Murad Alam, MD, MSCI

Conservative removal of tumors did not result in worse prognosis than more radical resection.

Subungual malignant melanoma is a rare manifestation of cutaneous melanoma (occurring in 0.7% to 3% of cases). Diagnosis is often delayed, and survival rates at 5 years are not promising. These authors report a case series and a review of 124 cases of subungual melanoma treated at the Mayo Clinic from 1914 to 2010 with primary resection and confirmed negative margins.

Mean duration of symptoms before diagnostic biopsy was 2.2 years. At diagnosis, most patients were found to have local disease involvement only (83.9%). Mean Breslow depth in 76 lesions diagnosed after 1970 was 3.1 mm. In all, 116 patients underwent amputations, and the amputations were classified for level of resection. Progression-free, overall, and disease specific survival were not significantly affected by amputation level once histologically free margins were obtained.

Citation(s):

Nguyen JT et al. Surgical management of subungual melanoma: Mayo clinic experience of 124 cases. Ann Plast Surg 2013 Oct; 71:346.