Case discussion: How would you treat this patient? [14 October]
This week we have another engaging case. A 75-year-old Caucasian Australian male with a past history of solar keratosis and no previous melanoma or significant personal or family history of melanoma. Previously, he worked only indoors. The patient presented for opinion on a darker area of change in an existing “freckle” on his neck that was present for several years.
How would you respond to this presentation?
How would you manage a patient with these findings? Please share your feedback.
SYNOPTIC REPORT FOR MALIGNANT MELANOMA
Diagnosis: Invasive malignant melanoma Site: Right mid neck Subtype: Superficial spreading Margin status: Involved Tumour Thickness (Breslow): 0.7mm Clark level: 3 Ulceration: Absent Mitotic count: 1/mm² Microsatellites: Not identified Perineural invasion: Not identified Lymphovascular invasion: Not identified Regression: – Early (TILS): Minimal (non-brisk) – Late (Fibrosis): Absent Associated benign naevus: Not identified Excision Margins: – Peripheral invasive: 1.5mm – Peripheral in-situ: Involved – Deep: Tumour focally abuts the deep margin.
We encourage you to participate in the case discussions and submit your own clinical images and questions, so we can all learn together.