A 56-year-old man underwent wide excision and primary closure for a melanoma of the anterior R thigh (depth unknown) in 1997. He developed local recurrence in 1998 and had another primary excision and direct closure with right groin dissection (3/22 nodes positive. He developed in-transit lesions of the right thigh, and underwent limb perfusion on protocol at the National Institutes of Health (NIH) in July 2000. He had complete resolution of thigh lesions, but 3 months later he was noted to have a left lung lesion consistent with melanoma (not bx'd). Six months later he developed local recurrence at the original site. He underwent immunotherapy trials under protocol, with failure to tolerate treatment, and now has rapid progressive growth with satellite lesions in the anterior right thigh centered around his primary excision site. The goal of surgery at this time is local control, with subsequent pulmonary wedge excision.