Painful Abdominal Ecchymotic Lesions

Ms. B is a 57-year-old female who had a 1.5 mm Clark level IV amelanotic melanoma removed from her right eyebrow in 1998. She was disease free until September 2001, when she presented with a mass below her left mandible; an open biopsy confirmed the recurrence of melanoma. She also was found to have a 7 mm lung lesion that was positive for melanoma. The treatment plan included both chemotherapy and surgery. Prior to initiating chemotherapy, Ms. B underwent a wedge resection of the metastatic lesion in her lung followed by two cycles of dacarbazine, vinblastine, cisplatin, interleukin, and interferon. After completing the initial two cycles, the left submental mass was removed. She then received two additional cycles of chemotherapy.