Cutaneous malignant melanoma is the fourth leading cancer type in men and the fifth in women in the USA. It is readily curable in early stages but in the disseminated state, it carries a grave prognosis.
Melanoma occurs more frequently in white adults, with peak incidence during the fourth and fifth decades of life melanoma is rare in dark-skinned races.
Women have a survival advantage. Most melanomas arise de novo. They also may arise from preexisting nevi.
Diagnosis is established by excisional biopsies (1- to 2-mm margin), full-thickness incisional biopsies, or punch biopsies of the thickest portion of the tumor, selected according to tumor site and size. Biopsies should be made with consideration of future definitive treatment in mind.
Histological types include nodular, lentigo maligna, superficial spreading, and acral lentiginous.
Primary mode of treatment for cutaneous melanoma is surgery, with full-thickness excision serving as proper staging as well as treatment. Adjuvant chemotherapy, systemic biological therapy, and radiation therapy may be indicated.
Survival rates have increased between the years 1995 and 2000 as compared with the 1970s, in part due to increased awareness and screening programs.
Depth of invasion correlates with survival in cutaneous malignant melanoma. For stages I, II, III, and IV tumors, 15-year survival rates approximate 80, 50, 35, and 5%, respectively.
Other prognostic factors include mitotic rate, ulceration, regression, host immune response, satellitosis, angiolymphatic invasion, and status of regional nodal involvement.