What is the likelihood of metastatic melanoma in a 31-year-old woman with a history of a benign-appearing mole on her abdomen, now with new darker spots and spreading, accompanied by lymphadenopathy (enlarged lymph nodes) in the neck, elbow, and axilla (armpit), and symptoms of night sweats and anxiety?

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Differential Diagnosis

  • Single Most Likely Diagnosis
    • Metastatic melanoma: This diagnosis is likely due to the patient's history of a mole with recent changes, including darker spots and spreading, which are concerning features for melanoma. The presence of palpable lymph nodes in the neck, elbow, and armpit, particularly on the left side, suggests possible metastasis. The patient's anxiety and panic attack are also relevant, as a diagnosis of metastatic melanoma would be a significant and life-altering event.
  • Other Likely Diagnoses
    • Lymphoma: The presence of palpable lymph nodes in multiple areas, including the neck, elbow, and armpit, could suggest lymphoma, a type of blood cancer that affects the immune system.
    • Infectious or inflammatory conditions (e.g., tuberculosis, sarcoidosis): These conditions can cause lymphadenopathy (enlarged lymph nodes) and systemic symptoms like night sweats.
    • Autoimmune disorders (e.g., rheumatoid arthritis, lupus): These conditions can cause lymphadenopathy, skin changes, and systemic symptoms like fatigue and anxiety.
  • Do Not Miss Diagnoses
    • Hodgkin lymphoma: This type of lymphoma is more common in young adults and can present with lymphadenopathy, night sweats, and weight loss.
    • Tuberculosis: This infectious disease can cause lymphadenopathy, night sweats, and systemic symptoms, and can be deadly if left untreated.
    • Sarcoidosis: This inflammatory condition can cause lymphadenopathy, skin changes, and systemic symptoms, and can be life-threatening if not properly managed.
  • Rare Diagnoses
    • Leukemia: This type of blood cancer can cause lymphadenopathy, fatigue, and systemic symptoms, but is less likely in this patient without other specific symptoms like bruising or bleeding.
    • Kaposi's sarcoma: This rare cancer can cause skin lesions and lymphadenopathy, but is typically associated with immunosuppression or HIV infection.
    • Angiosarcoma: This rare and aggressive cancer can cause skin lesions and lymphadenopathy, but is less likely in this patient without other specific symptoms like bleeding or ulceration.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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