The Treatment of the Malignant Melanoma of the Skin

Abstract

Since 1949 the author has had occasion to treat and/or follow more than 950 cases of malignant melanomas of the skin. The form of treatment based on this study is submitted. The author recommends surgical treatment consisting in wide excision, but without removing the fascia, exarticulation if the lesions affect toes and fingers, but no other form of amputation.

Lymph node dissection is done in the presence of me-tastases, but prophylactic evacuations only exceptionally. In the groin only superficial inguinal dissection is done, not abdominal.

Local and regional metastases are also treated by wide excision, but cutaneous remote metastases are removed by oval excision. The treatment is continued until visceral metastases are demonstrated, since some cases have shown that the disease may be “exhausted”.

A new theory concerning the metastasization is submitted.