title: Unknown Primary Melanoma: Worldwide Survey on Clinical Management.
abstract: BACKGROUND
  How to deal with melanoma of unknown primary (MUP) origin is a debated topic in the literature.
  
  
  OBJECTIVE
  We performed a worldwide survey to inquire what clinical and investigational workup is performed as well as the physicians' perception of this disease.
  
  
  METHODS
  A questionnaire was sent via mail to clinicians involved in melanoma care from December 2015 to April 2016 using the International Dermoscopy Society website.
  
  
  RESULTS
  119 physicians from 47 different countries answered the questionnaire. The most reported examination was skin examination followed by CT and/or PET scans. All the participants declared asking about previous excisions of skin lesions with 81% of them asking for a histopathological slide review of previous biopsies. Half of the participants checked for a possible vitiligo phenomenon that may explain regression of the primary lesion. BRAF, cKIT, and GNAQ mutations were screened by 32% of participants. The majority of participants (76%) applied the same treatment protocols for MUP as patients with known primary melanomas of the same AJCC stage.
  
  
  CONCLUSIONS
  Strong heterogeneity was found between physicians dealing with MUP. Thus, a consensus document should be strongly encouraged.
authors.affiliation: Section of Dermatology, Medical Sciences Department, University of Turin, Turin, Italy.
authors.forename: Simone
authors.initials: S
authors.lastname: Ribero
authors.forename: Riccardo
authors.initials: R
authors.lastname: Pampena
authors.forename: Veronique
authors.initials: V
authors.lastname: Bataille
authors.forename: Elvira
authors.initials: E
authors.lastname: Moscarella
authors.forename: Luc
authors.initials: L
authors.lastname: Thomas
authors.forename: Pietro
authors.initials: P
authors.lastname: Quaglino
authors.forename: Concetta
authors.initials: C
authors.lastname: Potenza
authors.forename: Alexander C J
authors.initials: ACJ
authors.lastname: Van Akkooi
authors.forename: Alessandro
authors.initials: A
authors.lastname: Testori
authors.forename: Paul
authors.initials: P
authors.lastname: Nathan
authors.forename: Susana
authors.initials: S
authors.lastname: Puig
authors.forename: Iris
authors.initials: I
authors.lastname: Zalaudek
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Argenziano
authors.forename: Caterina
authors.initials: C
authors.lastname: Longo
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008545:Melanoma / Q000175:diagnosis* / Q000556:secondary / Q000628:therapy*; D008875:Middle Aged; D009382:Neoplasms, Unknown Primary; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000556:secondary / Q000628:therapy*
keywords: Management; Melanoma; Survey; Unknown primary