Silent Spread: Metastatic Melanoma in an Elderly Patient with Cognitive Impairment

Tajala Aman MD¹, Chelsey Arvin DO¹, Folake Ishola MD M.Sc^1, , Muhammad Ulusyar Khan MBBS¹ and Lannie Cation MD FACP¹

¹Department of Internal Medicine, Ascension St. Vincent Hospital Indianapolis, Indiana, USA

Cite this paper:
Tajala Aman MD, Chelsey Arvin DO, Folake Ishola MD M.Sc, Muhammad Ulusyar Khan MBBS and Lannie Cation MD FACP. Silent Spread: Metastatic Melanoma in an Elderly Patient with Cognitive Impairment. American Journal of Medical Case Reports. 2026; 14(4):45-47. doi: 10.12691/ajmcr-14-4-1

Abstract

Malignant melanoma is an aggressive malignancy with a strong propensity for distant metastasis. Although melanoma represents a smaller proportion of total skin cancer diagnoses, it accounts for most skin cancer related deaths in the United States. Cutaneous metastases can be recognized as a manifestation of advanced disease. We report the case of a 75-year-old man with significant comorbidities who presented after recurrent falls and was found to have diffuse subcutaneous nodules. Imaging demonstrated extensive metastatic involvement of multiple organ systems and biopsy confirmed metastatic melanoma. Remote history of a skin lesion excision more than a decade earlier without documented diagnosis or surveillance was later identified. This case underscores the diagnostic significance of cutaneous metastases and the importance of long term follow-up after lesion excisions.

Keywords:
Malignant melanoma Metastatic melanoma Cutaneous metastases Multiorgan metastases Subcutaneous nodules Skin cancer Cancer surveillance Cognitive impairment

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