Medical Imaging Analysis Report

I. Imaging Findings

Based on the provided ultrasound and color Doppler images, a relatively distinct nodular or raised lesion can be observed in the local area of the skin and subcutaneous tissue. The specific characteristics include:

• On grayscale ultrasound images, the lesion appears slightly hyperechoic or mixed in echogenicity, with a boundary that differs somewhat from the surrounding tissue.
• Color Doppler shows blood flow signals within the lesion, indicating a certain degree of vascular distribution and suggesting a definite blood supply.
• The clinically described maximum diameter is about 2 cm, while histologically the tumor thickness (Breslow index) measures 2 mm.
• Ultrasound may overestimate tumor thickness to some extent, particularly in cases where a malignant lesion develops from an existing pigmented nevus (nevus cells).

II. Potential Diagnosis

Considering the patient’s age (51 years), the suspicious clinical lesion (a 2 cm skin lesion), and the abundant blood flow indicated by ultrasound-color Doppler, the main possible diagnoses or differential diagnoses include:

1. Malignant Melanoma (Melanoma): Patients often present with skin lesions that have uneven coloration, unclear boundaries, or abnormal raised areas. These lesions typically show rich blood flow. A pathological Breslow index of 2 mm supports the diagnosis of malignancy.
2. Pigmented Nevus (Naevus) or Atypical Nevus (Dysplastic Naevus): If morphological changes and abnormal blood flow appear on a pre-existing nevus, it needs to be differentiated from melanoma. However, the pathological examination suggesting a tumorous change makes a simple nevus less likely.
3. Other Pigmented Skin Tumors (such as pigmented basal cell carcinoma): They can also show increased blood supply on ultrasound, but their clinical presentation and histopathology differ significantly from melanoma, making them a secondary possibility.

III. Final Diagnosis

Based on the following factors:

• The patient is 51 years old and the lesion appears suspicious.
• Histopathological results indicate a Breslow index of 2 mm, consistent with the morphology and depth of malignant melanoma.
• Color Doppler shows evident tumor blood supply.

Based on this analysis, the most likely diagnosis is: Malignant Melanoma (Melanoma).
The actual diagnosis should still rely on the patient’s complete medical history, pathological findings, and surgical evaluation. If there is any doubt, further staging assessments such as lymph node ultrasound or other imaging evaluations can be considered to assess possible tumor dissemination.

IV. Treatment Plan and Rehabilitation Program

1. Treatment Strategy

• Surgical Excision: For a confirmed malignant melanoma, the primary treatment is surgery. According to French consensus, a Breslow index of 2 mm corresponds to at least a 2 cm safety margin (i.e., ensure a 2 cm margin of normal tissue when performing wide excision).
• Adjuvant Therapy: Depending on the staging and surgical margins, interferon or immunotherapy (e.g., PD-1 inhibitors) can be considered, but this decision should be made in conjunction with detailed clinical and pathological staging.
• Additional Assessments: A sentinel lymph node biopsy (SLNB) can be performed to evaluate potential metastatic risk, especially for patients with a Breslow thickness > 1 mm, which is routinely considered.

2. Rehabilitation and Exercise Prescription

For postoperative rehabilitation and physical/emotional adjustment, it is important to take into account the surgical wound healing, the location of the lesion, and the overall health status of the patient. The principle is a gradual and individualized approach:

• Early Stage (Postoperative Recovery):
  • Avoid excessive pulling on the surgical wound and inappropriate weight bearing to protect the incision.
  • Engage in basic physical activities such as indoor walking and simple stretching exercises at a comfortable range.
  • Frequency: 2-3 times a day, with 5-10 minutes of mild activity each session, keeping the wound dry and clean.
• Mid Stage (After the Incision Stabilizes):
  • Once the wound has healed well and does not hinder functional movement, gradually increase lower-limb and whole-body training (depending on the incision site).
  • Light to moderate intensity aerobic exercise is recommended, such as walking for 20-30 minutes, combined with mild muscle-strengthening exercises (using resistance bands or simple bodyweight resistance).
  • Frequency: 3-5 times per week, 20-30 minutes each session, increasing gradually based on tolerance.
• Late Stage (Functional Recovery and Maintenance):
  • Provided there are no signs of increased risk of tumor recurrence and with physician approval, higher-intensity aerobic activities (jogging, elliptical, cycling, etc.) may be introduced, and resistance training load can be gradually increased.
  • Generally follow the FITT-VP principle (Frequency, Intensity, Time, Type, Volume, Progression) within safe limits and steadily improve.
  • Include lower or upper limb resistance training (dumbbells or resistance bands) to enhance strength and endurance.
• Precautions: If the patient has poor cardiopulmonary function or other chronic comorbidities, exercise intensity should be managed under the guidance of medical professionals and rehabilitation specialists. Vital signs such as heart rate and blood pressure should be monitored, and any discomfort should lead to immediate medical consultation.

V. Disclaimer

This report is based on the provided basic medical history, imaging, and descriptive information. It offers recommendations for reference only, and cannot replace an in-person consultation or the formal diagnosis and treatment plan of a qualified physician. Patients should follow professional medical advice in conjunction with any clinical assessments and definitive diagnostic conclusions for their treatment and rehabilitation.