Clinico-pathological features of relapsing very thin melanoma

In the UK the incidence of malignant melanoma is increasing and more patien ts with thinner primary lesions are diagnosed earlier. Most patients with v ery thin melanoma (< 0.76 min Breslow thickness) are cured by surgical exci sion, however, 2-18% relapse over 0-11 years with local or distant metastat ic disease and may die. There are still no recognized prognostic or predict ive, clinical, serological or molecular markers that accurately determine w hich of these very thin melanoma will relapse: the Breslow thickness remain s the single most important prognostic factor for melanoma in general. impr oved prognostic indicators are therefore needed for this rare, but importan t, unusually aggressive group, to better direct new invasive and expensive investigations and treatment. This article reviews the clinical and histolo gical aspects of relapsing very thin melanoma and discusses the findings of several recent studies, including our own. There is no clinical or biologi cal evidence to support either wide surgical excision or sentinel node biop sy in these patients.