The medical team discusses the case

Multiple professionals are involved in the medical treatment of people with cancer. In order to coordinate the diagnosis and treatment, patients are discussed in a multidisciplinary tumor board meeting (MDO) where an individual treatment plan is drawn.

The University Medical Center Groningen (UMCG) is one of the 14 melanoma centers in the Netherlands. Weekly 15-20 melanoma patients are discussed in the MDO Melanoma. In the MDO melanoma at least a medical oncologist (chair), surgical oncologist (alternate chair), radiation oncologist, dermatologist, pathologist and radiologist are present.

Presenting the case

During the meeting where our patient is discussed, the dermatologist presents the case to the MDO.

The patient is a 52-year-old woman with no known health issues and no history of skin malignancies in the past. The patient came to the dermatologist with a basal cell cancer on her nose, which would need to be treated with Mohs surgery. During the physical examination, the dermatologist had discovered another suspicious lesion on the patient’s back. The dermatologist also displays a clinical photograph of the lesion. The dermatologist had performed a diagnostic excision of the lesion. Additionally, the pathologist had analyzed the excised tissue and shared the findings with the MDO. The melanotic lesion on the patient’s back has a Breslow thickness of 1.8 mm with ulceration, classifying it as a pT2b melanoma.

After the case presentation the chair of the meeting summarizes the findings and explains that according to the guidelines, the lesion needs to be excised with a 1 cm margin, and a sentinel lymph node procedure would be indicated. It is clear that the patient needs to be referred to a surgical oncologist to take over her treatment. The members of the board agree. The case will be discussed again in the MDO meeting to review the pathological findings and finalize the treatment and follow-up plan. We will discuss this in the next step.