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Melanoma and eye melanoma that has spread to the liver | CION Cancer Clinics
When melanoma spreads to the liver, it is still melanoma and is treated as melanoma. Eye melanoma reaches the liver far more often than skin melanoma, and the two respond to different medicines. This page explains how doctors tell them apart, which treatments are used, including immunotherapy and liver-directed options, and what to bring to your first appointment. At CION Cancer Clinics, a multidisciplinary tumour board weighs your liver function and your scans before recommending any treatment.
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Medically reviewed by Dr. Naresh GunduConsultant Medical Oncologist · MBBS, DNB (Internal Medicine), DM (Medical Oncology, AIIMS) · last reviewed October 2026, next review due October 2027
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On this page
- What does it mean when melanoma spreads to the liver?
- What do doctors look at before choosing treatment?
- What treatments are used for melanoma in the liver?
- How do skin and eye melanoma differ once they reach the liver?
- What do families often get wrong about melanoma in the liver?
- What this page cannot tell you
- Common questions about melanoma in the liver
The short answer
What does it mean when melanoma spreads to the liver?
It means melanoma cells have travelled from where the cancer started and are now growing in the liver. This is secondary liver cancer. It is still melanoma, and it is treated as melanoma, not as a cancer of the liver itself.
Skin melanoma and eye melanoma behave differently
Melanoma can start in the skin, or inside the eye, where it is called uveal or ocular melanoma. Skin melanoma can spread almost anywhere, and the liver is one of several places. Eye melanoma has a strong habit of spreading to the liver first, sometimes many years after the eye itself was treated. That is why people treated for eye melanoma are usually asked to have regular liver scans for a long time.
Why the difference matters to you
The two types respond to different medicines, so the first question the team asks is where the melanoma began. If you are reading this because a scan found a spot on the liver and nobody has yet said what it is, start with how primary and secondary liver cancer differ. A spot on the liver is not melanoma until a doctor has confirmed it.
Before a plan is made
What do doctors look at before choosing treatment?
The plan depends on the melanoma, the spread and the person. At CION, the tumour board reviews all three together.
Where the melanoma started
Skin and eye melanoma are close to separate diseases once they spread. Your old reports from the eye or skin treatment help the team confirm the link.
Whether it is only in the liver
A full body scan shows whether melanoma is also in the lungs, bones, skin or brain. Spread limited to the liver opens more options.
The tumour's own markers
Tests that may be asked for
- A BRAF gene test on skin melanoma tissue
- A blood test for a tissue type called HLA-A*02:01 in eye melanoma
- A biopsy if the link to the old melanoma is unclear
Your liver and your strength
Blood tests show how well the liver is working. How active you are day to day decides how much treatment your body can take safely.
Not sure whether this applies to you?
Ask an oncologistThe options
What treatments are used for melanoma in the liver?
Immunotherapy
Medicines such as nivolumab, ipilimumab and pembrolizumab help the immune system recognise melanoma. They are a main treatment for skin melanoma that has spread. They tend to work less well in eye melanoma. CION gives immunotherapy at its centres; side effects are covered on the combination immunotherapy page.
Targeted tablets
If skin melanoma carries a BRAF gene change, tablets that block that signal may be offered. Eye melanoma rarely carries this change.
Tebentafusp for eye melanoma
This medicine was developed for eye melanoma that has spread, and only for people with the HLA-A*02:01 tissue type. Approval and access in India are limited, and it may only be reachable through import or a trial. Ask your oncologist what applies to you today.
Treatment aimed at the liver itself
When melanoma is mostly in the liver, TACE, Y-90 radioembolisation, ablation or surgery may be considered. CION coordinates these through accredited partner hospitals. Read more on liver-directed treatment.
Side by side
How do skin and eye melanoma differ once they reach the liver?
Skin melanoma
Eye (uveal) melanoma
The liver is one of many places it may spread
The liver is usually the first and main place of spread
Often responds to immunotherapy
Responds to immunotherapy less often
BRAF tablets possible if the gene change is present
BRAF tablets rarely relevant
Liver-directed treatment used for selected spots
Liver-directed treatment has a larger role
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Commonly believed
What do families often get wrong about melanoma in the liver?
"The eye was treated years ago, so the liver cannot be connected."
Eye melanoma can return in the liver long after the eye was treated. That is why follow-up liver scans continue for years. Bring the old eye reports to every new doctor.
"It is in the liver now, so it is liver cancer."
It is still melanoma. Liver cancer medicines such as those used for hepatocellular carcinoma are not the right choice for it. The plan follows the melanoma.
"Melanoma is rare in India, so the scan must be wrong."
Melanoma is less common in people with darker skin, but it does happen. In Indian patients it more often starts on the soles, palms, nails, inside the mouth or in the eye. The scan and biopsy decide, not the statistics.
"Nothing can be done once it reaches the liver."
Treatment has changed a great deal. Many people are offered immunotherapy, targeted tablets or liver-directed treatment. What is right depends on the type and the spread, and your oncologist can explain your options honestly.
Being straight with you
What this page cannot tell you
It cannot tell you whether a spot on your liver is melanoma, or how your melanoma will respond. That needs your scans, your pathology and a melanoma team who can see the whole picture. It cannot give you a prognosis, and nobody should give you one from a single scan.
Who this page does not apply to
This page is not for cancer that started in the liver. It is also not for bowel cancer that has spread to the liver, which is covered on the colon cancer pages, or for other cancers that spread there, which have their own pages in this series. If you have a dark mark on the skin that has changed, this page is not where to start. See a doctor about the mark itself.
When the evidence is thin
Eye melanoma is uncommon, and good studies are small. Your oncologist may tell you plainly that the evidence for some liver treatments is limited. A clinical trial is sometimes the most sensible option to ask about.
If you have old eye or skin reports, bring them. They often save weeks of repeat tests.Questions we are asked
Common questions about melanoma in the liver
Is melanoma in the liver the same as liver cancer?
No. It is melanoma that has spread to the liver, also called secondary liver cancer. Under the microscope the cells look like melanoma, not liver cells. This matters because the medicines that work for melanoma are different from those used for cancer that starts in the liver.
Why does eye melanoma go to the liver so often?
Researchers do not fully understand it. Eye melanoma spreads through the blood rather than the lymph glands, and its cells seem especially suited to growing in the liver. This is why liver scans are the main follow-up test after eye melanoma treatment.
Do I need a biopsy of the liver spot?
Often, yes, especially if the melanoma was treated long ago or the scan is unclear. A biopsy confirms the spot is melanoma and gives tissue for gene tests. CION arranges liver biopsies through diagnostic partners. Your doctor will explain if it can be skipped in your case.
Is immunotherapy available for melanoma in India?
Yes. Nivolumab, pembrolizumab and ipilimumab are available in India, and CION gives immunotherapy at its centres. Whether it suits you depends on the type of melanoma, your health and your other conditions. Cost varies with the medicine and the plan, so ask for a written estimate.
Can melanoma spots in the liver be removed by surgery?
Sometimes, when there are only a few spots and no spread elsewhere. CION's surgical oncologists can assess this with the tumour board, and your team will tell you where the operation takes place. Surgery is usually combined with medicines rather than used alone.
What is HLA-A*02:01 and why was I tested for it?
It is an inherited tissue type, found with a blood test. It matters only for eye melanoma, because the medicine tebentafusp works only in people who carry it. Having it or not having it says nothing about how serious your melanoma is.
How will the liver be checked during treatment?
With repeat scans, usually CT or MRI, and blood tests of liver function. The team compares each scan with the last to see whether the spots are shrinking, stable or growing. The timing depends on the treatment. Read more on how liver metastases are monitored.
How do I get a second opinion?
Gather your scans on a disc, the biopsy report, any gene test results and the old eye or skin treatment records. Call the CION helpline and ask for a melanoma review. A medical oncologist will go through the reports with you and explain the options in plain words.
Your Specialists
Meet CION's liver cancer specialists. Bring your scan reports and liver blood tests.
Our medical and surgical oncologists plan liver cancer care together, weighing the tumour and how well your liver works before choosing surgery, a liver-directed procedure or medicines.
Medical Oncologist
Dr. C. Raghavendra Reddy
MBBS(Gold Medal), DNB(General Medicine), DM(Medical Oncology)(Gold Medal)
Medical Oncologist
Dr. Bharati Devi Gorantla
MBBS, MD(General Medicine), DM(Medical Oncology)(Adyar,Chennai), ECMO, MRCP SCE(UK)
Medical Oncologist
Dr. Owais Mohammed
MBBS, MD (General Medicine), DrNB (Medical Oncology), ECMO, MRCP SCE (Medical Oncology) (UK)
Medical Oncologist
Medical Oncologist
Surgical Oncologist
Dr. Muralidhar Muddusetty
MBBS (AIIMS), MS (Surgery) (AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh)
Surgical Oncologist
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Sources
- Cancer Research UK — Secondary liver cancer
- National Cancer Institute — Metastatic Cancer: When Cancer Spreads
- National Cancer Institute — Immunotherapy for Cancer
- RadiologyInfo.org (RSNA/ACR) — Radioembolization (Y90)
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
Metastatic melanoma and rare spread to the liverThe rarer cancers that reach the liver, side by sideLiver-directed treatment for metastasesTACE, Y-90, ablation and surgery aimed at the liverSecondary liver cancer: the full pictureThe general principles behind every type of spreadMelanoma brain metastases and immunotherapyHow immunotherapy is used when melanoma spreads
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Has melanoma been found in your liver?
Send us your scans and old eye or skin reports, and a medical oncologist will explain the options in plain words. One helpline serves every CION centre.