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Giant pretibial located melanoma developing after curettage of a “seborrheic keratosis“ – sometimes clinicians has to be careful, very very careful. Giant melanomas might be mistaken for seborrhiec keratosis.
Be careful – sometimes collision tumors are also possible between seborrheic keratosis and cutaneous melanoma. Dermoscopy could be helpful here.
Surgical removal with small surgical security field (as I have done here) might be always form benefit for the patients.

I have applied here the narrow surgical margin as it can be seen.
In stage 4 disease – actually it’s not from a significant importance , because the melanoma cells have spread already.