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Case Report: Acral Melanoma with Giant Local Recurrence in Rural Sierra Leone

Harry PutnamMasanga Hospital, Masanga, Tonkolili District, Sierra Leone;
Masanga Medical Research Unit (MMRU), Masanga, Tonkolili District, Sierra Leone;

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Alexandra TurnbullMasanga Hospital, Masanga, Tonkolili District, Sierra Leone;
Masanga Medical Research Unit (MMRU), Masanga, Tonkolili District, Sierra Leone;

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James BanguraMasanga Hospital, Masanga, Tonkolili District, Sierra Leone;
Masanga Medical Research Unit (MMRU), Masanga, Tonkolili District, Sierra Leone;

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Panagiota KitsantaHistopathology Department, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom;

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Martin P. GrobuschMasanga Medical Research Unit (MMRU), Masanga, Tonkolili District, Sierra Leone;
Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Amsterdam University Medical Centers, Amsterdam Infection & Immunity, Amsterdam Public Health, University of Amsterdam, Amsterdam, The Netherlands

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Jan H. DubbinkMasanga Hospital, Masanga, Tonkolili District, Sierra Leone;
Masanga Medical Research Unit (MMRU), Masanga, Tonkolili District, Sierra Leone;
Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Amsterdam University Medical Centers, Amsterdam Infection & Immunity, Amsterdam Public Health, University of Amsterdam, Amsterdam, The Netherlands

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ABSTRACT.

Malignant melanoma is rare in West Africa. Few cases of giant melanoma have been reported globally. We present a case of acral melanoma with giant local recurrence on the foot of a black-skinned woman from rural Sierra Leone, managed with below-knee amputation. Atypical, late presentation, poor access to diagnostics, and underreporting may contribute to underappreciation of melanoma as a healthcare problem in West Africa. This case highlights the need for improved cancer and skin health surveillance structures in West Africa—most importantly, increasing access to histopathology.

Author Notes

Address correspondence to Harry Putnam, 140/2 Dundas Street, Edinburgh, United Kingdom, EH3 5DQ. E-mail: putnamhwi@gmail.com

Authors’ addresses: Harry Putnam, Alexandra Turnbull, James Bangura, and Jan Henk Dubbink, Masanga Medical Research Unit, Masanga Hospital, Tonkolili District, Sierra Leone, E-mails: putnamhwi@gmail.com, alexandraturnbull2@gmail.com, jashebangs@gmail.com, and janhenkdubbink@gmail.com. Panagiota Kitsanta, Histopathology Department, Royal Hallamshire Hospital, Sheffield, United Kingdom, E-mail: panagiota.kitsanta@nhs.net. Martin P. Grobusch, Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Amsterdam University Medical Centers, Amsterdam, The Netherlands, E-mail: m.p.grobusch@amsterdamumc.nl.

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