title: [Role of surgery in patients with metastases from melanoma. A case report].
abstract: BACKGROUND
  The prognosis of patients with melanoma varies according to the staging of disease at the moment of diagnosis. Melanoma can metastasize to every organ or tissue, but the most common site involved is locoregional. In selected patients surgery plays a central role with the possibility of changing the prognosis at distance.
  
  
  METHODS
  A 65-year-old man with a diagnosis of neoplasm of the left thyroid lobe and metastatic melanoma with unknown primitive localization. Since 2003 the patient has undergone many operations to remove metastatic melanoma. Currently he is in good conditions and performs neoadjuvant palliative treatments.
  
  
  CONCLUSIONS
  The indication for surgery in cases of patients with distant disease (IV stage) or metastases in transit (IIIc stage) is linked to the possibility of surgical removal of individual lesions. In particular are candidates for surgery patients who have a visceral localization less than or equal to 2 sites, a number less than or equal to 8 metastases, in good health and having a melanoma-specific survival estimated more than 3 months; surgical approach requires an accurate and early identification by imaging study. The case report shows that in selected cases, some patients may benefit from aggressive surgery, especially in terms of survival at distance.
authors.affiliation: Dipartimento di Scienze Chirurgiche, Policlinico Umberto I, Sapienza Università di Roma, Roma, Italia.
authors.forename: Domenico
authors.initials: D
authors.lastname: Vendettuoli
authors.forename: Domenico
authors.initials: D
authors.lastname: Giannotti
authors.forename: Paola
authors.initials: P
authors.lastname: Grilli
authors.forename: Claudia
authors.initials: C
authors.lastname: D'Ercole
authors.forename: Alberto
authors.initials: A
authors.lastname: Santoro
authors.forename: Adriano
authors.initials: A
authors.lastname: Redler
authors.forename: Roberto
authors.initials: R
authors.lastname: Cirocchi
authors.forename: Stefano
authors.initials: S
authors.lastname: Trastulli
authors.forename: Nicola
authors.initials: N
authors.lastname: Avenia
authors.forename: Giorgio
authors.initials: G
authors.lastname: Di Rocco
mesh_terms: D000368:Aged; D006801:Humans; D008297:Male; D008545:Melanoma / Q000556:secondary* / Q000601:surgery*; D013964:Thyroid Neoplasms / Q000556:secondary* / Q000601:surgery*