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Melanoma pp 337-350 | Cite as

Surgical Management of Head and Neck Melanoma

  • Joseph Zenga
  • Kevin Emerick
  • Shaun Desai
Chapter

Abstract

Cutaneous malignancies are the most common group of cancers diagnosed in the head and neck. While basal and squamous cell carcinomas represent the most frequent diagnoses, cutaneous melanoma is responsible for the majority of disease-related mortality. Much of the data informing the workup and management of head and neck melanoma is extrapolated from large trials which include mostly trunk and extremity subsites. The anatomical constraints and intricacies of the head and neck region, however, require careful interpretation of the evidence to apply these treatment paradigms to care of the head and neck melanoma patient. Achieving appropriate resection margins and planning reconstructive efforts may present unique challenges. Sentinel node biopsy has proven to be safe and effective for regional nodal staging in the head and neck. Nonetheless, management of the cervical and parotid lymphatic basins requires a detailed understanding of the critical neurovascular structures involved and the potential drainage pathways. Similar to other sites, adjuvant therapy plays an important and expanding role in the management of head and neck melanoma. Clinical trials in systemic therapy, including immunomodulators and targeted inhibitors, provide future directions in the prevention and treatment of recurrent and metastatic disease. Currently, the management of head and neck melanoma requires a coordinated multidisciplinary approach and a comprehensive understanding of the available data to interpret and appropriately apply the evidence to individual patient care.

Keywords

Melanoma Head and neck Sentinel lymph node biopsy Neck dissection Parotidectomy Squamous cell carcinoma Basal cell carcinoma Immunotherapy 

Notes

Acknowledgement

No financial disclosures or conflicts of interest.

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Otolaryngology—Head and Neck Surgery, Massachusetts Eye and Ear InfirmaryHarvard Medical SchoolBostonUSA
  2. 2.Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology—Head and Neck SurgeryJohns Hopkins University School of MedicineBethesdaUSA

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