DOI: 10.36347/sjams.2019.v07i12.053

Pages: 4094-4097

Metastatic melanoma of unknown primary (MUP) is very uncommon and represents 3% of all melanomas. It is discovered first as a secondary deposit within lymph nodes essentially, subcutaneous tissues, or other organs without a clearly evident site of origin. The main hypothesis is that the primary melanoma undergoes immune-induced reaction after metastatic spread of tumor cells had taken place which involves a spontaneous regression but other theories are possible as well. It occurs mostly in men in their forties or fifties. Lymph nodes are the most common site since it represents 40 to 60%, for women it is the inguinal lymph nodes that are usually involved. Early aggressive surgical excision seems to be the best treatment but adjuvant therapy may also be proposed. Furthermore, in these lymph nodes it is exceptional to witness a granulomatous reaction coexisting with metastatic cells in case of melanoma. We report the case of a metastatic MUP in a 27 young women revealed by a granulomatous lymphadenitis treated with lymphadenectomy and 30 sessions of radiotherapy with no signs of relapse or active disease for three years now.