Abstract
We report a 62-old-man with a red-black tumor leading from melanonychia striata on the tip of his left big toe. There was no nail plate destruction. We diagnosed it as melanoma by excisional biopsy of the tumor. No metastasis had been revealed by CT or PET. We performed wide excision including nail matrix and sentinel lymph node (SLN) biopsy. Confirming extranodal invasion of metastatic melanoma cells in the SLN, we performed ilio-inguinal dissection. Four months later, whole-body metastasis had occurred. Nevertheless, we prescribed intravenous injection of DTIC and intradermal injection of IFNβ three times. We are now prescribing intravenous injection of Docetaxel bi-weekly for the patient. We experienced the rare acral lentiginous melanoma (ALM) case of its own clinical appearance. We must be careful in examining metastasis with extranodal invasion of melanoma cella in SLN, fort the possibility of occult pelvic or whole-body metastasis.[Skin Cancer (Japan) 2014 ; 29 : 313-317]
