A Case of Metastatic Melanoma in a Female Patient with Vitiligo

Abstract

Patients with metastatic melanoma occasionally develop de novo hypopigmentation, pathologically indistinguishable from Sutton's nevus and common vitiligo, respectively. The case of a 68-year-old female with vitiligo of 2 years of evolution is documented, presenting a left inguinal mass and a para-aortic lymph node conglomerate. In the left inguinal region, a ganglion with thickened cortex and liquid content was identified. The laboratory results report hemoglobin of 8.30 g/dL, leukocytes 19.12 u/L, albumin 2.2 mg/dl, DHL 1222 Ul/L, alpha-fetoprotein 2 ng/ml, Ca-125 14.30 U/ml, Ca-19.9 8.60 U/ml and carcinoembryonic antigen of 2.14 ng/ml. Upon inspection, hypochromic, bilateral, and symmetrical lesions can be seen on the back of the hands, wrists, scalp, facial region, and neck. Biopsy showing malignant metastatic melanoma is performed. Starting management with Pembrolizumab 1 mg/kg every 21 days. Currently in follow-up and adjuvant treatment. Melanoma is the most aggressive form of skin cancer. The association of malignant melanoma with de novo hypopigmentation has been found, synchronously or following the diagnosis of the tumor. In recent years, it has led to the development of monoclonal antibodies. However, its diagnosis has implications for life prognosis due to high mortality.