Article Text

Unusual presentation of more common disease/injury
Giant cutaneous melanomas: evidence for primary tumour induced dormancy in metastatic sites?
  1. William W Tseng1,
  2. Judy A Doyle2,
  3. Sheilagh Maguiness3,
  4. Andrew E Horvai4,
  5. Mohammed Kashani-Sabet5,
  6. Stanley P L Leong6
  1. 1
    UCSF, Surgery, 513 Parnassus Avenue, S-321, San Francisco, CA 94143-0470, USA
  2. 2
    California Pacific Medical Center, Pathology, 3700 California Street, San Francisco, CA 94118, USA
  3. 3
    UCSF, Dermatology, 1701 Divisadero Street, Box 0316, San Francisco, CA 94115, USA
  4. 4
    UCSF, Pathology, 1600 Divisadero Street, B220, San Francisco, CA 94115, USA
  5. 5
    UCSF, Dermatology, 1600 Divisadero Street, 2nd Floor, Box 1706, San Francisco, CA 94115, USA
  6. 6
    UCSF, Surgery, 1600 Divisadero Street, Box 1674, San Francisco, CA 94143-1674, USA
  1. Stanley Leong, stanley.leong{at}


Two patients with giant, 8 cm and 19 cm melanomas of the upper extremity, respectively, are presented and discussed. Both patients had neglected their tumours and sought medical attention only after the appearance of distressing symptoms (for example, bleeding). Palpable lymph nodes were found on physical examination but no evidence of distant metastases was noted on imaging studies despite such enormous primary tumours. Both patients underwent aggressive treatment, including complete surgical resection of the primary tumour and ipsilateral axillary lymph node dissection. One patient had no evidence of local recurrence, but developed metastatic disease at 6 months follow-up. The other patient developed local recurrence and distant metastases within 2 months of resection.

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  • Competing interests: none.

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