What are the American Academy of Dermatology recommendations for baseline and surveillance imaging of primary cutaneous melanoma?

Updated: Oct 13, 2020
  • Author: Susan M Swetter, MD; Chief Editor: Dirk M Elston, MD  more...
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Answer

It is not recommended that asymptomatic patients with newly diagnosed stage 0-II primary cutaneous melanoma undergo baseline radiologic imaging and laboratory studies.

For cutaneous melanoma at baseline, radiologic imaging and laboratory studies should be conducted only to assess the specific signs or symptoms of synchronous metastasis (regional nodal or distant).

At baseline or when physical examination of lymph nodes is equivocal and requires surveillance, the use of lymph node ultrasonography is encouraged. Surveillance with such imaging is also encouraged in the following patients:

  • Those who meet criteria for sentinel lymph node biopsy (SLNB) but do not undergo the procedure
  • Patients in whom SLNB is not possible or is technically unsuccessful (eg, because lymphoscintigraphic dye migration has failed and a draining sentinel lymph node cannot be identified)
  • Those in whom, despite a positive SLNB, complete lymph node dissection is not performed

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