A case of uterine metastasis of primary cutaneous malignant melanoma

A 62-year-old female who had noticed a tumor at the back of her head in 2005 visited our hospital after resection at the climic in June 2006 under a diagnosis of malignant melanoma (T4bN0M0, stage II C), which was treated by expanding resection in July 2006. She was treated with DAV-feron chemotherapy three times. During follow-up, in July 2011, laboratory result showed increased 5-S-cysteinyldopa (31.5nmol /1), and an abnormal uptake of PET-CT was shown in the left deep cervical lymph node and in a part of an enlarged uterus. She was observed in the Gynecology Department of our hospital for multiple uterine myomas from July 2010, but magnetic resonance imaging revealed a new solid lesion in the left side of her uterus and enlarged uterine myomas after menopause. The patient underwent a total hysterectomy plus bilateral salpingo-oophorectomy in September 2011. Solid blackish masses were noticed in the myoma, and the final diagnosis was metastasis of malignant melanoma involving a uterine myoma. After she was treated with CDV chemotherapy for a total of three times after surgery, the serum level of 5-S-cysteinyldopa became normal, and the abnormal uptake of PET-CT disappeared completely at both neck and uterus. Although she did not have subjective or objective symptoms such as atypical genital bleeding, metastasis was revealed by increased 5-S-cysteinyldopa levels and diagnostic imaging, and she was successfully treated. In patients with melanoma it is important to pay attention to subjective symptoms and never miss signs of metastasis.