Tumor conference No. 13. Fatal amelanotic nodular melanoma in a 15-year old girl.

The patient was a 15-year-old girl who was found to have a amelanotic nodular melanoma on a leg. The local malignancy was widely excised and an elective lymph node dissection was performed. On microscopic examination of the removed inguinal lymph nodes, one showed metastatic involvement. She was free of obvious disease for slightly more than one year at which time a subcutaneous metastasis was found on the chest wall. Soon thereafter she suffered dissemination of malignant melanoma and, despite systemic chemotherapy, rapidly deteriorated and died of metastatic melanoma one year later. The salient features of this patient are: (1) the onset of malignant melanoma early in life (age 15); (2) the poorer prognosis of amelanotic melanoma; (3) the often hopeless situation once distant metastases appear.