Presentation
Melanoma right hand for staging.
Patient Data
Age: 35 years
Gender: Male
From the case:
Melanoma metastases to axilla and lung
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10.6 x 12.7 x 13.4 cm matted lymph node mass with necrosis in the right axilla encasing and displacing the lateral thoracic artery.
Multiple necrotic lung metastases are variable in size and shape, measuring up to 4.6 x 4.0 cm in the inferior lingular segment abutting the left heart border.
Elevated left hemidiaphragm with asymmetric atrophy of the left crus.
Moderate right pleural effusion.
Case Discussion
The patient had a biopsy-proven melanoma of the palmar surface of the right hand.
Left diaphragmatic paresis is most likely due to the involvement of the left phrenic nerve by the large paracardiac lung metastasis.
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