Bilateral cervical nodal metastasis from unknown primary melanoma: a therapeutic dilemma

Metastatic melanoma with unknown primary [MUP] is a rare presentation. MUP with palpable lymphadenopathy without an identifiable primary or distant metastasis are a subgroup of this rare entity. MUP with nodal involvement most commonly involves axillary lymph nodes followed by inguinal and cervical lymph nodes. Immunohistochemistry (IHC) plays an important role in establishing the diagnosis in these cases. Studies have shown that lymphadenectomy improves survival in these cases. Role of adjuvant radiotherapy as well as chemotherapy remains controversial in view of lack of level 1 evidence. We are presenting a case of MUP involving bilateral submandibular nodes in which one lymph node on each side was completely replaced by melanoma but all other cervical nodes were disease free. Correspondence to: Vishwas. D. Pai, Department of Surgical Oncology, Kerudi Cancer Hospital and Research Centre, Bagalkot 587101, Karnataka, India, Tel: +91-9449333502; E-mail: [email protected]