When two lives intersect: melanoma in pregnancy: mechanisms, risks, and management strategies

Pregnancy-associated melanoma is one of the more frequently encountered malignancies during gestation, although its overall incidence remains low. Current evidence suggests that pregnancy itself does not adversely affect melanoma-specific survival when the tumour stage is considered, yet clinical management remains challenging. Physiological skin changes can obscure early detection, and limitations on imaging modalities and systemic therapies restrict standard diagnostic and treatment options. Additional uncertainty surrounds the safety and timing of sentinel lymph node biopsy during pregnancy. Although metastases to the placenta or foetus are exceedingly rare, placental histopathological examination is recommended in cases of advanced maternal disease to ensure appropriate follow-up. Optimal care relies on applying standard melanoma treatment principles with thoughtful adjustments to safeguard foetal well-being. Continued research and larger, higher-quality datasets are essential to improve prognostic accuracy and guide evidence-based management in this complex and clinically sensitive setting, supporting clinicians in delivering safer care for affected pregnant patients.