THE ROLE OF THE GENERAL SURGEON IN THE MANAGEMENT OF PATIENT WITH MALIGNANT MELANOMA

Abstract

Malignant melanoma is now a major public health problem. Annually, in the European Union about 10 cases of malignant melanoma occur per 100,000 inhabitants. Every 57 minutes, worldwide, a person dies due to the existence of a malignant melanoma. I report the case of a woman, C.V., aged 49, who comes to the emergency room of the University Emergency Hospital of Bucharest, for a posttraumatic abdominal pain syndrome (abdominal contusion caused by a traffic accident 5 days earlier); the thorough clinical examination performed in order to assess the posttraumatic lesions reveals no injury marks, and the paraclinical evaluations reveal no visceral injuries. During the clinical examination, the medical team on call identifies a dark brown pigmented tumor with a diameter of about 1 cm on the posterior face of the lower third of the left leg, which raises the suspicion of  malignancy. The patient is referred to a dermatology department. The corroboration of the dermatological clinical examination with the specific paraclinical investigations led to the decision to perform the surgical excision of the pigmented tumoral formation with the repair of the defect with a skin graft. The histopathological examination of the resected piece confirms the diagnosis of malignant extensive superficial melanoma. The patient returned to the department of general surgery with the indication for a surgical evaluation. The present paper attempts to answer the question: „What is the role of the general surgeon in the management of patients with malignant melanoma?” In the case of the presented patient, the role of the general surgeon was a complex one, with major prognostic implications.