An 85-year-old woman presented with an unusual metastatic melanoma that recurred as ecchymotic areas overlying numerous subcutaneous nodules and had twice completely resolved under treatment with chemotherapy. The course of additional recurrences, treatment, and outcome are summarized in the Table.
The pathology specimen for the first melanoma in 1986 could not be retrieved for review, but the second primary melanoma and recurrences were reviewed. Biopsy specimens of the subcutaneous nodules with overlying ecchymoses revealed highly vascular disease on histopathologic analysis (Figure) and displayed characteristics consistent with recurrent melanoma.
William Kelly DeHart, Anita C. Gilliam, Kurt Q. Lu, Joanna Brell. A Rare Case of Melanoma Recurring as Subcutaneous Metastatic Melanoma With Overlying Ecchymoses. Arch Dermatol. 2008;144(4):561–562. doi:10.1001/archderm.144.4.561