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Image Number 4929 (Melanoma)

 
Morphology:
Papules,black

Diagnosis: Melanoma

Site: Cheek

Sex: M

Age: 90

Type:

Description: Blue black papules cheek

Submitted by: Ian McColl

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Differential Diagnosis

History:

 This elderly gentleman had a long standing lentigo maligna on his cheek but developed a reactive clone of malignant melanocytes which invaded the local lymphatics to give this intransit spread. PET scans were negative for metastases elsewhere and he was treated with Keytruda a PD1 inhibitor drug with an excellent response.

See this reference for Side effects of Checkpoint Inhibitor Drugs



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