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Case Records of the Massachusetts General Hospital
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Volume 356:285-292 January 18, 2007 Number 3
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Case 2-2007 — A 49-Year-Old Woman with a Pigmented Lesion on the Arm
John F. Thompson, M.D., F. Stephen Hodi, M.D., and Artur Zembowicz, M.D.

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Presentation of Case

A 49-year-old woman was seen in the outpatient surgical clinic of this hospital because of a diagnosis of melanoma.

The patient had noted a flat, pigmented lesion on her left upper arm approximately 1 year earlier. Three months later, it began to itch and became slightly raised. Approximately 3 months before the current evaluation, the lesion began to bleed when she scratched it. She saw a dermatologist at another facility, who performed a punch biopsy. Pathological examination was reported to show an atypical Spitz tumor; reexcision was recommended. The lesion was reexcised; pathological examination disclosed a superficial, spreading malignant melanoma, . . . [Full Text of this Article]

Pathological Discussion

Pathological Prognostic Factors in Melanoma

Evaluation of Sentinel Lymph Node

Discussion of Management

Surgical Management of Melanoma

            Excision Margins

            Sentinel Lymph-Node Biopsy

            The Role of Sentinel-Node Biopsy in Thin Melanomas

            Complete Lymphadenectomy after Detection of a Positive Sentinel Node

Medical Management of Stage IIIa Melanoma

Interferon Therapy for Melanoma

Pathological Diagnosis


Source Information

From the Sydney Melanoma Unit, Sydney Cancer Centre, Royal Prince Alfred Hospital, Sydney, Australia (J.F.T.); the Department of Medical Oncology, Dana–Farber Cancer Institute, and the Department of Medicine, Brigham and Women's Hospital — both in Boston (F.S.H.); the Department of Pathology, Massachusetts General Hospital, Boston (A.Z.); and the Departments of Medicine (F.S.H.) and Pathology (A.Z.), Harvard Medical School, Boston.




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