April 2017 A 52-year-old female presented to her dermatologist with a pigmented lesion which had recently become darker; she had it removed for cosmetic reasons Pathology revealed a melanoma with a depth of 2.3 mm Genetic testing;BRAF V600mutation-positive LDH, WNL (174 UI/L) She underwent wide local excision and sentinel node mapping; staining is positive for melanoma in the right axillary node Complete dissection of the right axilla reveals no additional involved nodes CT of the chest, abdomen, and pelvis showed multiple masses in both lungs, the largest being 5 mm She underwent core-needle biopsy of the largest lung lesion Pathology revealed metastatic melanoma Mutation testing:BRAF-positive The patient is started on dabrafenib 150 mg bid and trametinib 2 mg qd