TITLE:
Conservative Surgery for Subungual Melanoma In Situ Using Matriderm®
AUTHORS:
Mariane Campagnari, Helio Alberto Carneiro, Andrea Schiavinato Jafelicci, Heidy Carmecide da Silva Reis, Elimar Elias Gomes, Eduardo Bertolli, João Pedreira Duprat Neto
KEYWORDS:
Melanoma, Amputation, Artificial Skin
JOURNAL NAME:
Journal of Cancer Therapy,
Vol.8 No.10,
October
13,
2017
ABSTRACT: Background: Standard treatment for subungual melanoma is wide
local excision including digit amputation in order to obtain safety margins.
Level of amputation has been discussed in order to achieve appropriate
oncological results along with preservation of limb function wherein local
excision of subungual melanoma in situ without amputation is an option. Methods: We report two cases of subungual melanoma in situ treated by using a conservative approach. Both cases were
treated with local excision with the resected tumor defect covered with an
artificial dermis, Matriderm?. One case was of a 65-year-old male with a left
thumb subungual melanoma in situ and
another of a 41-year-old female with the same type of melanoma in the left
hallux. Full-thickness skin graft was used for reconstruction after 7 weeks
from the first surgery in the latter, and in the former case re-epithelization
occurred within 90 days after surgery. To date, no clinical signs of recurrence
have been found, and finger/toe functions were completely preserved with a
minimized scar and little graft bed sensitivity. Follow-up time is two years
and ten months for the left thumb case, and one year and six months for the
left hallux subungual melanoma in situ. Conclusion: We present two cases of subungual melanoma in situ treated with digit sparing
surgery including excision of the periosteum followed by the use of an
artificial dermal template to guarantee coverage of the tumor bed defect,
providing good functional and cosmetic outcome.