Malignant melanoma of the external ear

Byers, Robert M.; Smith, J. L.; Russell, Nancy; Rosenberg, Vladimiro

doi:10.1016/0002-9610(80)90203-2

Cited by 89 publications

(86 citation statements)

References 1 publication

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“…The overall distribution of melanoma at different subsites (face, scalp, ear and neck) is similar to other large series (Fisher, 1989;O'Brien et al, 1991;Ringborg et al, 1993), and the male predominance of melanoma on the neck, scalp and ears also confirms results of other authors (Fitzpatrick et al, 1972;Knutson et al, 1972;Byers et al, 1980;Day et al, 1982a;Gussack et al, 1983;Fisher, 1989;O'Brien et al, 1991;Ringborg et al, 1993). The reasons for this are uncertain but baldness and shorter hair styles in men are likely to be the explanation.…”

Section: Discussionsupporting

confidence: 89%

Comparison between lentigo maligna melanoma and other histogenetic types of malignant melanoma of the head and neck

Cox

Aitchison²,

Sirel³

et al. 1996

Br J Cancer

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Summary A study of 953 invasive cutaneous malignant melanomas of the head and neck was performed to determine differences between lentigo maligna melanoma and other histogenetic types with regard to patients and sites affected; prognosis was analysed in 595 of these cases. The cases studied comprised all head and neck melanomas registered with the Scottish Melanoma Group between 1979 and 1992, apart from the 3% of cases that were unclassifiable or rare histogenetic types. The histogenetic types of melanoma were 498 (52%) lentigo maligna melanoma (LMM), 237 (25%) superficial spreading melanoma (SSM) and 218 (23%) nodular melanoma (NM). All types increased in incidence throughout the study period. Patients with LMM (mean age 73 years) and NM (mean 68 years) were significantly older than those with SSM (mean 57 years). There were significant anatomical subsite differences related to sex of patients and histogenetic type of melanoma; melanomas on the face were more frequent in females and 90% of LMM occurred at this site, whereas melanomas on the scalp, neck and ears were more frequent in men. Kaplan-Meier estimates of the probability of survival were produced for the 595 of these 953 patients with 5 year follow-up details. In this group of patients the prognostic significance of tumour thickness, Clark level of invasion, ulceration, histogenetic type of melanoma and number of mitoses were studied using stepwise variable selection of procedures. Each of these possible prognostic factors attained individual significance but the tumour thickness was the dominant risk factor in the proportional hazards analysis. When patients were divided into four sex/ulceration subgroups (male/ulcerated, female/ulcerated, male/non-ulcerated, female/non-ulcerated) and analysed by proportional hazards analysis, no variable other than the tumour thickness had any further prognostic effect. Histogenetic type did not remain an independent prognostic variable at this stage. Despite sex and subsite differences, the prognosis for invasive lentigo maligna melanoma does not differ from that for other histogenetic types after controlling for tumour thickness.

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Section: Discussionsupporting

confidence: 89%

Comparison between lentigo maligna melanoma and other histogenetic types of malignant melanoma of the head and neck

Cox

Aitchison²,

Sirel³

et al. 1996

Br J Cancer

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“…Bal¬ lantyne4 believed patients with scalp lesions tended to have a poorer prog¬ nosis, while those with lesions of the neck and face did better. This finding was also confirmed by Ames et al15 and Byers et al, 18 showing an overall survival of 49% with primary melano¬ ma of the ear. Because the skin of the ear is thin and has multiple areas of lymphatic drainage, this may contrib¬ ute to the poor prognosis for these thicker lesions.…”

Section: Commentsupporting

confidence: 79%

Cutaneous Melanoma of the Head and Neck: A Review of 399 Cases

Gussack¹,

Reintgen²,

Cox³

et al. 1983

Archives of Otolaryngology - Head and Neck Surgery

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\s=b\A retrospective search of the Duke University Melanoma Clinic patients identified 399 cases with primary malignant melanoma located in the head and neck region. Ninety-five percent of the deaths in this series were from metastatic melanoma. Various clinical and pathological data were examined and their effects on survivability and disease-free intervals were evaluated. The characteristics noted included sex, age, depth of the invasion, thickness, site of the lesion, histologic type, and nodal status. A multivariate regression analysis identified the following factors as having a negative effect on survival: nodular histologic type, scalp primary, increasing Clark level, and male sex. In comparing head and neck, extremity, and truncal primary sites, the median survival for patients with head and neck malignant melanomas was notably less. These differences correlated with a higher incidence for male patients, for patients with thicker lesions, and for patients with an increased frequency of nodular histologic type. (Arch Otolaryngol 1983;109:803-808) Management of malignant mela¬ noma has plagued physicians for centuries. Robert Carswell, MD,1 in 1834, is credited with the first clinical description of a malignant mel¬ anoma, while Pemberton,2 in 1855, reported one of the first cases of mela¬ noma of the head and neck. He de¬ scribed a 53-year-old manwhowasseen with a "black patch of disease on the right cheek."2 This patient soon died of diffuse metastatic disease. Primary melanoma of the head and neck ac¬ counts for 25% to 30% of all melano¬ mas. The head and neck region is highly visible to both the patient and the phy¬ sician, suggesting that early diagnosis of melanoma in this location should be possible. The skin of the head and neck, however, is unique for several reasons. It has a much higher density of melano¬ cytes than comparable areas on the trunk or extremities.3 The extent to which it is exposed to sunlight and its rich investment of both lymphatic drainage and vascular supply, causes ham, NC 27710 (Dr Fisher). the head and neck region to be more susceptible to the development of pri¬ mary melanoma and to show a higher propensity for both local and distant metastatic spread. Reported five-year survival rates for persons with head and neck mela¬ noma range from 8% to 60%.47 Most of these series involve a small number of patients collected over a long period during which the treatment regimens were not always comparable. This makes statistical evaluation and com¬ parison with other studies difficult. In this article, we describe our experi¬ ence with 399 patients with cutaneous head and neck melanoma treated dur¬ ing a ten-year period during which standardized treatment and adjuvant therapy protocals were performed. MATERIALS AND METHODS Patient Population General Characteristics.-The Duke University Melanoma Clinic in Durham, NC, has registered more than 2,500 patients with melanoma during the last ten years. During a retrospective, comput¬ er-aided data search, 399 cases of head and neck mela...

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“…The disease occurs mainly on chronically sun-damaged skin, especially on the facial of elderly individuals. In a review of 102 melanomas of the external ear, Byers et al 3 noted that the median age at diagnosis was 56 years (range 8-83) and that 75% were males. Superficial spreading and nodular melanomas are the most common histological types.…”

Section: Discussionmentioning

confidence: 99%

“…Between 25% and 30% of primary cutaneous MM occur in the head and neck, and of these, 5%-10% arise on the external ear. [1][2][3][4] The helix is the most common site, followed by the lobule, the tragus-preauricular skin, and the concha.3 Primary melanoma of the external auditory canal (EAC) is rare. We report a case of a primary malignant melanoma of the external auditory canal and describe its computed tomographic (CT) features.…”

mentioning

confidence: 99%

Primary Malignant Melanoma of the External Auditory Canal: CT Features

et al. 2002

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Malignant melanoma (MM) is a malignancy with poor prognosis. Between 25% and 30% of primary cutaneous MM occur in the head and neck, and of these, 5%-10% arise on the external ear. [1][2][3][4] The helix is the most common site, followed by the lobule, the tragus-preauricular skin, and the concha.3 Primary melanoma of the external auditory canal (EAC) is rare. We report a case of a primary malignant melanoma of the external auditory canal and describe its computed tomographic (CT) features. Case ReportA 65-year-old man presented with a two-year history of painful mass in the left ear, with recent increase in size and ipsilateral hearing loss. There was no previous history of ear problem, trauma or surgery. On physical examination, the EAC was obliterated by an ulcerated red brownish mass. The pinna was intact with no evidence of regional lymphnode enlargement. The facial nerve function was normal. The endoscopic biopsy microscopically showed malignant epithelioid melanocytes with pigmented granular cytoplasm, large nuclei and prominent eosinophilic nucleoli expanding in the dermis. Mitoses were present and there was brisk lymphoid infiltrate at the base. On plain skull x-ray, no obvious bony changes were observed. Temporal bone CT scan in transverse and coronal planes demonstrated a soft tissue mass obliterating the EAC and eroding its inferior margin as well as the roof of the temporo-mandibular joint (TMJ). The mass was invading the hypotympanic cavity through the tympanic membrane. The inferior tympanic bony margin was partially eroded. The tumor had involved the ossicular chain with erosion of the malleus and the long process of the uncus. The mass was moderately and homogeneously enhancing after intravenous contrast injection. The epitympanic cavity, the mastoid cells and the internal ear were preserved. No intracranial extensions or metastases were detected. Magnetic resonance imaging (MRI) examination was not done due to lack of facilities. The patient underwent a subtotal tumor excision with regional lymph node dissection. The surgical treatment was followed by multiple sessions of radiotherapy. Six months later, the patient presented with a large local recurrence, intracranial and lymphnode metastases, and died one month later.

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Malignant melanoma of the external ear

Cited by 89 publications

References 1 publication

Comparison between lentigo maligna melanoma and other histogenetic types of malignant melanoma of the head and neck

Comparison between lentigo maligna melanoma and other histogenetic types of malignant melanoma of the head and neck

Cutaneous Melanoma of the Head and Neck: A Review of 399 Cases

Primary Malignant Melanoma of the External Auditory Canal: CT Features

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