title: Rare clinical experiences for surgical treatment of melanoma with osseous metastases in Taiwan.
abstract: BACKGROUND
  Malignant melanoma occurs infrequently in Taiwan. Once it has progressed into osseous metastases, the prognosis is poor. There are no reported clinical experiences of surgical management in this area.
  
  
  METHODS
  To improve our understanding of the rare clinical experiences, we retrospectively investigated clinical characteristics, radiological findings, treatment modalities, survival outcomes and prognoses of 11 Taiwanese patients with osseous metastasis of melanoma treated surgically at two national medical centers, National Taiwan University Hospital and National Cheng Kung University Hospital from January 1983 to December 2006.
  
  
  RESULTS
  Six patients suffered from acral-lentiginous melanoma. Nine patients sustained multiple osseous metastases and most lesions were osteolytic. Nine patients also had sustained metastases to other organs including liver, lungs, lymph nodes, brain and spleen. Second malignancies including lung cancer, thyroid papillary carcinoma, renal cell carcinoma and cervical cancer co-existed in four patients. The interval from the initial diagnosis of melanoma to the clinical detection of osseous metastases varied from 0-37.8 months (mean 9.75 months). Metastatic melanoma was invariably fatal; the mean survival time from bone metastases to death was 5.67 months.
  
  
  CONCLUSIONS
  Due to the high morbidity and poor survival of Taiwanese patients with osseous metastases of melanoma, surgical treatment should be directed towards pain relief and the prevention of skeletal debilitation in order to maintain their quality of life.
authors.affiliation: Department of Orthopaedics and Institute of Clinical Medicine, College of Medicine, National Cheng Kung University Medical Center, Tainan city, Taiwan. hkyuan@mail.ncku.edu.tw <hkyuan@mail.ncku.edu.tw>
authors.forename: Kuo-Yuan
authors.initials: KY
authors.lastname: Huang
authors.forename: Chrong-Reen
authors.initials: CR
authors.lastname: Wang
authors.forename: Rong-Sen
authors.initials: RS
authors.lastname: Yang
mesh_terms: D000328:Adult; D000368:Aged; D001859:Bone Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary* / Q000601:surgery*; D001932:Brain Neoplasms / Q000556:secondary / Q000601:surgery; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary / Q000601:surgery; D008175:Lung Neoplasms / Q000556:secondary / Q000601:surgery; D008207:Lymphatic Metastasis / Q000000981:diagnostic imaging; D008297:Male; D008545:Melanoma / Q000000981:diagnostic imaging / Q000601:surgery*; D008875:Middle Aged; D011859:Radiography; D035583:Rare Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D013160:Splenic Neoplasms / Q000556:secondary / Q000601:surgery; D013624:Taiwan