A 55-year-old Japanese male consulted our clinic complaining of a large tumor on his left ankle. The tumor was black colored with papillomatous proliferation and sized 15×18×12cm. Histopathologically the tumor was identified as malignant melanoma. Plasma serum 5-S-CD level was as high as 99.7nM/L. Based on the large inguinal lymphadenopathy and paraaortic nodal metastasis by CT, the patient was diagnosed as having malignant melanoma pT4a, bN2Mla. After surgical removal of the primary tumor, he was treated with lesional IFN-gamma, OK-432 and nodal irradiation followed by 4 courses of DAC-Tam combination chemotherapy. The tumors responded remarkably. The patient has been tumor free for more than 15 months without elevation of serum 5-S-CD level. [Skin Cancer (Japan) 2002; 17: 274-278]
