How to distinguish whether melanoma is benign or cancerous

Written by Huang Ling Juan
Dermatology
Updated on April 01, 2025
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Melanomas are always malignant; there are no benign melanomas.

Benign lesions are called pigmented nevi, which are usually classified into three types: intradermal nevi, junctional nevi, and compound nevi. When a pigmented nevus becomes malignant, it is then referred to as melanoma. Therefore, in clinical practice, when we mention melanoma, we are referring to malignant melanoma.

Malignant melanoma is staged based on the degree of invasion and whether it has metastasized. Treatment methods vary depending on the stage, and there are differences in treatment approaches.

Therefore, if a pigmented nevus visibly enlarges over a short period, and shows symptoms such as ulceration, bleeding, or pain, it is necessary to promptly visit a reputable hospital's dermatology department for surgical removal, followed by a pathological examination.

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How to diagnose melanoma

For the judgment of melanoma as a malignant tumor, it cannot solely rely on clinical experience. Instead, the skin lesion should undergo surgical excision. During the surgery, freezing can be scheduled, and the results of the freezing report will determine the scope of the surgery. The final diagnosis still depends on the paraffin section. The diagnostic gold standard is based on the pathological results, and only a pathology examination can determine whether the lesion is a malignant melanoma. Diagnosing such diseases requires extreme caution due to their high malignancy and ease of metastasis, which can endanger life. Standardized surgical excision is necessary, supplemented by chemotherapy and other methods.

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Can melanoma be excised?

Melanoma, also known as malignant melanoma, generally appears on the skin or in areas such as mucous membranes and the choroid of the eye. It is the most malignant type of skin tumor and is prone to distant metastases. Early diagnosis and treatment are crucial in the initial stages of the disease. If a diagnosis of melanoma is confirmed at a formal hospital, it is recommended that patients undergo a complete excision biopsy of the lesion. If the lesion is too large to be removed, a superficial skin lesion theft or punch biopsy may also be considered.

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Melanoma check what items

If patients suspect that they have melanoma, they must go to a qualified hospital for examination. The diagnosis of melanoma mainly relies on visual inspection of colored moles that vary in color and shape, which can be directly observed with the eye. Also, if previously existing moles have enlarged or changed shape recently, these are signs that we need to pay attention to. If patients are suspected of having melanoma after a diagnosis, it is recommended to perform a complete excisional biopsy of the lesion, followed by a pathological examination after the surgery.

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Melanoma originates from which tissue?

Melanoma does not originate from any specific tissue, but from melanocytes. Therefore, melanoma can occur in any tissue where melanocytes are present. The most common sites for melanoma are the skin and mucous membranes. Additionally, because melanocytes are widely present throughout the body, melanoma can also occur in hollow organs such as the gastrointestinal tract, in skeletal muscles, and in the nervous system. Once diagnosed, melanoma needs to be treated promptly. The main treatments include surgery, radiation therapy, chemotherapy, targeted therapy, and immunotherapy.

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Melanoma deterioration symptoms

Patients with early-stage melanoma generally experience symptoms such as moles rapidly growing larger, changing in shape and color. Slightly more severe cases may exhibit signs like itching and bleeding. If the melanoma progresses, it might lead to non-healing ulcerations, repeated occurrences of satellite lesions, regional lymph node metastasis, and migratory metastasis. In advanced stages, patients may experience bone metastasis pain. Lung cancer metastasis might manifest as coughing and coughing up blood, and symptoms can vary depending on the site of metastasis.