Diagnosis of Stage IV Melanoma

The development of distant metastasis – stage IV disease – is associated with a dramatic decrease in the survival rate of patients who have melanoma. As seen with other tumor types, the success of treatment mainly depends on early diagnosis as well as initiation of optimal treatment. In the past decade, there has been dramatic expansion of the treatment armamentarium for patients with advanced melanoma with the development of two most important novel therapeutic strategies, immune checkpoint inhibitors and selective kinase inhibitors, which have led to significant improvement in survival and prognosis of metastatic melanoma patients. In this chapter, we provide a comprehensive overview of clinical aspects of the diagnosis of stage IV melanoma, including the timing and pattern of metastasis, clinical and imaging evaluation of distant metastases, and clinical application of biomarkers for diagnosis of metastatic melanoma. Also, various common and uncommon sites of metastasis of cutaneous melanoma are elucidated in detail.