Malignant melanoma of the external ear: Review of 102 cases

The medical records of 102 patients with a diagnosis of melanoma of the external ear seen at The M.D. Anderson Hospital over approximately a 30 year period were reviewed. Survival was correlated with the sex, the clinical appearance of the lesion, the anatomic site of origin, the microscopic thickness and level of invasion, the absence or presence of clinical and pathologic nodal metastasis, the type of neck dissection and the type of definitive surgical treatment to the ear. The thickness and nodal metastasis adversely affected prognosis. Proper surgical treatment usually involves less than total amputation of the ear. A randomized prospective study should answer the question of whether elective neck dissection of the periauricular, parotid and upper posterior cervical and jugulodigastric nodes is justified. The use of chemoimmunotherapy offers negligible therapeutic benefits for disseminated disease but may be of prophylactic value in a planned, adjunctive protocol for poor risk patients.