Same-day diagnosis and robotic resection of rare primary pulmonary melanoma: a robotic bronchoscopy-guided approach

This case report describes a rare presentation of pulmonary melanoma of unknown primary managed through a same-day robotic diagnostic and therapeutic approach. A man in his 70s with an incidentally detected lingular pulmonary nodule suspicious for non-small cell lung cancer underwent robotic navigation bronchoscopy for biopsy and dye marking, immediately followed by robotic-assisted thoracic surgery. Intraoperative frozen section revealed a malignant spindle cell neoplasm, prompting definitive surgical resection during the same anaesthetic event. Final histopathology and molecular analysis confirmed melanoma, with no identifiable cutaneous, mucosal or ocular primary. The patient subsequently received adjuvant immunotherapy and remains disease-free at 24 months. This case highlights the diagnostic challenge of pulmonary melanoma mimicking lung carcinoma and demonstrates how integration of robotic bronchoscopy and robotic surgery can enable rapid diagnosis, definitive management and streamlined care within a single operative session.