Chapter 25 : Management of Head and Neck Melanoma

Cutaneous melanoma is a capricious neoplasm characterized by a clinical behavior that can be considered archetypical of malignancy. The obscurity of its causes, the often unpredictable pattern of lymphatic and hematogenous metastases, the inscrutable differences between potentially curable and incurable lesions, and the often relentless progression of disease despite apparently adequate treatment all characterize this malignancy. The recognition of these characteristics led early cancer surgeons to adopt a philosophy of extensive surgical resections even for melanomas of the smallest size. Such dogma became a cornerstone in surgical oncology and in the treatment of melanomas.