[How I explore ... an orphan metastasis from melanoma]

A presumed melanoma metastasis is sometimes found without any evidence for the primary neoplasm. Such an orphan metastasis merits a complementary exploration. Searching for the primary melanoma must then be performed using non invasive and clinically oriented methods. Beside a thorough skin examination, otorhinolaryngological, ophtalmic and gynecologic searches are recommended. In addition, paraclinical investigations are conducted according to the metastatic location, the gender and the functional complaints of the patient. The prognosis of these orphan metastases is not more dramatic than when the primary lesion is identified. Therapies are similar to those proposed in the classical presentation of the disease.