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Case Reports in Medicine
Volume 2015, Article ID 879460, 4 pages
http://dx.doi.org/10.1155/2015/879460
Case Report

Metastatic Malignant Melanoma of the Inguinal Lymph Node with Unknown Primary Lesion

1Department of Internal Medicine, Monmouth Medical Center, Long Branch, NJ 07740, USA
2Department of Pathology, Monmouth Medical Center, Long Branch, NJ 07740, USA
3Department of Medicine, Cairo University Medical School, Cairo 11562, Egypt
4Department of Oncology, Monmouth Medical Center, Long Branch, NJ 07740, USA

Received 23 December 2014; Accepted 15 January 2015

Academic Editor: Sarkis Meterissian

Copyright © 2015 Sherif Ali Eltawansy et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Malignant melanoma could present with metastasis with unknown primary (MUP) and this happens in 2-3% according to the studies. Around 90% of melanomas have cutaneous origin, but still there are melanomas that could be found in visceral organs or lymph nodes with unknown primary site. Spontaneous regression of the primary site could be an explanation. Case Report. We report a 58-year-old Caucasian male who presented with a right sided swelling in the inguinal region. Surgery was performed and biopsy showed metastatic malignant melanoma. No cutaneous lesions were identified by history or physical examination. Work up could not detect the primary lesion and patient was started on radiotherapy and immunotherapy. Conclusion. We present a case of malignant melanoma of unknown primary presenting in an unusual place which is the inguinal lymph node. Theories try to explain the pathway of development of such tumors and one of the theories mentions that it could be a spontaneous regression of the primary cutaneous lesion. Another theory is that it could be from transformation of aberrant melanocyte within the lymph node. Prognosis is postulated to be better in this case than in melanoma with a known primary.