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Upon full skin examination, abnormal lesion found on right thigh. Patient also presents with persistent cough.
CT of Abdomen/Pelvis, Chest: 8mm lower lobe pleural nodule. Peri-tracheal lymph node mass suspicious for metastasis.
CAT: Multiple pulmonary nodules consistent with metastasis.
Elevated serum LDH, less than 1.5 times the upper limit of normal.
Right thigh surgery: wide local excision of lesion on right thigh. Right inguinal lymph node dissection.
Thorascopic surgery: RUL wedge resection - nodules consistent with metastatic melanoma.
Tissue, right thigh: Malignant melanoma, extends to underlying muscle, margins clear, approximately 1.5 cm.
Nodal dissection: 0 inguinal nodes positive.
Tissue, right lung: Metastatic melanoma.
Surgery: Excision of right thigh lesion and inguinal lymph node dissection.
Surgery: Wedge resection of RUL metastasis