The incidence of cutaneous melanoma, the most lethal form of skin cancer, is increasing all over the world. Malignant melanoma spreads through hematogenous, lymphagenous path, or by iatrogenic implantations. In this report, we present an unusual case in which a patient experienced the development of melanoma within the split-thickness skin graft donor site on the contralateral lower extremity. Metastases of malignant melanoma occurred in the donor site of the graft, 8 weeks after primary tumor excision, ipsilateral axillary dissection, and reconstruction with a split-thickness skin graft harvested from the contralateral upper thigh. As eight melanoma nodules were seen in donor area, we strongly suspect that spreading of melanoma occurred via a true hematogenous pathway in this case.
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