Clinical Case: Mr. Phillips' Lymph Nodes
 
Symptoms & History

Physical Findings

Stop & Think

Lab and X-Ray

Differential Diagnosis

The Disease

Treatment

Conclusions

Quiz & Evaluation

Mr. Phillips has metastatic malignant melanoma.
  • Even though we didn't see a suspicious lesion on the initial physical, we need to go over him now with a fine tooth comb.
  • Melanomas can arise in places you wouldn't guess.
    • Anal verge skin and/or distal rectal mucosa.
    • Esophageal mucosa.
    • Vaginal mucosa.
    • Conjunctiva, retina even the iris. 
    • Meninges
    • They can be hidden above someone's hair line.
  • And, of course, the lesion he had removed, but wasn't sent for pathology exam, could be our source.
So where do melanomas come from?                 Back
 

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