Melanoma on combination immunotherapy
History
58-year-old woman. Wide excision of a 3.1 mm ulcerated melanoma of the right upper back 2 years ago (BRAF wild-type). Now a palpable right axillary mass; fine-needle aspiration confirms melanoma. LDH normal; brain MRI normal. Baseline FDG PET/CT before ipilimumab plus nivolumab.
Step 1 · Baseline scan
The scan shows right axillary nodes, two liver lesions (metastases on MRI) and a subcutaneous nodule in the left flank. What is the M category (AJCC 8th edition)?