SURGICAL TREATMENT OF ADVANCED PALMOPLANTAR MELANOMA

Abstract

Aim: Palmoplantar melanoma is a rare and aggressive subtype of malignant melanoma. Not like other subtypes, sunlight is not the primary etiologic factor. We aim to expand the knowledge on this rare and neglected malignant melanoma subtype and add our findings to the literature. Materials and Methods: Malignant Melanoma patients admitted to our hospital between 2008 and 2020 were retrospectively analyzed. Twenty-seven patients with plantar and one with palmar melanoma were identified and included in our study. Data about gender, age at the diagnosis, histopathological features, sentinel lymph node localization, performed surgeries, sentinel lymph node biopsy (SLNB) and regional lymph node dissection results, recurrence, survival time, primary tumor localization, and systemic metastases were collected. Results: 26 plantar and one palmar melanoma patients were operated on in this period. Six patients died during follow-up. Twenty-three patients were treated with wide excisions, and four were treated with amputations. The defect was reconstructed with a skin graft in all cases with excisions. In 6 patients with suspicious lymph nodes in the preoperative imaging, lymph node dissection was added to the treatment. Other patients had sentinel lymph node biopsies and continued with dissection if a metastatic node was encountered. Conclusion: Our findings are congruent with the current literature. Skin grafting may enhance the success of palmoplantar melanoma follow-up and demands attention.