한국인의 두피에 발생한 악성 흑색종의 임상병리학적 특징: 단일기관 후향적 연구

Abstract

Background: Melanoma arising from the scalp is rare and often diagnosed at advanced stages due to difficulty in detection.

Objective: This is the first study that aimed to analyze the clinicopathological findings of scalp melanoma among Korean patients at a single institution.

Methods: In this single-centered retrospective study, medical records were used to review data of patients with scalp melanoma between 2006 to 2021. Chronic sun damage (CSD) was evaluated by reviewing histopathological findings of scalp melanoma.

Results: Fifteen patients were identified. Mean age at diagnosis was 53.93 years. In 14 cases, the tumors were located on hair-covered areas. Mean Breslow’s thickness was 6.06 mm. Nodular melanoma was the most common histologic type (n=9), followed by superficial spreading (n=5), and lentigo maligna (n=1). Ulceration was present in five cases. In nine cases, CSD was moderate. Elective neck node dissection was performed in 13 cases, with five revealing nodal involvement. At initial staging, three patients were in stage I, six were in stage II, four were in stage III, and two were in stage IV. Recurrence occurred in seven of the 15 cases. There were five confirmed mortalities during a mean follow-up period of 35 months.

Conclusion: In this study, the Breslow’s thickness of scalp melanoma was relatively deep, and the most frequent type was nodular melanoma. Since detection can be affected by black hair among Koreans, it may result in delayed diagnosis and poor prognosis. Therefore, more caution is needed when examining suspicious lesions on the scalp.