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Chapter 43. Malignant Melanoma of the Head and Neck

Which of the following is not a risk factor for the development of head and neck melanoma?

A. Fitzpatrick type I skin type

B. Ultraviolet A exposure from tanning booths

C. Presence of multiple nevi on the cheeks

D. Four blistering sunburns in the teenage years

Which of the following drugs does not modulate the immune response to melanoma?

A. Vemurafenib

B. Ipilimumab

C. IL-2

D. Pembrolizumab

What is the proper margin, if feasible, for a nonulcerated lesion with 1.25-mm depth of invasion?

A. 0.5 cm

B. 1 cm

C. 1.5 cm

D. 2 cm

You are planning to resect an ulcerated malignant melanoma that has 2.1-mm depth of invasion from the left anterior parietal scalp of a 40-year-old male patient. He has no cervical or parotid lymphadenopathy and no suspicious nodes on imaging. What is the most appropriate next step in management?

A. Wide local excision with 2-cm margin

B. Wide local excision with 1-cm margin, elective neck dissection

C. Wide local excision with 2-cm margin, with sentinel lymph node biopsy

D. Wide local excision with 2-cm margin, radiation therapy to the draining lymph node basin, including the parotid gland

A patient presents with a large, left auricular melanoma with three palpable lymph nodes in the left neck. Which of the following is not an appropriate test for distant metastasis?

A. LDH

B. Brain MRI

C. Full body PET-CT

D. Evaluation for V600E activation mutation in BRAF

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