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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We present the case of a 79-year-old man with a history of colon adenocarcinoma&#46; The patient consulted for a lesion on the back that appeared a year ago&#44; which had grown and bled&#46; The physical examination revealed a blackish swelling measuring 2&#46;5<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>3&#46;5<span class="elsevierStyleHsp" style=""></span>cm on the back &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>a&#41;&#44; as well as numerous surrounding bluish satellite lesions and skin infiltration &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>b&#41;&#46; Adjacent to the main swelling&#44; we palpated a subcutaneous nodule with a normal skin color&#46; There was no clinical evidence of axillary adenopathies&#46; A skin biopsy of the nodule revealed intraepidermal melanocytic proliferation&#44; with irregular and convergent thecal groups &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>c&#41;&#46; The invasive component consisted of cell masses that dissected the dermal collagen throughout its thickness&#46; The melanocytes had epithelioid and fusocellular morphology&#44; with a high degree of cytoplasmic pigmentation&#46; The maximum thickness &#40;Breslow index&#41; was 5<span class="elsevierStyleHsp" style=""></span>mm&#46; We also observed extensive mitosis and ulceration but no signs of vascular invasion or regression&#46; The extension study using brain and chest-abdomen-pelvis computed tomography showed adenopathies in the left axilla&#44; with irregular contours due to capsular infiltration and a subcutaneous node of pathological appearance&#44; with a hypodense area of central necrosis &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>d&#41;&#46; Extirpation was performed with extensive margins of the main lesion and satellitosis&#46; Selective sentinel node biopsy was not performed because we did not consider it indicated&#46; After 6 months&#44; the patient showed rapid disease progression and died due to hepatic and brain metastases&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span>"
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Medicine in Images
DOI: 10.1016/j.rceng.2018.03.019
Aggressive animal-type melanoma in a 79-year-old man
Melanoma agresivo tipo animal en varón de 79 años
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A. Robledo-Sánchez
Corresponding author
robledosanchezaitana@gmail.com

Corresponding author.
, C. Delgado Mucientes, P. Manchado López
Servicio de Dermatología, Hospital Clínico Universitario de Valladolid, Valladolid, Spain

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