Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents for follow-up of metastatic melanoma with known hepatic involvement. Reports [stable/worsening] abdominal discomfort, early satiety, and unintentional weight loss of [X] kg over [X] weeks. Denies jaundice, acholic stools, or hematemesis. Current systemic therapy: [Insert Regimen]. Performance status: ECOG [0-4].
Clinical Examination Findings
Abdominal exam reveals [soft/distended] abdomen, hepatomegaly with [smooth/nodular] edge palpated [X] cm below the right costal margin. Tenderness to deep palpation in the RUQ. No evidence of ascites or caput medusae. Scleral icterus [present/absent]. Skin exam: multiple pigmented lesions noted, [biopsy sites/scars] identified.
Treatment Protocol
Plan: 1. Continue systemic therapy [Immunotherapy/Targeted therapy] as per oncology protocol. 2. Monitor LFTs and CBC every [X] weeks. 3. Repeat abdominal imaging [CT/MRI] in [X] weeks to assess treatment response (RECIST criteria). 4. Consider interventional radiology consultation for potential biopsy or palliative embolization if indicated. 5. Pain management optimization.