Resumen

FLEITAS GOIRIZ, Braulio Mauricio et al. Cutaneous melanoma with lymph node involvement. Rev. virtual Soc. Parag. Med. Int. [online]. 2026, vol.13, n.1, e13142605.  Epub 18-Feb-2026. ISSN 2312-3893.  https://doi.org/10.18004/rvspmi/2312-3893/2026.e13142605.

Between 9-10% of melanomas present with regional lymph node involvement, and the primary tumor may go unnoticed. Whole-body skin examination and dermatoscopy allow for the detection of subtle primary melanomas, while staging according to the 8th edition of the AJCC guidelines guides specific treatment. We present the case of a 56-year-old man with a rapidly growing, initially painless mass in his right axilla that had been present for three months. He also had a tumor on his right arm that had been present for a year, which he considered trivial.

After dermatological evaluation, an excisional biopsy was performed on the tumor on his right arm. Histopathology, both lymph node and tumor, and imaging staging confirmed the diagnosis of ulcerated nodular melanoma with lymph node involvement (stage IIIB), and adjuvant anti-PD-1 immunotherapy was initiated. This case highlights the diagnostic sequence and active search for the primary tumor.

Palabras clave : melanoma; dermatoscopy; biopsy; lymphatic metastasis.

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