A 45-year-old HIV-negative Caucasian man with
no reported past medical history was referred to our
Department with a large (7 cm in diameter) oozing
nodule on the occipital region of the scalp with spontaneous
periodical bloody or purulent discharge.
The lesion had appeared over a period of six months,
had an irregular color, non-specific dermoscopic features,
and resembled squamous cell carcinoma. The
physical examination revealed three more atypical
melanocytic lesions (on the abdomen, back, and buccal
mucosa), and multiple swollen occipital, postauricular,
as well as superficial and deep cervical lymph
nodes. After clinical evaluation, the patient reported
having another in situ melanoma (submammary region)
excised 7 years ago. All the lesions were excised
and sent for histopathologic examination, which was
compatible with primary cutaneous melanoma. Total
body computed tomography revealed the presence
of multiple visceral metastases, and the patient was
referred to an oncologist. He did not consent to proceed
to genetic testing
