Atypical presentation of a giant melanoma of the vertex: A case report

Abstract

We report the case of an 82-year-old female patient with a history of hypertension and a pacemaker, who presented to the emergency department with a large scalp tumor evolving over 9 months. Clinical examination revealed a painful, ulcerative, and exophytic tumor on the left parietal scalp, bleeding on contact, surrounded by satellite nodules and associated with peripheral lymphadenopathy. Dermoscopic examination and skin biopsy confirmed the diagnosis of invasive nodular melanoma. The extension workup revealed regional lymph node involvement without distant metastasis. The patient was referred to the oncology department for specialized management. This represents an extensive scalp melanoma with in-transit metastases. This case highlights the importance of dermatological evaluation for any chronic skin lesion that is resistant to treatment and increasing in size, in order to allow early diagnosis and timely management.