Postoperative Recurrent Cutaneous Malignant Melanoma: A Report of Five Cases

Abstract

Malignant melanoma is a neoplasm of the cells that develops from melanocytes. The annual incidence of
melanoma has increased dramatically over the past few decades and various medical imaging techniques are
the best tools for diagnosis: Chest radiography, M.R.I of the brain, Ultrasound and Computerized Tomography.
The Positron Emission Tomography (PET) is considered to be one of the best imaging techniques for identifying
sites of metastasis. Surgery is the definitive treatment for early stage melanoma whilst medical management is
generally reserved for adjuvant treatment of advanced Melanoma.
The objective of our study is to demonstrate the importance of regular follow up and scanning, especially with
PET scanning, (taking into consideration that in the Tripoli Medical Center, there is a new PET machine which
commenced working in 2014). For the early detection of melanoma recurrence and to determine the best tool
of investigation which can be used for follow up in the postoperative malignant melanoma, we studied five cases
of postoperative cutaneous malignant melanoma. All five cases were treated with total excision of the primary
tumor with a safe margin and no local recurrence of the tumor was observed, however, loco-regional lymph node
metastasis was observed with a mean time of recurrence of the tumor of two months from the first surgery. All
our cases had no regular follow up.
In conclusion: regular follow up of postoperative cutaneous malignant melanoma is mandatory. A guideline
should be established in Libya and the PET scan should be used as one of the tools for early detection of metastatic
malignant melanoma.