Unlike other cancers, melanoma can spread to any organ in the body. However, the most common metastatic sites are lung, liver, brain, small bowel, and lymph nodes. Clinical signs and symptoms correspond to the involved organ system. Because clinical presentation of melanoma metastases can be so variable, new symptoms such as pain, gastrointestinal distress, or seizures in a patient previously diagnosed with melanoma should prompt imaging and laboratory studies for the appropriate organ system. Metastases in nasal mucosal or paranasal sinuses may present with nasal obstruction, hemorrhage, or exophthalmos. Lymphadenopathy outside of the expected regional drainage basin may also be a sign of advanced systemic disease (7).
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