Melanoma of the head and neck

Cutaneous melanoma of the head and neck accounts for approximately 20 per cent of all melanomas. Variation in the incidence of melanoma by sex and by subsites within the head and neck is related to exposure to sunlight. Study of the precursor skin lesions of individuals and families at high risk for melanoma are providing new insights into the biology of melanoma. The clinical importance of such information is earlier diagnosis and treatment. With microstaging techniques it has become apparent that in many instances the primary tumor can be excised safely with narrower margins than were thought necessary in the past. The role of elective lymph-node dissection remains controversial, but when it is performed a complete dissection is recommended. Improvement in adjunctive methods of treatment is needed, but significant palliation can be achieved, with occasional long-term survival.