About one out of ten malignant melanomas are classified histologically as superficial. That is, dermal invasion by nests of melanoma cells is absent.1 Within the widely variable behavior of melanoma, patients with superficial tumors present a particular set of clinical problems.2,3 This kind of histological report, often recovered by the aggressive physician who has excised suspicious nevi, prompts several difficult clinical questions. Is the diagnosis consistent with cancer, or is there an implication that the lesion is simply comparable to an aggressive nevus? Should such a diagnosis be based on clinical data, or solely on histological interpretation, or both? Should he consider definitive the complete, though minimal, excision, or should the patient be subjected to the radical local measures ordinarily employed in the curative approach to this disease? In the absence of clinically significant regional lymph nodes, should elective dissection be carried out either in continuity or separately?
DeCosse JJ, McNeer G. Superficial Melanoma: A Clinical Study. Arch Surg. 1969;99(4):531–534. doi:10.1001/archsurg.1969.01340160111026
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