Sentinel bruising as a presentation of metastatic melanoma.

BMJ Case Reports
Lloyd Steele, Chit Cheng Yeoh

Abstract

A 46-year-old man presented with a 4-week history of bruising with subcutaneous nodules and weight loss. He also had a 2-week history of progressive back and hip pain. He had been diagnosed with stage Ib cutaneous melanoma 30 months previously, which had been fully excised. A sentinel lymph node biopsy was negative. On examination, there were five skin lesions at different stages. Each had spontaneously appeared as a bruise with a central subcutaneous nodule, and the bruising then faded to leave a persistent subcutaneous nodule. Excision of one of the nodules demonstrated a 4.5 mm diameter partly necrotic melanoma deposit in the dermis. CT scan of the head, chest, abdomen and pelvis showed widespread metastases. This rare presentation of cutaneous malignant melanoma metastases has been termed 'sentinel bruising'. There are fewer than 10 cases reported in the literature.

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Citations

Mar 18, 2020·Skin Research and Technology : Official Journal of International Society for Bioengineering and the Skin (ISBS) [and] International Society for Digital Imaging of Skin (ISDIS) [and] International Society for Skin Imaging (ISSI)·Flavio Giulio LisoElisa Cinotti

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