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Node-positive transcranial recurrent melanoma: is an aggressive resection warranted?
Alex Senchenkov1, Frank E Barone
1Division Plastic and Reconstructive Surgery, Mayo Clinic, Rochester, MN, USA.
Annals of Plastic Surgery
|April 20, 2005
Summary
Recurrent malignant melanoma, even when advanced, can be treated effectively. Aggressive surgical resection and adjuvant therapy led to a 12-year disease-free survival in a challenging scalp melanoma case.
Area of Science:
- Oncology
- Surgical Oncology
- Dermatology
Background:
- Locally advanced, node-positive recurrent malignant melanoma indicates a poor prognosis and risk of distant metastases.
- Malignant melanoma exhibits unpredictable biological behavior, influencing clinical outcomes.
- Recurrence of melanoma, particularly on the scalp, can present with extensive local invasion.
Observation:
- A patient presented with recurrent malignant melanoma on the scalp, characterized by skull erosion and regional lymph node involvement with extracapsular extension.
- The patient underwent a comprehensive treatment regimen.
- Treatment included wide local excision, bilateral neck dissection, and microvascular reconstruction.
Findings:
- Adjuvant radiation therapy was administered post-operatively.
- The patient achieved a remarkable 12-year disease-free survival.
- This outcome suggests the efficacy of aggressive surgical management.
Implications:
- Aggressive surgical resection should be strongly considered for operable patients with locally advanced recurrent melanoma.
- Complete surgical removal is crucial for achieving long-term disease-free status.
- This case highlights the potential for favorable outcomes in challenging melanoma recurrences with multidisciplinary treatment.