A 10-year recurrence-free natural course of high-risk stage II cutaneous melanoma: A case report

Background

pT4b melanoma of the skin, especially the nodular subtype with present ulceration, typically entails a poor prognosis with high risk for metastatic spread. The accuracy of classic risk prediction models lacks at times. When situated in the face, these malignancies can pose a specific challenge to reconstructive surgeons. Profound fears of cancer treatment further complicate the management of these cases.

Case presentation

We present a case of facial reconstruction in a 58-year-old female patient with a high-risk stage II melanoma with recurrence-free survival (RFS) despite an almost 10-year delay of surgical treatment due to existential fears.

Conclusions

The presented case provides several key takeaways. First, from a dermatological standpoint, clinicians must expect the unexpected and should look for explanations. Second, from a reconstructive view, complex cases are rarely linear—staged revisions, and setbacks are integral to surgical success. Finally, from a human perspective, sincere empathy, and emotional intelligence are indispensable.