[Update on surgical treatment of primary and metastatic cutaneous melanoma].
Melanoma is a common cutaneous tumour. It is of great importance due to its increasing incidence and aggressive behaviour, with metastasis to lymph nodes and internal organs. When suspecting melanoma, excisional biopsy should be performed to obtain complete histological information in order to determine the adverse factors such as ulceration, mitosis rate, and Breslow depth, which influence preoperative staging and provide data for sentinel lymph biopsy decision making. The indicated management for melanoma is wide local excision, observing recommended and well-established excision margins, depending on Breslow depth and anatomical location of the tumour. Therapeutic lymphadenectomy is recommended for patients with clinically or radiologically positive lymph nodes. This article reviews surgical treatment of melanoma, adverse histological factors, sentinel lymph node biopsy, and radical lymphadenectomy. Details are presented on special situations in which management of melanoma is different due to the anatomical location (plantar, subungual, lentigo maligna), or pregnancy.
Servicio de Dermatología, Hospital Universitario Dr. José E. González, Monterrey, Nuevo LeónMéxico.
María Alejandra
MA
Zuluaga-Sepúlveda
Servicio de Dermatología, Hospital General de México Dr. Eduardo Liceaga, México D.F., México.
Ivonne
I
Arellano-Mendoza
Servicio de Dermatología, Hospital Universitario Dr. José E. González, Monterrey, Nuevo LeónMéxico. Electronic address: jocampo2000@yahoo.com.mx.
Jorge
J
Ocampo-Candiani
D000328:Adult; D001706:Biopsy / Q000379:methods; D000075202:Contraindications; D005260:Female; D006801:Humans; D018327:Hutchinson's Melanotic Freckle / Q000601:surgery; D008197:Lymph Node Excision / Q000379:methods; D008207:Lymphatic Metastasis; D008297:Male; D008545:Melanoma / Q000235:genetics / Q000473:pathology / Q000556:secondary / Q000601:surgery*; D009260:Nail Diseases / Q000601:surgery; D009364:Neoplasm Recurrence, Local / Q000601:surgery; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000601:surgery; D019651:Plastic Surgery Procedures; D021701:Sentinel Lymph Node Biopsy; D012878:Skin Neoplasms / Q000235:genetics / Q000473:pathology / Q000601:surgery*
Biopsia ganglio centinela; Cutaneous melanoma; Linfadenectomía radical; Melanoma cutáneo; Quirúrgico; Radical lymphadenectomy; Sentinel lymph node biopsy; Surgical; Tratamiento; Treatment