Metastatic Melanoma presenting 24 years after surgical resection: a case report and review of the literature

INTRODUCTION: Malignant Melanoma is becoming increasingly common. Recurrence is common in, with late recurrence up to 10 years being recognised. We present a case of recurrent metastatic melanoma 24 years after initial presentation, which is the longest interval reported to date. CASE PRESENTATION: EF presented with iron-deficiency anaemia, lethargy, and weight loss. He had an enucleation of his left eye 24 years previously for a uveal melanoma. Endoscopy and biopsy confirmed recurrent duodenal and gastric metastasis. A staging CT demonstrated wide spread thoracic, liver, adrenal and bone metastasis. He was treated with palliative chemotherapy, and died 3 months later. CONCLUSION: Late presentation of metastatic melanoma is common, and should be remembered in patients with a distant history of melanoma. Even, as in our case, if the history is more than two decades previously. Treatment options are poor; earlier recognition may lead to improved survival.