Very rare surprise during cyst removal surgery, large black “coal like” Melanoma removed. This is a great patient of mine, extremely nice man, who first of all I would like to deeply thank for allowing us to share his procedure and story. He presented post antibiotics for an “inflammatory tender firm nodule on back.” Likely an inflamed cyst. When I did his exam, it did feel and look like a cyst. However, something was a little off to me. 1-The growth was large (4cm), and came up very quickly (less than 2 months). 2- the growth was strangely firm- it didn’t feel like a normal cyst at all, or even a normal calcified cyst. This is where experience is important (why they call it “practicing” medicine). I have felt thousands of cysts and instantly knew something was a little off. We were going to have him back in several weeks for surgery, but I just prepped him and did the surgery right then. I’m glad I did, because everyday Melanoma is left unchecked it becomes more and more dangerous. Obviously the patient has a long road ahead with a larger surgery including sentinel lymph node removal and multiple full body scans but we stay hopeful and positive. I will be giving updates on his progress moving forward. Metastatic Melanoma. Cyst surgery surprise. Black coal nodule deep in the fat tissue. Dermatology excision. Running suture. Dermatology Physician Assistant. MrPopZit.

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