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Acta stomatologica Croatica, Vol.38 No.4 December 2004. -

We present the case of unusual metastasis of a facial melanoma in a lymph node of the neck, after sixteen years.

A 40-year-old male patient was referred to the oral surgeon because of an enlarged lymph node on the right side, region one. Due to the fact that he had a number of untreated teeth and radiating pain on the right side of the face he was admitted for examination with suspected odontogenic lymphadenitis. From the case history it was learnt that the patient had had an operation for melanoma in the right nasolabial cheek sixteen years previously. An examination revealed a postoperative scar on the right cheek, which was hard and painless, and a lymph node, two centimetres in size in region one, and also several untreated teeth. The patient was first sent for cytopuncture of the node, which showed metastasis of the melanoma. For preoperative preparation radical dissection was performed of the right side of the neck and all teeth extracted which could not be treated. Only one positive lymph node was found In the PHD specimen. The patient was included in the protocol for melanoma and all tests were carried out according to clinical guidelines.

As all findings are presently normal no further therapy is necessary.

The case shows that even in such situations we cannot disregard enlarged lymph nodes of the neck in differential diagnostics.

Author: Irina Filipović-Zore - Aleksandar Milenović - Zoran Ivasović - Jurica Šiljeg -

Source: http://hrcak.srce.hr/


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