Abstract

Objectives: - Identify causes of melanoma understaging related to partial biopsies - Recognize clinical and dermoscopic features associated with higher tumor risk - Integrate imaging and pathology to improve staging accuracy and surgical decisions Introduction: Accurate melanoma staging is essential for prognosis and treatment planning. Partial biopsies and limited clinicopathologic correlation frequently lead to tumor understaging, resulting in inadequate surgical margins and missed indications for sentinel lymph node biopsy. Materials / method: Representative melanoma cases initially assessed by partial sampling were reviewed. Clinical examination, dermoscopy and advanced imaging were correlated with histopathological parameters including Breslow thickness, ulceration and mitotic index to evaluate their impact on staging accuracy. Results: Partial biopsies often underestimated tumor thickness and failed to detect high-risk features. Excisional assessment revealed higher Breslow values in several cases, leading to changes in surgical margins and in the indication for sentinel lymph node biopsy. Conclusion: Melanoma understaging is a major source of therapeutic error. Integrating clinical, dermoscopic, imaging and pathological data improves staging accuracy and supports more appropriate surgical and oncologic management.