[Malignant melanoma of the skin. Pathogenesis, clinical aspects and prognosis]

Cutaneous malignant melanoma is not among the most frequent cancer types at an incidence of 10-12/100,000 persons/year in Central Europe. However, the number of melanomas has doubled within the last 10-15 years. This increase is higher than that of most other malignancies. It has been attributed to an increased UV-light exposure, whereby the latency period probably reaches decades. Persons at high risk for melanoma were identified in various studies: those from families with other melanoma patients and those who have more than 50 benign nevi, atypical nevi and actinic freckles. The majority of melanomas develops de novo and not from preexisting nevi. Treatment of choice is complete surgical excision of the tumors. Prognosis of these patients is mainly determined by tumor thickness. Metastatic spread occurs most frequently within lymph vessels, local recurrences as well as regional metastases significantly impairing the prognosis. From long-term experience in Australia it is evident that the dilemma "melanoma" can only be addressed effectively by rigorous prophylaxis and early diagnosis of the tumors.