Indurate plaque in an elderly woman
A 76-year-old woman was admitted for 1-month evolving painful indurated
plaques of the right buttock without fever. On physical examination, the
patient had a 10 cm plaque with multiple erythematous nodules (Figure
1). CT-scan showed multiple tumor processes in the lung, stomach with
nodular tissue thickening of the buttock. Biopsy showed subcutaneous
infiltration by a malignant tumor whose morphology and
immunohistochemical staining are matching with cutaneous melanoma (CM).
(Figure 2)
The patient reported a history of surgical excision of a CM located on
the breast two years ago.
Diagnosis of melanoma erysipeloid (ME) was made. Because of the advanced
tumor stage and the limited treatment options in our country, palliative
attitude was recommended.
Malignant melanoma presenting as an inflammatory skin metastasis is an
exceedingly rare phenomenon.1 To our knowledge there
are only 11 reported cases of ME. 2
In our patient, clinical aspect of the lesion, absence of fever and
negative biological findings were suggestive of ME. Differential
diagnosis between erysipelas and ME may be difficult. Histology remains
the main key for diagnosis.2
While cases of ME have been located around the primary tumor, in the
skin overlying regional lymph node metastases 2, our
patient’s location is quite unusual.