Keys To Diagnosing Metastatic Melanoma In The Foot And Ankle

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Christopher Witt, DPM, and Steven Geary, DPM

In Conclusion

Melanoma is the sixth most common cancer in the United States. There will be an estimated 76,250 new cases this year with 9,180 deaths.1 Lesions of the feet and ankle are notoriously misdiagnosed. Without early detection and treatment, survival rates plunge for these patients.

   The patient in our case report was receiving primary treatment from an oncologist. By the time we saw him in the podiatry clinic, palliative care was the only treatment available for his chronic pain. Our patient died one year later. It is of paramount importance to identify these lesions and provide proper treatment as early as possible.

   Dr. Witt is a podiatry resident at the Captain James A. Lovell Federal Health Care Center in North Chicago, IL

   Dr. Geary is a podiatry attending affiliated with the Captain James A. Lovell Federal Health Care Center in North Chicago, IL.


1. American Cancer Society: Cancer Facts and Figures 2012. American Cancer Society, Atlanta, GA, 2012. Available at . Accessed Jan. 23, 2014.
2. Bristow IR, Berker DA, Acland KM, et al. Clinical guidelines for the recognition of melanoma of the foot and nail unit. J Foot Ankle Res. 2010; 3:25.
3. Bates B. Gender differences seen in foot, ankle melanoma. Family Practice News. Available at: Published Nov. 1, 2006. Accessed January 27, 2014.
4. Rashid OM, Schaum JC, Wolfe LG, et al. Prognostic variables and surgical management of foot melanoma: a review of 25-year institutional experience. ISRN Dermatol. 2011; 384729.
5. Fortin PT, Freiberg AA, Rees R, Sondak VK, Johnson TM. Malignant melanoma of the foot and ankle. J Bone Joint Surg Am. 1995; 77(9):1396-1403.
6. Bristow I, Acland K. Acral lentiginous melanoma of the foot and ankle: a case series and review of literature. J Foot Ankle Res. 2008; 15(1):11.
7. Huang KY, Wang CR, Yang RS. Rare clinical experiences for surgical treatment of melanoma with osseous metastases in Taiwan. BMC Musculoskeletal Disorders. 2007; 8:70.

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