Late metastases of cutaneous melanoma: case report and literature review. The development of delayed metastases, although rare, is well documented in patients with invasive cutaneous melanoma. Only 24 cases, including ours, are clearly documented in the literature. We describe a 56-year-old woman who had an acral lentiginous melanoma of the right hand (thickness 1.2 mm). Thirteen years after excision and postoperative irradiation, a subcutaneous metastasis developed in the right arm. One year later the patient died with disseminated bone metastases. This case, as with most of those with delayed metastases, has typical features: female sex; location at a site other than the back, arm, neck, or scalp; and primary tumor thickness between 1.2 and 2.5 mm. 