MALIGNANT-MELANOMA OF THE HEAD AND NECK - CLINICAL AND IMMUNOLOGICAL CONSIDERATIONS

Prolonged exposure to sun for long periods during most of the year has led to an increase in the frequency of malignant melanoma in Israel, especially for head and neck (H & N) melanoma. H & N melanoma is found in males more than in females and diagnosed when already locally adva nced. The disease-free interval between treatment of the primary lesio n and recurrence of the disease correlated with the patient's age and the depth of invasion according to Breslow. A higher recurrence rate c orrelated with male gender, location in the scalp, and the stage of th e disease. Metastatic disease involved the lungs, liver, and brain and responded poorly to systemic therapy. Improved survival was related t o female gender, early stage of the disease, low Breslow thickness, an d location of the primary lesion elsewhere than the scalp. Immunologic ally, we found that the titers of antimelanoma antibodies in patients with metastatic disease originating in the area of the head and neck w ere higher than the titer in disease-free H & N melanoma patients (p = 0.05). Moreover, patients with metastatic H & N melanoma had a higher titer of antityrosinase antibodies compared with healthy subjects. Th ese two types of antibodies might be used as markers for disease progr ession in H & N melanoma. The more aggressive character of H & N melan oma was not reflected by different titers of antimelanoma antibodies n or by antityrosinase antibodies in patients with H & N versus non-H & N melanoma.