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Malignant melanoma of the ear

Published online by Cambridge University Press:  29 June 2007

Åke Davidsson*
Affiliation:
From the Departments of Otorhinolaryngology, Örebro Medical Center Hospital, Örebro, Sweden.
Henrik B. Hellquist
Affiliation:
From the Departments of Pathology, Head and Neck Unit, Örebro Medical Center Hospital, Örebro, Sweden.
Kenneth Villman
Affiliation:
From the Departments of Oncology, Örebro Medical Center Hospital, Örebro, Sweden.
Gunnar Westman
Affiliation:
From the Departments of Oncology, Örebro Medical Center Hospital, Örebro, Sweden.
*
Å. Davidsson, M.D., Department of Otorhinolaryngology, Örebro Medical Center Hospital, S-701 85 Örebro, Sweden.

Abstract

This paper reports on 16 cases of primary malignant melanoma of the external ear and the patients were followed up for two to 116 months. Fourteen patients had surgical excision with wide margins as initial treatment, whilst two had an amputation performed. Eleven patients had no recurrences, two died of other diseases, and four died of malignant melanoma. The five patients who developed recurrences received further surgery and two also radiotherapy.

Seven of the cases were histologically of the nodular type, six were superficial spreading, two were in situ melanoma, and one was a lentigo maligna. The thickness ranged from 0.15 to 11.5 mm. Classification according to Clark et al. (1969) revaled that as many as nine cases were Clark level IV or more. Immunostaining with PCNA yielded strong positivity in all cases, however, statistical analysis did not reveal any differences that could be correlated to the prognosis. Estimation of the vascularization at the base of the tumours by means of immunostaining with CD31 did not reveal any significant differences either.

We concluded that in our material the thickness of the tumour is of greater prognostic value than the estimation of proliferation by PCNA and vascularization by CD31. The value of PCNA and CD31 as possible prognostic parameters needs to be evaluated in a larger series. It is emphasized that malignant melanoma of the external ear is a highly malignant tumour, and that four of our 16 patients died of their disease, three of them within a year after diagnosis. Malignant melanoma of the external ear is readily inspected and thereby an early diagnosis should be possible.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 1993

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References

Ames, F. C, Sugarbaker, E. V, Ballantyne, A. J. (1976) Analysis of survival and disease control in stage I melanoma of the head and neck. American Journal of Surgery 132: 484491.CrossRefGoogle Scholar
Ballantyne, A. J. (1970) Malignant melanoma of the skin of the head and neck. An analysis of 405 cases. American Journal of Surgery 20: 425431.CrossRefGoogle Scholar
Batsakis, J. G. (1979) Melanomas (cutaneous and mucosal) of the head and neck. In: Tumours of the head and neck. Clinical and pathological considerations. 2nd Edition. Williams & Wilkins, Baltimore, London, pp 431447.Google Scholar
Breslow, A. (1970) Thickness, cross-sectional areas and depth of invasion in the prognosis of cutaneous melanoma. Annals of Surgery 172: 902908.CrossRefGoogle ScholarPubMed
Byers, R. M., Smith, J. L., Russell, N., Rosenberg, V. (1980) Malignant melanoma of the external ear. Review of 102 cases. American Journal of Surgery 140: 518521.CrossRefGoogle ScholarPubMed
Clark, W. H., From, L., Bernardino, E. A., Mihm, M. C. (1969) The histogenesis and biologic behaviour of primary malignant melanomas of the skin. Cancer Research 29: 705727.Google ScholarPubMed
Cohen, C., Walker, B. F., Solomon, A. R., DeRose, P. B. (1992) DNA ploidy and cell cycle analysis in ear malignant melanoma by flow and image cytometry. Analytical and Quantitative Cytology and Histology 14: 8188.Google ScholarPubMed
Cox, N. H., Jones, S. K., MacKie, R. M. (1987) Malignant melan oma of the head and neck in Scotland: an eight-year analysis of trends in prevalence, distribution and prognosis. Quarterly Journal of Medicine 64: 661670.Google Scholar
Hellquist, H. B. (1990) Malignant melanoma and metastatic neoplasms. In: Pathology of the nose and paranasal sinuses. Butterworths, London, pp 143148.Google Scholar
Hudson, D. A., Krige, J. E. J., Strover, R. M, King, H. S. (1990) Malignant melanomas of the external ear. British Journal of Plastic Surgery 43: 608611.CrossRefGoogle ScholarPubMed
Parums, D. V, Cordell, J. L., Micklem, K., Heryet, A. R., Gatter, K. C, Mason, D. Y. (1990) JC70: a new monoclonal antibody that detects vascular endothelium associated antigen on routinely processed tissue sections. Journal of Clinical Pathology 43: 752757.CrossRefGoogle ScholarPubMed
Ringborg, U., Afzelius, L. E., Lagerlbf, B. et al. (1993) Cutaneous malignant melanoma of the head and neck: analysis of treatment results and prognostic factors in 581 patients. A report from the Swedish Melanoma Study Group. Cancer 71: 751758.3.0.CO;2-9>CrossRefGoogle ScholarPubMed
Urist, M. M., Balch, C. M., Soong, S-J. et al. (1984) Head and neck melanoma in 534 clinical stage I patients. Annals of Surgery 200: 769775.CrossRefGoogle ScholarPubMed
Wanebo, H. J., Cooper, P. H., Young, D. V., Harpole, D. H., Kaiser, D. L. (1988) Prognostic factors in head and neck melanoma. Effect of lesion location. Cancer 62: 831837.3.0.CO;2-X>CrossRefGoogle ScholarPubMed