Thumb subungual melanoma: is amputation necessary?

Area of Science:

• Oncology
• Dermatology
• Surgical Oncology

Background:

• Subungual melanoma is a rare cancer.
• Traditional treatment involves digit amputation.
• Thumb involvement leads to significant functional and aesthetic deficits.

Purpose of the Study:

• To present a novel, conservative, digit-sparing surgical approach for subungual melanoma of the thumb.
• To evaluate the efficacy and outcomes of this approach.

Main Methods:

• Four patients with subungual melanoma of the thumb underwent local excision with 1cm margins.
• Excision extended to the periosteum.
• Reconstruction was performed using local flaps.

Main Results:

• Minimum follow-up of 6 years.
• One recurrence was observed.
• No deaths occurred in the study cohort.
• The conservative approach preserved digit length and minimized disability.

Conclusions:

• Selected cases of subungual melanoma of the thumb can be managed conservatively.
• Digit-sparing surgery allows for preservation of function and aesthetics.
• This approach offers a viable alternative to amputation.