Prolonged survival in a patient with metastatic malignant melanoma.

We report the case of a young,woman initially treated with surgery, radioth erapy, chemotherapy and BCG therapy Sol stage II malignant melanoma involvi ng the li,nbs. Considering that the risk of metastasis is usually maximal b etween 2 and 5 years after initial treatment, metastatic dissemination of t his,melanoma was rather unusual. Metastases were observed locally, regional ly, and irt the lungs 8, 10 and 12 years respectively after the primary dia gnosis. Repeat surgery was performed to resect pulmonary nodules. Such surg ery is possible in less than 10% of the cases of,metastatic melanoma. Our patient has survived without relapse for 2 years after the initial diag nosis and 8 years after the last tumor excision. Recurrent pulmonary metastasis without extrapulmonary dissemination would s uggest the tumor cell population was composed of a particular metastatic ph enotype.