Giant cutaneous melanoma presenting with hemorrhagic complications

Lovšin, Klemen (author), Plesničar, Ana (author), Cencelj-Arnež, Romi (author), Matjašič, Alenka (author), Luzar, Boštjan (author)

Giant cutaneous melanoma is a rare presentation characterized by significant morbidity and mortality. We report the case of a 45-year-old male presenting with an acute life-threatening hemorrhage from a giant melanoma on his right thigh. The tumor, measuring 90 × 50 × 85 mm, was immediately excised under local anesthesia to achieve hemostasis. The patient exhibited acute anemia and required postoperative blood transfusion. Histopathological analysis confirmed superficial spreading melanoma with a Breslow thickness of 85.0 mm and extensive ulceration. Genetic testing identified critical mutations, including BRAFV600D and alterations involving the ARID2, CDKN2A/B, AKT3, PTEN, and HRAS genes. Remarkably, no metastatic disease was detected upon thorough diagnostic evaluation. The patient received adjuvant immunotherapy with programmed cell death-1 inhibitors. Six months after the procedure, he remains free of metastasis. This case underscores the urgent need for timely recognition and intervention in giant melanoma with acute complications. It also highlights the effectiveness of modern adjuvant therapies in improving prognosis.

• Language: English
• Keywords: dermatologic surgery, dermatopathology, melanoma, skin cancer
• Work type: Article
• Typology: 1.03 - Other scientific articles
• Organization: MF - Faculty of Medicine
• Publication status: Published
• Publication version: Version of Record
• Year: 2026
• Number of pages: Str. 129-132
• Numbering: Vol. 35, iss. 2
• PID: 20.500.12556/RUL-188592
• UDC: 617
• ISSN on article: 1318-4458
• DOI: 10.15570/actaapa.2026.1
• COBISS.SI-ID: 283158531

Copyright

Na pristajalni strani revije: https://acta-apa.mf.uni-lj.si/submissions.php navedeno, da je članek objavljen z licenco CC BY 4.0: https://creativecommons.org/licenses/by/4.0/.

• Publication date in RUL: 24.09.2026

Record is a part of a journal

• Title: Acta dermatovenerologica Alpina, Panonica et Adriatica
• Shortened title: Acta dermatovenerolog. Alp. Panon. Adriat.
• Publisher: Association of Slovenian Dermatovenerologists
• ISSN: 1318-4458
• COBISS.SI-ID: 31649024

Licences

• License: CC BY 4.0, Creative Commons Attribution 4.0 International
• Link: http://creativecommons.org/licenses/by/4.0/
• Description: This is the standard Creative Commons license that gives others maximum freedom to do what they want with the work as long as they credit the author.