Therapy Delayed is Therapy Denied: A Case Report of Melanoma Misdiagnosed as Diabetic Foot Ulcer

Figures & data

Figure 1 Melanoma of right heel. Right heel, with a black, well-defined plaque. There is evidence of bleeding and there is a white fissure stretching from 12 o’clock to the centre of the lesion.

Table 1 Timeline for Tests Done

Date	Event	Comments
16 Dec 2017	Initial patient visit, with biopsy for suspected acral melanoma right foot	18 Dec 2017, histopathology confirms acral lentiginous melanoma
08 Jan 2018	Whole-body CT	Numerous uncalcified micronodules in the lungs (5–8mm diameter)
18 Jan 2018	Lymphoscintigraphy	Multiple sentinel lymph nodes at right inguinal region
23 Jan 2018	Right inguinal node sampling	31 Jan 2018, rare, scattered tumour cells (HMB45, MelanA, PanMelanoma cocktail staining)
02 Mar 2018	Immunohistochemistry	Reactive adenopathy, no tumours
12 Apr 2018	Genetic testing	NO mutations in BRAF gene detected
18 Jul 2018	Whole-body PET-CT	Active areas at right heel, right inguinal area and lungs
18 Jan 2019	CT thorax and abdomen	Pulmonary nodules increased in size and number compared to previous year
23 Mar 2019	PET-CT	Progression of lesions with abdominal and thoracic lymph node involvement, as well as pulmonary and leg and foot bone involvement