Combined Immunotherapy and Hepatic Resection in Cutaneous Melanoma Liver Metastases

Melanoma is an aggressive malignancy with a high risk of distant metastasis, including hepatic involvement, which is associated with poor prognosis. We report a patient initially diagnosed with stage IA melanoma who developed an isolated liver metastasis seven years later. Molecular analysis identified a TP53 mutation and PD-L1 expression ≥ 1%. Treatment with nivolumab achieved a sustained radiological and biochemical response over four years. Owing to favorable systemic control and resectable disease, surgical liver resection was performed. Follow-up demonstrated no evidence of recurrence. At 48 months after initiation of immunotherapy and 12 months after surgery, the patient remains alive and disease-free. This case supports the integration of immunotherapy and surgery in selected patients with metastatic melanoma to the liver and highlights the importance of multidisciplinary management.