Macerola et al. found TERT promoter mutations to associate with unfavorable prognostic parameters such as increasing thickness, high mitotic rate, lymph node metastasis, and presence of ulceration when BRAF mutations were also present, although survival analysis was not performed and no significant correlations were found between the presence of promoter mutations and regional and distant metastases24. Here, TERT is linked to metastatic malignant neoplasm in the lymph nodes.