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Reminder of important clinical lesson
It is never too late: ultra-late recurrence of melanoma with distant metastases
  1. Dina Mansour,
  2. Deepak Kejariwal
  1. Department of Medicine, University Hospital of North Durham, Durham, UK
  1. Correspondence to Dr Dina Mansour, dmansour299{at}


The authors present the case of a 73-year-old lady presenting with weight loss, personality changes, transient confusion and visual loss, 38 years after initial surgical excision of a melanoma of the neck. CT and MRI of the brain showed cerebral metastases and positron emission tomography (PET)-CT showed an additional fludeoxyglucose avid lesion in the lung, which was biopsied. Histology confirmed metastatic malignant melanoma. She declined whole brain radiotherapy in favour of best supportive care and died 4 months after diagnosis. Life-long vigilance among patients with previous melanoma and awareness among physicians are necessary if late recurrences are to be recognised early, and outcomes improved. New imaging techniques including PET-CT may be helpful in diagnosing and staging melanoma recurrence. Treatment options for patients presenting with distant metastases are limited and the prognosis remains poor.

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  • Competing interests None.

  • Patient consent Obtained.

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