When in doubt, cut it out - treating malignant melanomas

A CCS study that looks into the difficulty of diagnosing malignant melanomas has found that in the event of uncertain diagnosis or failed treatment of a lesion, an appropriate standard of care is full excisional biopsy if not previously performed, or referral of the case to an appropriate specialist or melanoma centre. The study is co-authored by the Director of the Victorian Melanoma Service, Alfred Health, Clinical Associate Professor John Kelly.


It notes that clinicians should remain aware of the existence of higher-risk, easily misdiagnosed melanomas with a high mortality rate. Therefore, they should aim to identify these at the earliest opportunity.

The study looks at a recent Supreme Court of New South Wales case where a misdiagnosis of melanoma occurred, but there was failure to establish causation of the patient’s poor prognosis. According to the article, aggressive melanomas may grow quickly, fail to conform to standard and commonly taught diagnostic criteria, and frequently escape early detection.

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