Acral lentiginous melanoma

A patient presented with leftLeft big toe mass under the nail, with proven histopathology of acral lentiginous melanoma.

Acral lentiginous melanoma describes theis melanoma of the hands and feet.'Acral' derives from the Greek word 'akra', meaning highest point or extremity. 'Lentiginous' means that the lesion initially appears as a brown macula resembling lentigo, a benign cutaneous lesion composed of melanocytes.

An irregular shapeirregularly-shaped soft tissue lesion was noted in the dorsal aspect of the big toe at the level of the nail bed. It is seen, immediately under the nail bed.Evidence of cortical irregularity and subcortical mild reactive bone marrow oedema seen in in the dorsal aspect of the distal phalanx which shows enhancement after IV contrast administration, indicating involvement of the distal phalanx by the lesion.The extensor tendon attachment intoat the base of the distal phalanx is likely involved.The interphalangeal joint of the big toe seems not to be not involved.The proximal phalanx is clear.The flexor tendon attachment is not definitely involved.These changes are consistent with the patient's known Acralacral lentiginous melanoma.