Giant Scalp Metastasis: an Unusual Presentation of Cutaneous Malignant Melanoma

Cutaneous metastases from primary malignant melanoma of the skin are fairly common. However, distant cutaneous metastasis to the scalp is unusual. We present a case of giant scalp metastasis secondary to primary cutaneous nodular malignant melanoma of the heel in the setting of disseminated disease. Majority of melanomas occurring over the feet are acral lentiginous type, nodular melanomas being extremely uncommon. An association of a rare site of primary nodular melanoma with a rare site of metastases makes this case extremely unusual and, hence, worth reporting. Besides the atypical and rare manifestation of a common disease, the main aim of presenting this report is to highlight that scalp metastasis may rarely be the initial presentation of an occult cutaneous melanoma, and in such cases, a thorough head-to-toe cutaneous examination is essential to identify the primary lesion. Although prognosis of metastatic cutaneous melanoma is poor, awareness about the aggressive course of such lesions will assist clinicians in prompt diagnosis and early initiation of palliative treatment options.