Surgical technique for margin widening in the treatment of polypoid nodular malignant back melanoma

• Published in: International journal of surgery case reports Vol. 110; p. 108659
• Main Authors: Navarro-Nuño, Damaris Estefanía, Villarreal-Salgado, José Luis, Grano-González, Víctor Hugo, García-Marín, Gustavo, Nuño-Rodríguez, Víctor Hugo, Torres-Salazar, Quitzia Libertad
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01-09-2023; Elsevier
• Subjects: Case Report; Malignant melanoma; Margin widening; Oncologic surgery; Oncologic surgery; Malignant melanoma; Margin widening
• ISSN: 2210-2612; 2210-2612
• DOI: 10.1016/j.ijscr.2023.108659

Nodular melanoma is the second most frequent cutaneous melanoma worldwide and due to its rapid growth rate and non-malignant appearance, is the most aggressive one. In its polypoid form, it is usually found in mucosal areas, but can also be seen on the trunk. This case is presented because it is an unusual manifestation and surgical treatment required wide excision, however, the patient's evolution is favorable.
70-year-old female patient shows a progressively growing lesion with irregular border, abnormal color and a heterogeneous appearance. The biopsy yields the histological diagnosis of nodular polypoid melanoma. The surgical technique results in the resection of a 10 × 9 × 67 cm piece with favorable evolution of the patient.
The surgical technique of margin widening is considered a recommended option for polypoid nodular back melanomas. Although the excision is considered vast, the patient's evolution may turn out to be favorable.
•Nodular melanoma can appear in any part of the body.•In lesions greater than or equal to a Breslow index of 2 mm, 2 cm excision margins are recommended.•Polypoid nodular melanoma is more common on the trunk and mucosal surfaces; its location in this clinical case is unusual.