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Clinical diagnosis and therapy of cutaneous melanoma in situ
Author(s) -
Bartoli Cesare,
Bono Aldo,
Clemente Claudio,
Prato Ivan Del,
Zurrida Stefano,
Cascinelli Natale
Publication year - 1996
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/(sici)1097-0142(19960301)77:5<888::aid-cncr12>3.0.co;2-#
Subject(s) - medicine , melanoma , malignancy , wide local excision , dermatology , surgery , incidence (geometry) , radiology , pathology , physics , cancer research , optics
BACKGROUND The frequency of in situ melanoma is increasing, and it is often diagnosed fortuitously by histology. METHODS We retrospectively reviewed 121 melanomas in situ in 113 patients with the aim of identifying the clinical features of, and optimal surgical treatment for this cutaneous malignancy. Treatment was limited surgery with 3 mm margins of excision in 69 cases (57%) and wider margins of excision (more than 3 mm) in 52 cases (43%). The lesions had a median diameter of 1 cm (range, 2–35 mm) and were generally macular (92% of cases) and asymmetric (87%), with an irregular border (88%) and nonuniform pigmentation (98%), usually in shades of brown (41%) and black (48%). These features had permitted a clinical diagnosis of melanoma or suspected melanoma in 62% of cases and of doubtful nevus in an additional 18% of cases. RESULTS At a median follow‐up of 4 years, there were six local recurrences (three treated by limited surgery and three by wider excision), all in situ melanomas. CONCLUSIONS The typical clinical features of melanoma in situ, which are similar to those of early invasive melanoma, are usually sufficiently distinctive to suggest the clinical diagnosis of melanoma or suspected melanoma. Except for large size and superficially extended lesions (larger than 2 cm), adequate treatment is excision with 3 mm margins, although larger lesions (larger than 2 cm) may have an appreciable incidence of local recurrence. Cancer 1996;77:888‐92.