A Hidden Foot Melanoma’s Path to The Inguinal Nodes: Diagnostic Pitfalls and Therapeutic Considerations
Keywords:
Malignant melanoma, Inguinal lymph node metastasis, Lower extremity melanoma, MisdiagnosisAbstract
Malignant melanoma of the lower limb and foot frequently metastasizes to the inguinal lymph nodes, carrying a poor prognosis akin to other tumors with distant spread. Due to patient unawareness, foot melanomas are often misdiagnosed or undetected, delaying diagnosis. In rare instances, the popliteal fossa serves as the initial site of nodal metastasis, with popliteal metastasis rates in lower extremity melanomas ranging from 0.3% to 7%. Concurrent popliteal and inguinal lymph node metastases are exceptionally uncommon. We report the case of a 67-year-old woman presenting with a right inguinal mass, later diagnosed with metastatic malignant melanoma following surgical excision. Further history revealed a prior excision of a lesion on the right sole of the foot without histopathological analysis, suggesting an undiagnosed primary melanoma. This case underscores the diagnostic challenges of foot melanoma and the rare potential for atypical metastatic patterns.
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