Melanoma and Other Tumors of the Skin

Abstract

The most commonly occurring human neoplasms are those arising in the skin. The nonmelanoma neoplasms are chiefly squamous and basal cell carcinomas that evolve slowly, generally permitting early recognition and cure by local. Less often, radiation and topical chemotherapeutic approaches are used. Melanoma is a less common but more aggressive cutaneous neoplasm that in up to 15% of patients, has a considerably more lethal progression pattern, involving regional and distant sites. Recently, new biologic therapies capable of preventing relapse after surgical excision and leading to sustained regression in patients with metastatic disease have been identified. Melanoma less frequently arises in a variety of noncutaneous sites, including the mucosae and subungual areas of the toes and fingers and the uveal tract of the eye. Indeed ocular melanoma is the most lethal tumor of the eye in adults. The incidence of melanoma has risen more rapidly than any other solid tumor. Approximately 45,000 patients develop melanoma annually, with one in 75 white patients expected to be at risk for developing melanoma in their lifetime at the beginning of this millennium [1]. Interestingly, the increase appears to be primarily in thin melanomas, those most readily cured with simple excision [2]. The following chapter will deal solely with cutaneous melanoma and basal and squamous cell carcinomas, the predominant skin cancers that confront the clinician.