Metástase axilar como apresentação de melanoma oculto: relato de caso

Abstract

Objective: To report a case of metastatic axillary lymph node enlargement as a presentation of hidden melanoma diagnosed in a patient at Hospital Universitário Walter Cantidio (HUWC-UFC) in 2017. Methodology: The patient’s medical file service was retrieved at the HUWC Medical Archives Service, where the patient was attended in an Oncology Surgery Outpatient Clinic, and a tumor resection under armpit surgery performed. We began a bibliographical research of the national and international literature, covering case reports, case studies, review articles written in the English, Portuguese and Spanish languages. Results:Patient, 60 years old, female, arrived at the HUWC oncological surgery clinic with right axillary lymph node enlargement, painful, approximately 10 cm in diameter, with 6 months of evolution. It brings histopathological results from March 2017 showing metastatic axillary lymphadenectomy with signet ring cells. Immunohistochemistry without changes that directed the diagnosis. Investigated and ruled out gastric neoplasia. Chemotherapy was started for breast cancer with no adequate response. Requested immunohistochemical review that now demonstrates positivity for Mel-CAM. Excision of right axillary lymphadenopathy was performed with surgical margins. Conclusions: we have a frequency of 3.2% metastatic melanoma with occult primary tumor, being relevant and necessary case reports for constant discussion of this topic.