title: It is never too late: ultra-late recurrence of melanoma with distant metastases.
abstract: The authors present the case of a 73-year-old lady presenting with weight loss, personality changes, transient confusion and visual loss, 38 years after initial surgical excision of a melanoma of the neck. CT and MRI of the brain showed cerebral metastases and positron emission tomography (PET)-CT showed an additional fludeoxyglucose avid lesion in the lung, which was biopsied. Histology confirmed metastatic malignant melanoma. She declined whole brain radiotherapy in favour of best supportive care and died 4 months after diagnosis. Life-long vigilance among patients with previous melanoma and awareness among physicians are necessary if late recurrences are to be recognised early, and outcomes improved. New imaging techniques including PET-CT may be helpful in diagnosing and staging melanoma recurrence. Treatment options for patients presenting with distant metastases are limited and the prognosis remains poor.
authors.affiliation: Department of Medicine, University Hospital of North Durham, Durham, UK. dmansour299@yahoo.co.uk
authors.forename: Dina
authors.initials: D
authors.lastname: Mansour
authors.forename: Deepak
authors.initials: D
authors.lastname: Kejariwal
mesh_terms: D000368:Aged; D003937:Diagnosis, Differential; D017809:Fatal Outcome; D005260:Female; D019788:Fluorodeoxyglucose F18; D006258:Head and Neck Neoplasms / Q000473:pathology* / Q000601:surgery; D006801:Humans; D008175:Lung Neoplasms / Q000556:secondary*; D008279:Magnetic Resonance Imaging; D008545:Melanoma / Q000556:secondary* / Q000601:surgery; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D014057:Tomography, X-Ray Computed
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18