A 67-year-old woman with a remote history of stage II cutaneous melanoma treated with surgical excision presents to her primary care physician with persistent dry cough and dyspnea for more than 8 weeks. Chest X-ray imaging is concerning for right hilar fullness and bilateral pulmonary nodules. Computed tomography (CT) scan of the chest confirms the presence of multiple bilateral intrapulmonary masses and right-sided hilar lymphadenopathy. The patient undergoes endobronchial ultrasound-guided fine-needle aspiration of the right hilar mass, with histopathology showing metastatic melanoma. BRAF mutation testing is negative for any actionable mutations. The patient’s ECOG performance status is 1.