The incidence of malignant melanoma the most malignant of all skin neoplasms, has doubled within the last 10 years. Exposure to high intensity sunlight, racial susceptibility, hormonal status, age, environmental factors as well as injury have all been shown to play a role individually or synergistically in the activation of the melanocytic oncogen. Controversies still exist in which factors actually determine prognosis, in patients with advanced malignant melanoma. Management has remained even more controversial, with surgical excision, with or without lymphadenectomy, radiotherapy, chemotherapy, laser therapy and more recently immunotherapy and intra-arterial neutron thermal capture therapy, having their proponents and opponents.
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