Conservative surgical treatment of a thin acral lentiginous melanoma of the thumb with no recurrences: a case report


Address correspondence and reprint requests to: Gianluca Proietto, MD, Department of Dermatology, G. D'Annunzio, University of Chieti, via dei Vestini, Chieti 66100, Italy, or email:


Surgical treatment for acral lentiginous melanoma (ALM) is usually radical and severely invalidating, given its distinctly aggressive nature and poor prognosis. We report on a 76-year-old male patient with ALM of the left thumb who refused total amputation that would limit his gripping function. A “surgical degloving” was consequently performed, followed by plastic reconstruction with a radial antebrachial (the so-called Chinese) flap. A year after surgery, the patient was able to perform most finalized thumb movements without difficulty, and no metastases were recorded over a 5-year follow-up. The authors discuss the indications for such a treatment for thinner ALM in relation to the biological behavior of ALM.