Melanoma is a malignant tumor of melanocytes, which are found predominantly in skin but also in the bowel and the eye. It is one of the rarer types of skin cancer, but causes the majority of skin cancer related deaths. Despite many years of intensive laboratory and clinical research, the sole effective cure is surgical resection of the primary tumor.

Moles that are irregular in color or shape are suspicious of a malignant or a premalignant melanoma. Following a visual examination and a dermatoscopic exam (an instrument that illuminates a mole, revealing its underlying pigment and vascular network structure), the doctor may biopsy the suspicious mole. If it is malignant, the mole and an area around it need excision. This will require a referral to a surgeon or dermatologist.

Metastatic melanomas can be detected by X-rays, CT scans, MRIs, PET and PET/CTs, ultrasound, LDH testing and photoacoustic detection.

The treatment includes surgical removal of the tumor; adjuvant treatment; chemo- and immunotherapy, or radiation therapy.

Complete surgical excision with adequate margins and assessment for the presence of detectable metastatic disease, along with short and long term follow up is standard. Often this is done by a "wide local excision" (WLE) with 1 to 2 cm margins. The wide excision aims to reduce the rate of tumor recurrence at the site of the original lesion. This is a common pattern of treatment failure in melanoma.

Radiation therapy is often used after surgical resection for patients with locally or regionally advanced melanoma or for patients with unresectable distant metastases.

Also read