What is the prognosis for melanoma that recurs in the same spot?

A fellow caregiver asked...

I have had three operations to remove melanoma on the top of my ear. What is the usual outcome? How prevalent is this?

Expert Answer

Jessica J. Krant, MD, MPH, is a board-certified dermatologist specializing in medical, cosmetic, and surgical dermatology, including Mohs micrographic skin cancer surgery. In addition to her work in private practice, Krant is assistant clinical professor of dermatology at SUNY Downstate Medical Center.

The prognosis (expected outcome) for recurring melanoma in the same spot is not clearly defined. Two recurrences (three surgeries)on the same exact spot is relatively uncommon. Traditionally, complete surgical removal for a true melanoma includes a very wide, and sometimes disfiguring, surgical margin, since melanoma has the potential to be life-threatening and all cells must be removed. A local recurrence of the same lesion may imply that the original surgical margins were not clear. It may also imply that a second melanoma has occurred very near the first, in an unrelated manner. Melanoma surgery should include stitches and pathologic evaluation under the microscope of the tissue that has been removed. In the case of head and neck tumors or recurrent tumors, PET scan or some form of imaging, or possibly lymph node testing, may be indicated to make completely sure there isn't more undetected involvement in the area.

There can be no overstating the risks associated with melanoma, and if you have had a recurrence twice in the same area after what you thought was complete treatment, assuming the diagnosis is accurate, I would recommend seeing an oncologist or a dermatologist who specializes in melanoma treatment for a team approach as soon as possible.