Case Report: Melanoma – the black Chameleon

A 38-year-old Patient was introduced with a since one year progressively growing indolent tumor on the left temporal side, without any visible skin lesion and without any dysfunction of the facial nerve. The MRI-Examination showed an expanding mass of a maximum size of 55 × 44 mm, growing beneath the deep temporal fascia to the lateral orbital wall, over and beneath the zygomatic arch to the masseter muscle. In the CT-Scan a thinned cranial part of the zygomatic arch and also a narrowed lateral orbital wall, at the same level as the tumor, was shown. Altogether there was no sign of an osseous infiltration. The initially taken sample of the tumor tissue didn't provide the final diagnosis, whereupon an excision of the whole tumor followed. This time a hyperpigmented spindle-cell malignant Melanoma, which most likely developed on the ground of a blue nevus, with infiltration of fat/connective and muscle tissue has been proven. In the as part of staging completed PET-CT-Scan no lokal or distant metastasis was found. Three months after the intervention a residual tumor was seen via MRI-Scan and removed in the following surgery. Simultaneously a lateral parotidectomy and a selective left-sided Neck dissection (3 Levels) were carried out. The surgery was followed by an adjuvant Radiotherapy. Due to the untypical location of the Melanoma and the lack of any skin lesion the standard clinical classification couldn't be applied. One year passed since the patient has been diagnosed and he's being closely monitored, including diagnostic imaging.

Publication History

Publication Date:
18 April 2018 (online)