PMC3975206_01
Clinical feature from 14 years ago. A black mole on the fifth toe of the left foot. A diagnosis of malignant melanoma in situ was made.
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F1
His medical history included hypertension, diabetes, and malignant melanoma that was surgically removed (fifth toe amputation) at our department 14 years ago (fig. 1).
Clinical feature at the time of re-examination. a A skin ulcer measuring 25 x 20 mm is located on the amputated surface of the fifth toe of the left foot. b Multiple red nodules on the anterior surface of the lower left leg.
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F2
At the amputation site on the left foot, there was a skin ulcer measuring 25 x 20 mm with several red nodules, primarily on the anterior surface of the lower left leg (fig. 2).
Histopathology (HE stain). a Skin ulcer on the foot. b Nodules on the lower leg. Tumor cells with eosinophilic cytoplasm and medium-to-large nuclei with distinct nucleoli extend through all layers of the dermis and into some fatty tissue. The tumor comprises an alveolar structure and solid proliferative areas.
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F3
The tumor comprised an alveolar structure and had a solid proliferative area (fig. 3).
Clinical feature after 26 weeks. a The skin ulcer on the amputated surface of the fifth toe of the left foot has healed. b The red nodules on the lower left leg have disappeared, and only pigmentation can be observed.
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F4
Twenty-six weeks later, the skin ulcer on the fifth toe of the left foot was cured, the nodes on the left leg had disappeared, and only pigmentation was observed (fig. 4).
Clinical feature at 1 year and 9 months. a There is no local recurrence on the fifth toe of the left foot. b The pigmentation on the lower left leg has lightened.
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F5
The patient's progress has been satisfactory, with no evidence of recurrence or metastasis at 1 year and 9 months after treatment (fig. 5).