Melanoma — Clinical Staging

A 52-year-old man presents with a 2 cm dark nodular lesion on his left shoulder with recent onset bleeding and irregular borders. Dermoscopy confirms melanoma with Breslow thickness of 3.2 mm. Which investigation is most appropriate for staging and assessing metastatic disease in this patient?

A 58-year-old Indian woman presents with a 4-month history of a dark nodular lesion on her right calf. On examination, she has a 12 mm dark brown-black nodule with irregular borders and surface bleeding. Histopathology reveals invasive melanoma with Breslow thickness of 3.8 mm, ulceration present, 8 mitoses per mm², and Clark level IV invasion. Sentinel lymph node biopsy shows 1 micrometastasis (0.5 mm) in a single right inguinal lymph node with no extranodal extension. No distant metastases are detected on staging imaging. What is the AJCC TNM stage?

A 68-year-old woman from Mumbai presents with a 10-month history of a dark nodular lesion on her right calf. She reports that the lesion has grown rapidly and recently started bleeding. On examination, the lesion is 12 mm in diameter, deeply pigmented, with a dome-shaped appearance and surface bleeding. Histopathology reveals melanoma with a Breslow thickness of 3.8 mm, ulceration present, and 8 mitoses per mm². Imaging (CT chest/abdomen/pelvis and brain MRI) shows no evidence of distant metastasis. Sentinel lymph node biopsy reveals metastatic melanoma in 2 of 3 sentinel nodes. What is the AJCC TNM stage?

A 58-year-old woman from Bangalore is found to have a Stage IIIB cutaneous melanoma on her forearm with a Breslow thickness of 3.2 mm, ulceration present, and 2 positive regional lymph nodes. Which of the following statements about AJCC Stage III melanoma is INCORRECT?

According to the AJCC 8th edition staging system for cutaneous melanoma, which of the following is the PRIMARY determinant of T stage?