MALIGNANT-MELANOMA OF THE EAR

This paper reports on 16 cases of primary malignant melanoma of the ex ternal ear and the patients were followed up for two to 116 months. Fo urteen patients had surgical excision with wide margins as initial tre atment, whilst two had an amputation performed. Eleven patients had no recurrences, two died of other diseases, and four died of malignant m elanoma. The five patients who developed recurrences received further surgery and two also radiotherapy. Seven of the cases were histologica lly of the nodular type, six were superficial spreading, two were in s itu melanoma, and one was a lentigo maligna. The thickness ranged from 0. 15 to 11.5 mm. Classification according to Clark et al. (1969) rev aled that as many as nine cases were Clark level IV or more. Immunosta ining with PCNA yielded strong positivity in all cases, however, stati stical analysis did not reveal any differences that could be correlate d to the prognosis. Estimation of the vascularization at the base of t he tumours by means of immunostaining with CD31 did not reveal any sig nificant differences either. We concluded that in our material the thi ckness of the tumour is of greater prognostic value than the estimatio n of proliferation by PCNA and vascularization by CD3 1. The value of PCNA and CD31 as possible prognostic parameters needs to be evaluated in a larger series. It is emphasized that malignant melanoma of the ex ternal ear is a highly malignant tumour, and that four of our 16 patie nts died of their disease, three of them within a year after diagnosis . Malignant melanoma of the external ear is readily inspected and ther eby an early diagnosis should be possible.