Recurrence of Melanoma

When melanoma comes back after it has been treated, it is called a recurrence. Recurrent melanoma may appear locally (at or near the site of the original primary melanoma tumor), or in another part of the body. Melanoma can come back as many as 10 or more years after it was first treated. This is not the same as developing a new primary melanoma that is unrelated to the first primary melanoma.

Learn about developing a second melanoma

Factors That Increase the Risk Your Primary Melanoma Will Recur:

The thickness of the primary melanoma, with thicker tumors carrying greater risk than thin tumors
The presence of ulceration in the primary melanoma
The presence of satellite metastases surrounding the primary melanoma
The presence of an increased mitotic rate in the primary tumor

Recurrences can occur at the original site of the primary melanoma or in the surrounding skin or tissues, in lymph nodes or at other sites in the body including internal organs.

Treatment of Recurrent Melanoma

Treatment of recurrent melanoma depends on the stage of the original melanoma, the initial treatment, and the type of recurrence. There are three types of recurrence; isolated local recurrence, lymph node recurrence, and distant recurrence.

Isolated Local Recurrence

In this case, a single melanoma reappears in the general area of the original tumor. Recommended treatment depends on the site of recurrence, as shown below.

Site of Recurrence	Recommended Treatment
At the site of the original surgical scar	Reexcise the site
1 in-transit lesion	Reexcise the site to a negative surgical margin
More than 1 in-transit lesion	Immunotherapy, systemic chemotherapy, or regional chemotherapy with isolated limb perfusion

Lymph Node Recurrence

In this case recurrence occurs in the lymph node(s) in the area nearest your primary (original) melanoma. Recommended treatment depends on the type of previous treatment, as shown below.

Previous Treatment	Recommended Treatment
No previous lymph node dissection	Therapeutic lymph node dissection
Sentinel lymph node mapping or sentinel lymph node biopsy	Therapeutic lymph node dissection
Therapeutic lymph node dissection or elective lymph node dissection	Excise lymph node recurrence to negative surgical margins

Distant Recurrence

Treated the same way as Stage IV melanoma; immunotherapy, targeted therapy, chemotherapy, and/or radiation therapy.

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