Abstract
A 55-year-old woman presented to her primary physician with the chief complaint of multiple lymphadenopathy in the right axilla. Axillary lymphadenectomy was performed ; however, extensive adhesion to surrounding structures precluded complete excision of the involved nodes. Examination of the excised nodes showed findings consistent with metastasis of malignant melanoma. A thorough preoperative examination detected no primary lesions, and she was referred to our hospital. A total excisional biopsy of a dark brown macula on the inside of the right elbow, which had previously exhibited a blackish brown color, revealed findings consistent with spontaneous regression of malignant melanoma. The finding led to the diagnosis of lymph node metastasis of malignant melanoma originating on the inside of the right elbow. Treatment with dacarbazine, nimustine, cisplatin, and tamoxifen (DAC-Tam) was initiated. After six courses of therapy, radiographic complete remission was achieved, and the minimal residual nodes were excised. Histopathological examination revealed necrotic tumors and scars without viable tumor cells. As of this writing, no recurrence or new metastasis has been noted for 18 months after the start of treatment.
