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Metastatic melanoma with an unknown primary.
J Norman1, C W Cruse, K E Wells
1Division of General Surgery, H. Lee Moffitt Cancer Center, Tampa, FL 33682-0179.
Annals of Plastic Surgery
|January 1, 1992
Summary
Malignant melanoma can present as metastatic disease without a known primary lesion. This study found unknown primary melanoma has a similar survival rate to known primary melanoma with regional nodal disease.
Area of Science:
- Oncology
- Dermatology
- Medical Research
Background:
- Malignant melanoma diagnosis without an identifiable primary lesion is infrequent.
- The workup, treatment, and prognosis for unknown primary melanoma remain unclear in medical literature.
Purpose of the Study:
- To investigate the clinical characteristics and survival outcomes of patients with unknown primary melanoma.
- To compare the prognosis of unknown primary melanoma with that of known primary melanoma presenting with regional nodal disease.
Main Methods:
- Retrospective chart review of 580 melanoma patients at University Treatment Center.
- Identification of 18 patients with unknown primary melanoma.
- Comparison of survival curves between unknown primary melanoma and a control group with known primary melanoma (Stage III).
Main Results:
- Unknown primary melanoma most commonly presents as metastatic disease in a nodal basin (94%).
- Formal lymph node dissection in patients initially diagnosed via biopsy of a single positive node yielded more disease in 59% of cases.
- No significant difference in survival was observed between patients with unknown primary melanoma and those with known primary melanoma and Stage III disease (p = 0.96).
Conclusions:
- Unknown primary melanoma shares similar survival outcomes to known primary melanoma with regional nodal metastasis.
- Further research may clarify optimal diagnostic and therapeutic strategies for this rare presentation.