The tumor may be any thickness, with or without ulceration (a break in the skin), and one or more of the following is true: (1) cancer has spread to one or more lymph nodes; (2) lymph nodes may be joined together (matted); (3) cancer may be in a lymph vessel between the primary tumor and nearby lymph nodes; and/or (4) very small tumors may be found on or under the skin, not more than 2 centimeters away from where the cancer first started.