A candidate for rose bengal therapy?

When you know the patient has a history of melanoma in the same limb and had a groin gland dissection, these nodules can only signify local amelanotic melanoma recurrence or metastases.

If a PET scan shows no lesions elsewhere, the nodules are likely to be local lymphatic recurrences from the primary tumour. It is still advisable to biopsy to confirm diagnosis and to have tissue for potential melanoma vaccines and gene analysis.

If these lesions show BRAF mutations, then new BRAF mutation inhibitor drugs such as vemurafenib can be used.