Cataldo
C
De Gaudio
D000328:Adult; D017809:Fatal Outcome; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008545:Melanoma / Q000556:secondary* / Q000601:surgery; D009364:Neoplasm Recurrence, Local; D012878:Skin Neoplasms / Q000473:pathology* / Q000601:surgery; D014067:Tonsillar Neoplasms / Q000556:secondary* / Q000601:surgery; D014068:Tonsillectomy