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Recurrence of malignant melanoma after 45 years

Malignant melanoma shows the highest rate of metastasis among all cutaneous malignancies and is responsible for more than 90 % of skin tumor-related deaths. However, late metastasis after more than ten years is generally considered a rare event. We present the case of an 82-year-old woman who developed a satellite metastasis on the lower leg after 45 years in remission. In 1967, the patient (37 years old at the time) was diagnosed with melanoma of the right lower leg. The hospital's patient file described an oozing, pigmented lesion the size of a cherry pit, which was resected in May of 1967 and histologically diagnosed as malignant melanoma. Further histologic characteristics of the primary tumor could not be ascertained. In September 1967, the patient received radiation therapy (Chaoul therapy and cobalt-60) of the primary tumor region. In January 1968, she underwent radical re-excision of the previously irradiated area and elective right inguinal lymph node dissection. Here, histopathology did not reveal any signs of metastasis. In November 1968, the patient was also diagnosed with stage 1 medullary seminoma of the right ovary, which was resected and subsequently irradiated. Clinical Letter