The eye of the tiger: Case report of a featureless invasive melanoma disguised within a tattoo with implications for clinical practice (R1)

Raghu Vasanthan MBChB, FRACGP, Cand MMed, Louise Vivien Killen MBBS (Hons), FRCPA, Cliff Rosendahl MBBS, PhD

We present the case of a 59-year-old Australian man with an invasive melanoma within a decorative tattoo of a tiger. The only morphologic clues to malignancy which were present could alternatively be explained by tattoo pigment. The patient has provided written consent for publication of this case report.

The patient with Fitzpatrick skin type II, and a naevus count exceeding 50, presented to his general practitioner for his first skin cancer examination. A lesion noted on his chest was nestled within the blue pigment of a tattoo (Figure 1a). The tattoo had been present for more than a decade, the patient being unable to recall when the skin lesion had first appeared, whether prior to the tattoo or subsequently.

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