Melanoma surgery

Donaldson, R. C., Canaan, A., McLean, B. and Ackerman, L. V. (1974) Uveitis and vitiligo associated with BCG treatment for malignant melanoma. Surgery, 76, 771. 

Surgery is the primary treatment modality for nonmelanoma and melanoma skin cancer. 

Brain metastasis is common in melanoma, and treatment options for brain metastasis include surgery, radiation, and chemotherapy. The choice of therapy depends on the number of metastatic lesions, accessibility of the lesions for surgery, the presence of neurologic symptoms, and the status of extracranial disease. 

Bestatin has been st ]died clinically during the last 6 years. Dally oral administration of 30 or 60 mg to cauicer patients restored the lowered immunity indices in stx h patients (64). Clinical randomization tests for the therapeutic effects of bestatin have been conducted. For instance, the survival period of patients with melanoma after the macroscopic elimination of tumors by surgery emd chemotherapy has been significantly prolonged by bestatin administration (30 mg, dally, orally) compared with the cases of controls without stich bestatin treatment. 

GMK vaccine was compared with high-dose Interferon alfa 2b in high-risk melanoma patients who had undergone surgery. Interferon-treated patients were 50% less likely to experience a return of their disease and 52% less likely to die than were GMK-treated patients (55). 

Melvin (Mel) Anoma is a 46-year-old man who noted a superficial, brownish-black, 5-mm nodule with irregular borders in the skin on his chest. He was scheduled for outpatient surgery, at which time a wide excision biopsy was performed. (In an excision biopsy, the complete mole is removed and biopsy performed). Examination of the nodule indicated histologic changes characteristic of a malignant melanoma reaching a thickness of only 0.7 mm from the skin surface (Stage I). 

Melanins are produced by specialized cells, the melanocytes. An accumulation of these cells causes moles. If these cells become malignant, a melanoma develops, a type of skin cancer which requires immediate surgery. 

Three patients suffered metastasis from melanotic melanoma which had a median survival after PDT of 12 months. One patient suffered from metastasis of a squamous carcinoma of the lung with two recurrences every 3 months despite radiotherapy after the first relapse. The tumor recurred again 6 months after reoperation and PDT. A second patient suffered from metastasis of an adenocarcinoma of unknown primary location with recurrence within 3 months after surgery and no adjuvant treatment. After reoperation, PDT and conventional radiotherapy of 45 Gy the patient has been recurrence free for over 7 years. 

Richard, Nashville, Tennessee. Melanoma recurrence, stage 3, diagnosed in 2006 at age sixty-four. (Treatment surgery. Chemo cisplatin, vinblastine, dacarbazine and interferon.)... 

Additional indications for resection/ablation are isolated liver metastases of hreast cancer, renal cell cancer and Wilms tumors, sarcoma, melanoma (mostly of ocular origin), and, rarely, other G1 cancers neuroendocrine liver metastases are a frequent indication for curative resection or cytoreductive surgery in combination with the primary tumor location and extrahepatic metastases. 

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