Late recurrence of cutaneous melanoma.

Most patients treated for cutaneous melanoma who have recurrent disease do so within the first ten years after primary diagnosis. This report covers seven patients with clinical stage I disease in whom local or regional recurrence developed 11 to 23 years after first treatment. Six of the seven patients were premenopausal at the time for primary diagnosis, suggesting that gonadal steroids may affect the natural history of cutaneous melanoma by lengthening the disease-free interval. The seventh patient was male. All seven of the patients had regional recurrence that was definitively treated by further surgery. Lymph node metastases occurred in six of these seven patients. After surgical retreatment, all patients lived for at least 2.5 years. Four remain alive, three disease free, and one with partially controlled systemic and regional disease free, and one with partially controlled systemic and regional disease. This study underlines the importance of continued long-term follow-up in patients treated for cutaneous melanoma.