Article Text

Rare disease
Amelanotic melanoma presenting with cervical lymphadenopathy
  1. Abhishek Karnwal1,
  2. Edward Hadjihannas2,
  3. Ali Sherif3,
  4. Simon Grumett4,
  5. Sudha Karnwal3,
  6. John Mathews3
  1. 1
    Dudley Group of Hospitals NHS Trust, Flat 92 Kennett House, Bushey Fields Road, Dudley DY12LU, UK
  2. 2
    Dudley Group of Hospitals, Head and Neck Surgery, Pensnett Road, Dudley DY1 2LU, UK
  3. 3
    Dudley Group of Hospitals NHS Trust, Pensnett Road, Dudley DY1 2LU, UK
  4. 4
    New Cross Hospital NHS Trust, Wednesfield Road, Wolverhampton WV10 0QP, UK
  1. Abhishek Karnwal, karnwal{at}


We present a rare case of an amelanotic melanoma of unknown primary presenting with cervical lymphadenopathy. A 20-year-old man presented with large left sided neck lump, associated dysphagia and weight loss. Examination revealed a hard mass in the left posterior triangle of neck and sacral sensory loss. Fine needle aspiration cytology of the mass suggested a poorly differentiated carcinoma. Computed tomography showed a left sided, 8×13 cm cervical mass with liver, lung and bony metastases. Histological examination of the lymph nodal mass confirmed the diagnosis of a metastatic amelanotic melanoma. The patient was treated with glucocorticoids, radiation therapy for the sacral bony deposit, and chemotherapy. Despite an initial reduction of his target lesions, his condition subsequently deteriorated and he died 4 months after diagnosis.

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  • Competing interests: none.

  • Patient consent: Patient/guardian consent was obtained for publication