Lentigo maligna melanoma of the head and neck

Historically, lentigo maligna melanoma has been considered a “favorable” histological type of melanoma, and treatment by wide local excision was considered curative. A retrospective multivariate analysis of 143 head and neck patients with stage I lentigo maligna melanoma was performed from a database of 1067 head and neck patients followed at Duke Medical Center. Fifty‐six percent of all lentigo maligna melanomas presented with lesions deeper than 0.76 mm, and 8% presented with stage II or III disease. Recurrent disease occurred in 45% of stage I patients, with a 5‐year disease‐free interval of 6 years and a median survival time of 10 years. Multivariate analysis demonstrated no significant difference in disease‐free interval or survival by histological subtype. The data suggest that treatment should be based on tumor thickness and not histologic subtype.