Laryngeal metastasis from a thumb melanoma after a 5-year disease-free interval: A case of acute airway presentation and review of the literature

Abstract

Metastatic malignant melanoma to the larynx is an exceptionally rare clinical entity. We report the case of a 55-year-old woman with a history of thumb melanoma treated 5 years prior, who presented with laryngeal dyspnea. Imaging revealed a large, non-enhancing laryngeal mass infiltrating all 3 levels, with thyroid cartilage lysis and an ipsilateral metastatic cervical lymph node. Following emergency tracheotomy, histopathology confirmed metastatic melanoma (HMB-45+, Melan-A+). The patient underwent total laryngectomy with bilateral neck dissection, followed by adjuvant nivolumab immunotherapy. At the 1-year follow-up, she shows no evidence of recurrence with good stoma function and manageable immunotherapy-related fatigue. This case highlights the diagnostic challenges, the potential for aggressive curative treatment in oligometastatic disease, and underscores the need for lifelong surveillance in melanoma patients.