Epithelioid cell malignant melanoma of the nail-bed of the lower limb: case report

Malignant melanoma take origin from melanocytes of the skin and of the mucous membranes. Authors report the case of a 69 years-old man with a tumefaction of the left first toe. After a few exams, the patient underwent incisional biopsy and had diagnosis of epithelioid cell malignant melanoma. In Day Hospital he underwent bone scintigrafhy and lynfoscintigrafhy. In Day Surgery he underwent disjointing of the left first toe and inguinal sentinel lymph node removal. The extemporary histological exam considered the lymph node free of metastases. Four months after surgery, the patient was in very good general and topic conditions. The therapeutic approach to bednail melanoma consists in surgical removal of the lesion with excision margins of almost 2 cm, and sentinel lymph node removal at the same time. Lymphoscintigraphy and gamma-probe are a very accurate, rapid and safe method to localize the sentinel lymph node. Authors’ experience shows that also complex diagnostic and therapeutic procedure, following actual oncological guidelines, may be performed in Day Hospital, reducing cost and improving patients’ compliance.