Superficial spreading melanoma
Superficial spreading melanoma is a melanoma rising within a precursor in situ lesion. The atypical lesion spreads in a radial fashion for up to several years, generally increasing in atypia of color, edge, and surface. An invasive component can develop within this atypical lesion.
- The treatment of superficial spreading melanoma in situ and invasive is surgical excision. The width of normal skin included in the surgical excision depends to a certain extent upon thickness in mm of the primary tumor.
- In situ superficial spreading melanoma can be treated with a 0.5 -1 cm surgical margin.
- Invasive melanoma is treated with a 1-3 cm surgical margin, depending on thickness.
- Patients with lesions greater than 1.5 mm deep may also have elective lymph node dissection but the role of elective lymph node dissection has not been well defined.
- Metastatic melanoma does not respond well to systemic chemotherapy, but the single best agent is dacarbazine.
- Investigative treatments include immune manipulation of tumor infiltrating lymphocytes and gene therapy.