Melanoma of the External Auditory Canal: A Review of Seven Cases at a Tertiary Care Referral Center

被引:8
作者
Appelbaum, Eric N. [1 ]
Gross, Neil D. [1 ]
Diab, Adi [2 ]
Bishop, Andrew J. [3 ]
Nader, Marc-Elie [1 ]
Gidley, Paul W. [1 ]
机构
[1] Univ Texas MD Anderson Canc Ctr, Dept Head & Neck Surg, Houston, TX 77030 USA
[2] Univ Texas MD Anderson Canc Ctr, Dept Melanoma Med Oncol, Houston, TX 77030 USA
[3] Univ Texas MD Anderson Canc Ctr, Dept Radiat Oncol, Houston, TX 77030 USA
关键词
Melanoma; external auditory canal; auricular melanoma; otologic malignancies; sentinel lymph node biopsy; MALIGNANT-MELANOMA; TEMPORAL BONE; RADIATION-THERAPY; CELL CARCINOMA; NODE BIOPSY; EAR; HEAD; SURVIVAL; NECK; MANAGEMENT;
D O I
10.1002/lary.28548
中图分类号
R-3 [医学研究方法]; R3 [基础医学];
学科分类号
1001 ;
摘要
Objectives/Hypothesis Examine the presentation and management characteristics of seven patients with melanoma of the external auditory canal (EAC). Study Design Retrospective case series and review of the relevant literature. Methods Records of seven patients from 2003 to 2017 with melanoma of the EAC were reviewed for characteristics of presentation, subsequent management, and outcomes. A thorough review of relevant literature is presented. Results The median age is 52 years, with four females. The average Breslow depth was 3.6 mm, with five patients having a Clark level IV or greater on presentation. Six patients underwent lateral temporal bone resection, and one patient underwent wide local excision of the cartilaginous canal. Sentinel lymph node biopsy (SLNB) was performed in three patients. Three patients experienced distant recurrence an average of 20 months following primary therapy. Median follow-up was 21 months. At last follow-up, four were free of disease, one had active disease, and two were deceased from melanoma. Conclusions This is the largest series and the first to report the use of SLNB for patients with EAC melanoma in the peer-reviewed literature. Patients with external auditory canal melanoma present with higher Breslow thickness and stage relative to all external ear melanomas. Management should include wide local excision, which entails lateral temporal bone resection when the bony ear canal is involved. SLNB has a critical role in identifying patients with early metastatic disease. Postoperative radiation therapy should be considered for patients with high-risk features to reduce the risk of locoregional relapse. Chemotherapy, and especially immunotherapy, has an emerging role for this disease. Level of Evidence 4 Laryngoscope, 2020
引用
收藏
页码:165 / 172
页数:8
相关论文
共 45 条
[1]   Metastatic pathways in patients with cutaneous melanoma [J].
Adler, Nikki R. ;
Haydon, Andrew ;
McLean, Catriona A. ;
Kelly, John W. ;
Mar, Victoria J. .
PIGMENT CELL & MELANOMA RESEARCH, 2017, 30 (01) :13-27
[2]   The Benefits of Adjuvant. Radiation Therapy After Therapeutic Lymphadenectomy for Clinically Advanced, High-Risk, Lymph Node-Metastatic Melanoma [J].
Agrawal, Shefali ;
Kane, John M., III ;
Guadagnolo, Beverly A. ;
Kraybill, William G. ;
Ballo, Matthew T. .
CANCER, 2009, 115 (24) :5836-5844
[3]  
Amando Garcia L, 2003, ACTA OTORRINOLARINGO, V54, P89
[4]  
American Cancer Society, 2019, CANC TREATMENT SURVI
[5]  
Banerjee A R, 1993, Clin Oncol (R Coll Radiol), V5, P255, DOI 10.1016/S0936-6555(05)80241-9
[6]   Elective radiotherapy provides regional control for patients with cutaneous melanoma of the head and neck [J].
Bonnen, MD ;
Ballo, MT ;
Myers, JN ;
Garden, AS ;
Diaz, EM ;
Gershenwald, JE ;
Morrison, WH ;
Lee, JE ;
Oswald, MJ ;
Ross, MI ;
Ang, KK .
CANCER, 2004, 100 (02) :383-389
[7]   Basal cell carcinoma of the temporal bone and external auditory canal [J].
Breen, Joseph T. ;
Roberts, Dianna B. ;
Gidley, Paul W. .
LARYNGOSCOPE, 2018, 128 (06) :1425-1430
[8]   Adjuvant radiotherapy versus observation alone for patients at risk of lymph-node field relapse after therapeutic lymphadenectomy for melanoma: a randomised trial [J].
Burmeister, Bryan H. ;
Henderson, Michael A. ;
Ainslie, Jill ;
Fisher, Richard ;
Di Iulio, Juliana ;
Smithers, B. Mark ;
Hong, Angela ;
Shannon, Kerwin ;
Scolyer, Richard A. ;
Carruthers, Scott ;
Coventry, Brendon J. ;
Babington, Scott ;
Duprat, Joao ;
Hoekstra, Harald J. ;
Thompson, John F. .
LANCET ONCOLOGY, 2012, 13 (06) :589-597
[9]   MALIGNANT-MELANOMA OF THE EXTERNAL EAR - REVIEW OF 102 CASES [J].
BYERS, RM ;
SMITH, JL ;
RUSSELL, N ;
ROSENBERG, V .
AMERICAN JOURNAL OF SURGERY, 1980, 140 (04) :518-521
[10]   CTLA-4-mediated inhibition in regulation of T cell responses: Mechanisms and manipulation in tumor immunotherapy [J].
Chambers, CA ;
Kuhns, MS ;
Egen, JG ;
Allison, JP .
ANNUAL REVIEW OF IMMUNOLOGY, 2001, 19 :565-594