Surgical treatment of malignant melanoma of the skin

Abstract

Surgery is the primary therapeutic modality in the treatment of primary melanomas and metastases to lymph nodes. Surgery also plays an important role in the therapy of locally recurrent tumors and distant metastases in selected cases. Wide excision of the primary tumor in stage I malignant melanoma results in a recurrence rate of about 2%. Surgical techniques for lymph node dissection are the same for melanoma as those performed for other malignancies. There is little question that dissection is necessary in obviously involved nodal areas, but controversy remains regarding the value of lymph node dissection of clinically uninvolved regional nodes. A prospective, randomized study by the World Health Organization has shown no improvement in survival for patients who underwent elective regional node dissection.Surgery is the treatment of choice when melanoma recurs locally as a single cutaneous or subcutaneous nodule. Surgery may also result in long-term, disease-free survival in patients with a solitary distant metastasis after treatment of a primary lesion.According to Attie and Kafif [1], identification of the neoplastic nature of melanoma and the first use of the word "melanoma" to define pigmented skin lesions dates back to 1833. In 1858, wide excision of the primary tumor, en bloc with the underlying muscle fascia, was first suggested as the treatment of choice. In 1907, the spread of melanoma cells along fascial planes and lymphatics was described, and in 1908, wide excision of the primary tumor in continuity with the intermediate lymphatic vessels and regional lymph nodes was initiated as the treatment of choice. In 1945, Pack et al. [2] published a

Fine‐needle‐aspiration cytodiagnosis of recurrent malignant melanoma

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Isolated Metastatic Malignant Melanoma of the Right Inguinal Lymph Node with Unknown Primary Lesion

“…Surgery is the treatment of choice for localized cutaneous melanoma. 11 Other treatment modalities are immunotherapy, chemotherapy, and radiotherapy. These may improve survival in more advanced disease.…”

Subcutaneous malignant melanoma of the scalp surgical flap after brain irradiation for anaplastic astrocytoma

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