A Case Of The Incidence Of Nodular Malignant Melanoma And Basal Cell Carcinoma

Objective:In recent years,multiple cutaneous tumor incidence increcsed year byyear.But the malignant melanoma with basal cell carcinoma is rare.Malignantmelanoma is a highly malignant tumor,metastasis,and poor prognosis.Early diagnosis isvery important.Often misdiagnosed as other skin diseases or tumors,delayedtreatment.Occurrence of multiple primary carcinoma is not rare.When the cancer lesionwas found,treatment of cancer,should pay attention to inspection and observation,toavoid misdiagnosis of second primary cancer.Methods：This paper reports a rare case of malignant melanoma and basal cellcarcinoma for treatment in our hospital.This manifested as a front left tibial keratoticnodule.The keratotic nodule was about2.5cm in diameter.The nodule was prominentsurface with black pigment and ulceration in the nodules and edge.And hard nodule wastouched painful,and the surrounding skin irritation.Case: Patient, male,73years old.The patient found one black papules on the leftnose wing. Then slowly increased.In the same year the patient found a black keratoticnodule on the front left lower leg,increased rapidly.The patient came to my outpatientand had a histopathological examination.The facial lesion pathology showed basal cellcarcinoma.The pathology of keratotic nodule on the front of the lower leg showedmalignant melanoma. Laboratory tests: WBC2.9210e9/LNEUT43.60%，LYMPH46.20%，HB121.00g/L，PLT70.0010e9/L.Cancer genetic tests:wild-type gene of c-kit,mutant-type gene of BRAF.Abdominal CT showed:1thechanges of stomach postoperative;.2gallstones;3liver multiple smallcysts.Chest CT showed:multiple small nodules in the lower lobe oflung.Treatment:facial radical resection of basal cell carcinoma;local excision ofmaligant melanoma on the front left lower leg;dissection of inguinal lymph node.Sixmonths later,enhanced chest CT showed:blurred nodules diffused lung. The patientreceived a treatment of DP program (dacarbazine0.4g d1-5+DDP40mg d1-3+Endostar15mg d1-14, Q28d) chemotherapy three weeks.The patient had chemotherapyfor three weeks.One-year follow-up,no new lesions.Conclusion:1.The patient suffered from malignant melanoma and basal cell carcinoma.Theclinical manifestations of the patient with malignant melanoma was not typical,easilymisdiagnosised.The clear diagnosis could be used by pathological biopsy diagnosis2.The patient suffered from cancer,and then consider wether the relationship ofmalignant melanoma and basal cell carcinoma.