Patients with malignant melanoma generally present with a history of a new mole, or a change in an existing mole, which may bleed or itch. There are 4 clinical descriptions of melanoma: superficial spreading, nodular, lentigo maligna and acral lentiginous. GPs should refer patients to a Consultant dermatologist or a plastic surgeon.
The specialist should excise the primary lesion. Staging will be confirmed following histological diagnosis and a CT scan.
Localised melanoma is very well treated by wide excision. By contrast, the outlook for patients with metastatic melanoma is poor. Treatment includes surgery and radiotherapy of single metastaic sites. Those with multiple metastases are treated with chemotherapy. Patients generally have disease in multiple sites and the median survival is approximately 4 months. Therefore early diagnosis is crucial and mistakes in diagnosing melanoma can be very serious. Melanoma misdiagnosis claims may be brought for:
- Failures to carry out an adequate examination
- Failure to advise a patient to return if a suspicious lump or mole change or grew
- Failure to refer a patient to a dermatologist or a plastic surgeon
- Mistakes by pathologists in reporting the biopsy
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