Cutaneous Melanoma: Principles of Oncologic Resection and Reconstruction

Cutaneous melanoma is a malignant neoplasm of melanocytic origin characterized by high biological aggressiveness and metastatic potential, with tumor thickness representing the most important prognostic factor (1,2). Early diagnosis is essential, as survival is closely related to Breslow depth, ulceration, and mitotic rate (3). We present the case of a 62-year-old female with a pigmented lesion in the right scapular region with progressive growth and ulceration. Excisional biopsy confirmed superficial spreading melanoma with a Breslow thickness of 2.1 mm, Clark level IV, ulceration, and high mitotic rate (6,7). The patient underwent wide local excision with 2 cm margins and sentinel lymph node biopsy, followed by immediate reconstruction using a local V-Y advancement flap. Final pathology confirmed negative margins and a negative sentinel lymph node. The postoperative course was uneventful, with satisfactory functional and aesthetic outcomes. This case highlights the importance of integrating oncologic and reconstructive principles to optimize disease control and patient outcomes (14,15).