A completely excised cutaneous melanoma is 0.9 mm thick, non-ulcerated, with lymphovascular invasion and a mitotic index of 1/mm². Staging imaging is

Question

A completely excised cutaneous melanoma is 0.9 mm thick, non-ulcerated, with lymphovascular invasion and a mitotic index of 1/mm². Staging imaging is otherwise not indicated. What should the skin MDT discuss?

Accepted Answer

Discuss sentinel lymph-node biopsy because lymphovascular invasion qualifies this 0.9 mm melanoma

Answer

Obtain whole-body PET-CT before deciding whether pathological nodal staging adds clinically useful information

Answer

Use serial nodal ultrasonography because a non-ulcerated melanoma below 1 mm is excluded from pathological staging

Answer

Proceed directly to completion lymph-node dissection because lymphovascular invasion predicts occult nodal disease

Answer

Omit sentinel-node biopsy because ulceration and at least 2 mitoses/mm² must coexist in a 0.8–1.0 mm melanoma

Melanoma Excision Margins — SCE Medical Oncology MCQ

A completely excised cutaneous melanoma is 0.9 mm thick, non-ulcerated, with lymphovascular invasion and a mitotic index of 1/mm². Staging imaging is otherwise not indicated. What should the skin MDT discuss?