Management Controversies in Head and Neck Melanoma

Zenga, Joseph; Nussenbaum, Brian; Cornelius, Lynn A.; Linette, Gerald P.; Desai, Shaun C.

doi:10.1001/jamafacial.2016.1038

Cited by 19 publications

(13 citation statements)

References 94 publications

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“…44,45 Management follows the same principles as for nonhead and neck melanoma. 46 Breslow thickness of the SM gives instructions for the excision margins. Surgery should be performed with resection margins, as for other cutaneous melanomas.…”

Section: Managementmentioning

confidence: 99%

“…Rarely flap coverage is required, especially in defects where the bony skull has also been removed 49 (many studies compared narrow (1 or 2 cm) to wide (3-5 cm)) margins, and none of these identified a difference in local recurrence or overall survival between the narrow or wide margin groups. [43][44][45][46] One study, however, found a significant increase in regional recurrence for narrow margins for patients with melanoma thicker than 2 mm, while for thin melanoma, excision margins of less than 1 cm increased the risk of local recurrence. 50…”

Section: Managementmentioning

confidence: 99%

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Diagnosis and Management of Melanoma of the Scalp: A Review of the Literature

Licata

Scharf

Ronchi

et al. 2021

CCID

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Cutaneous melanoma is a public health issue and the head and neck region is of particular interest, despite accounting for only 9.0% of the total body surface, it harbours 20% of melanoma cases. Data from the literature show that scalp melanomas (SM) carry high mortality rates, with a 10-year survival rate of 60% which lead them to be named as the "invisible killer". Moreover, SMs are more common in the elderly than in young population, and they occur six times more frequently in men than in women. This is probably related to the higher incidence of androgenetic alopecia and a higher cumulative and intermittent ultraviolet damage on the scalp. Histologically, SM is a heterogenous group, including lentiginous melanoma (LM), desmoplastic melanoma, superficial spreading and nodular melanoma. Thin melanomas tend to display an atypical network or pseudo-network and regression in dermoscopy. Blue-white veil, irregular pigmented blotches and an unspecific pattern are most commonly detected in thick lesions. On reflectance confocal microscopy (RCM), the most frequent pattern is irregular meshwork, but also ringed and disarranged pattern have been described. Differential diagnosis includes benign solar lentigo, actinic keratoses, lichen planus like keratosis, melanocytic nevi and blue nevi. All suspicious lesions should be biopsied; therefore, an excisional biopsy with 2 mm margins is usually the best option. The management of SM is the same as for melanoma on other body sites. However, sentinel node biopsy tends to be more challenging, as well as achieving adequate excision margins of the primary tumor. In this review, we summarize clinical, pathologic, dermoscopic and RCM features of SM, and focus on its epidemiology, risk factors and best management options.

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Section: Managementmentioning

confidence: 99%

Section: Managementmentioning

confidence: 99%

Diagnosis and Management of Melanoma of the Scalp: A Review of the Literature

Licata

Scharf

Ronchi

et al. 2021

CCID

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“…The article by Zenga et al 1 in this issue of JAMA Facial Plastic Surgery is a timely addition to the literature for those clinicians who treat patients with pigmented lesions of the face, scalp, and neck. While many of the brown lesions we see in our practices will be benign, the incidence of melanoma is increasing.…”

Section: Invited Commentarymentioning

confidence: 99%

The Increasing Incidence of Melanoma

Moyer

2017

JAMA Facial Plast Surg

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Hoffmann-La Roche. BRIM8: a study of vemurafenib adjuvant therapy in patients with resected cutaneous BRAF mutant melanoma. https: //clinicaltrials.gov/ct2/show/NCT01667419. Accessed November 14, 2015. 88. Laboratorio Pablo Cassará SRL. Phase II/III clinical study CSF470 plus BCG plus GM-CSF vs IFN alpha 2b in stage IIB, IIC and III melanoma patients. https://clinicaltrials.gov/ct2/show/NCT01729663 ?term=melanoma+AND+adjuvant&phase=23& rank=6. Accessed November 14, 2015. 89.Ascierto PA, Chiarion-Sileni V, Muggiano A, et al. Interferon alpha for the adjuvant treatment of melanoma: review of international literature and practical recommendations from an expert panel on the use of interferon.

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“…A recent systemic review on the management controversies of head and neck melanoma published by Zenga et al showed level 4 evidence supporting delayed reconstruction. The authors cited that existing studies could not identify factors predictive of positive margins and therefore advocated that immediate reconstruction be limited to low‐risk lesions amenable to primary closure …”

Section: Introductionmentioning

confidence: 99%

“…The authors cited that existing studies could not identify factors predictive of positive margins and therefore advocated that immediate reconstruction be limited to low-risk lesions amenable to primary closure. 9 To address this controversy, a systematic review of the literature was undertaken to examine the oncologic outcomes, specifically, the rates of positive margins and local recurrence, that are associated with the immediate versus delayed reconstruction of cutaneous melanoma in the head and neck region.…”

Section: Introductionmentioning

confidence: 99%