A 40-year-old man, Vibhu presents with pulmonary lesions seen on chest CT scan. He has a history of melanoma which was treated with wide local excision with negative margins and lymph node dissection. Biopsy of these pulmonary lesions proves to be metastatic melanoma. General condition of the patient is good & there is no evidence of recurrence or extrathoracic disease. What is the most appropriate treatment for this patient?

This is likely a case of metastasis from the earlier removed malignant melanoma. Since the primary lesion is excised & there is no evidence of extrathoracic disease and patient's general condition is good, the appropriate treatment is pulmonary metastasectomy. There is no role for radiation therapy pre or postoperatively for melanoma. Pulmonary metastasectomy can be performed for sarcomas, melanomas, germ cell tumors, and carcinomas of colon, renal cell and head and neck.