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Desmoplastic melanoma. Histologic correlation with behavior and treatment
S Beenken1, R Byers, J L Smith
1Department of Head and Neck Surgery, University of Texas M. D. Anderson Cancer Center, Houston, TX 77030.
Archives of Otolaryngology--Head & Neck Surgery
|March 1, 1989
Summary
Desmoplastic melanoma, a rare skin cancer, often affects the head and neck. Early detection and wide surgical excision are key to managing local recurrence and preventing metastasis.
Area of Science:
- Dermatology
- Surgical Oncology
- Pathology
Background:
- Desmoplastic melanoma is a distinct histologic subtype of cutaneous melanoma.
- This variant exhibits unique clinical behavior requiring specific management strategies.
Purpose of the Study:
- To review the clinical behavior of desmoplastic melanoma.
- To identify optimal treatment strategies for this rare melanoma subtype.
Main Methods:
- Retrospective review of medical records for 16 patients treated for desmoplastic melanoma over 12 years.
- Analysis of lesion location, thickness, local recurrence, and regional node metastasis.
Main Results:
- Head and neck lesions were common, particularly on the ear.
- Average lesion thickness was 5.75 mm.
- Local recurrence occurred in 46.2% of patients; regional node metastasis was rare (15.4%).
- No clinically negative nodes were positive after elective neck dissection, irrespective of primary lesion thickness.
Conclusions:
- Wide excision with frozen section margin control is crucial for desmoplastic melanoma.
- Careful examination for perineural invasion guides surgical resection extent.
- Elective neck dissection may not be necessary for clinically node-negative patients.