Clinical and molecular characteristics and metastatic pathways of patients with primary cutaneous melanoma

This thesis examines the sequence of events from melanoma diagnosis to disease progression. Different diagnostic aids to facilitate early detection are evaluated. Characteristics and prognosis of melanomas that arise as new lesions compared to those that arise within a pre-existing mole are investigated. Patient, pathological and mutational factors related to the pathways of disease spread are explored. Patients with tumours harbouring certain mutations were associated with particular sites of spread. A role for heightened surveillance may be warranted in these patients. The characteristics and mutational profile of patients with multiple melanomas and of patients with clinically atypical melanomas are investigated.