Melanoma (cutaneous)

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Melanoma

NIH - Medical Encyclopedia Melanoma

"Melanoma is the most dangerous type of skin cancer. It involves the cells that produce pigment (melanin), which is responsible for skin and hair color. Melanoma can also involve the pigmented portion of the eye. … The primary symptom of any skin cancer is usually a mole, sore, lump, or growth on the skin. Any change in appearance of a pigmented skin lesion over time is a warning sign. Also, watch for any bleeding from a skin growth. The ABCD system may help you remember features that might be a symptom of melanoma: Asymmetry: One half of the abnormal area is different from the other half. Borders: The lesion or growth has irregular edges. Color: Color is varied from one area to another, with shades of tan, brown, or black (sometimes white, red, or blue). A mixture of colors may appear within one lesion. Diameter: The trouble spot is usually (but not always) larger than 6 mm in diameter -- about the size of a pencil eraser.

If you notice any suspicious skin markings, see your health care provider as soon as possible."

Highlighted Article

Comparison of risk patterns in carcinoma and melanoma of the skin in men: a multi-centre case-case-control study. (Br J Cancer. 2006)

"… Subjects with fair hair had a significant risk increase for all types of tumours ... The effect of pale eyes was significant … Intermittent sun exposure measured in hours spent at beach during holidays was significant … and number of naevi …"

Melanoma (cutaneous)

Diagnosis, Imaging, and Screening

NEWS:

New Research Differentiates Melanoma From Sun-Exposed Skin " 'The data from our study should help physicians to discern increased melanocyte density in sun-damaged skin from that in early melanoma,' lead researcher Ali Hendi, MD, assistant professor of dermatology at the Mayo Clinic in Jacksonville, Florida, told Medscape. At present, there is a tendency to err on the side of caution and overdiagnose melanoma in sun-damaged skin to avoid the obvious medical and legal consequences of missing true melanoma. But this can result in unnecessary surgery to remove those areas of skin and lead to unnecessary morbidity and deformity, he pointed out."

Report from AMI: Melanoma PET/CT need not cover brain or uninvolved extremities

UK male deaths from melanoma skin cancer rising fast "The charity urged people to be aware of changes in the skin including a new growth or a spot or mole that itches, hurts, bleeds or won't heal."

ARTICLES:

eMedicine Image Melanoma

JOURNAL ARTICLES:

A possible additional diagnostic tool for cutaneous melanoma. (Skinmed. 2006) "The rise in incidence of malignant melanoma and the dismal prognosis of late detection emphasize the need for early detection and recognition of the disease. The well-known ABCD method for detection of melanoma has recently been revised by adding an "E" for changes in size, shape, color, crusting, itching, bleeding, and erythema. In an observational study, 8 of 14 (57%) melanoma patients exhibited a particular reddish hue to the skin adjacent to the melanoma, with no distinguishable borders. … erythema can help alert the clinician to the presence of malignant melanoma and serve as a prognostic factor or an indicator of the efficacy of treatment."

[Cutaneous malignant melanoma : Excision margins and lymph node dissections.] (Hautarzt. 2006)

Cutaneous melanoma and intervention strategies to reduce tumor-related mortality: what we know, what we don't know, and what we think we know that isn't so. (Dermatol Ther. 2006)

Cutaneous melanoma: family screening and genetic testing. (Dermatol Ther. 2006)

Cutaneous melanoma: making a clinical diagnosis, present and future. (Dermatol Ther. 2006)

Cutaneous melanoma: public health approach to early detection. (Dermatol Ther. 2006)

Diagnosing and managing cutaneous pigmented lesions: primary care physicians versus dermatologists. (J Gen Intern Med. 2006) "CONCLUSIONS: Dermatologists have both better diagnostic accuracy and ability to manage pigmented lesions than PCPs. Yet, there is a shortage of dermatologists to meet the demand of accurate melanoma screening. More innovative strategies are needed to better train PCPs and enhance skin cancer screening."

Does the Method of Biopsy Affect the Incidence of Sentinel Lymph Node Metastases? (Breast Journal 2006)

Imaging of metastatic melanoma. (Cancer Imaging. 2006) "Cutaneous melanoma is arguably the most widely metastasising neoplastic disease and it has a particularly unpredictable pattern of spread. Imaging has an important role in the management of this disease as the demonstration and delineation of metastases influences management and prognosis."

Lymphatic mapping and sentinel lymphadenectomy in primary cutaneous melanoma. (Expert Rev Anticancer Ther. 2006) "The management of clinically normal regional lymph nodes in early-stage melanoma has been controversial for over 100 years. Lymphatic mapping and sentinel lymphadenectomy has been developed as a minimally invasive surgical technique to stage regional lymph nodes without the associated morbidity of complete lymph node dissection. … "

Method of Biopsy and Incidence of Positive Margins in Primary Melanoma. (Ann Surg Oncol. 2006)

Possible role of dermoscopy in the detection of a primary cutaneous melanoma of unknown origin. (J Eur Acad Dermatol Venereol. 2006) "For 2-8% of patients with metastatic melanoma, cutaneous and mucosal clinical examination does not lead to diagnosis of the primary tumour, which remains unknown. We report the case of a 41-year-old male patient who had received a diagnosis of metastatic melanoma after histological examination of an enlarged axillary lymph node, without previous detection of the primary lesion at his first dermatological examination. No pigmented skin lesions located in the anatomical area potentially drained by the affected axillary basin showed clinical features suggestive of a melanoma."

Progress and Prospects on Melanoma: The Way Forward for Early Detection and Reduced Mortality (Clinical Cancer Research 2006)

Routine use of FDG-PET scans in melanoma patients with positive sentinel node biopsy. (Eur J Nucl Med Mol Imaging. 2006) "CONCLUSION: In a number of stage III melanoma patients with positive SNB, postoperative whole-body FDG-PET scanning revealed further melanoma dissemination not found by conventional screening methods and thus identified these cases as stage IV. Relevant therapy can accordingly be instituted earlier on the basis of FDG-PET scanning."

Sentinel and nonsentinel node status in stage IB and II melanoma patients: two-step prognostic indicators of survival. ( Clin Oncol. 2006) "CONCLUSION: Evaluation of the sentinel node is a useful procedure to identify patients to be submitted for complete lymph node dissection. The procedure makes it possible to assess the best prognosis of patients."

Sentinel Node Biopsy for Thin Melanomas: Which Patients Should Be Considered? (Cancer Control. 2005)

Sentinel node biopsy in cutaneous melanoma. (Scand J Plast Reconstr Surg Hand Surg. 2006)

Sentinel-node biopsy or nodal observation in melanoma. (N Engl J Med. 2006) "CONCLUSIONS: The staging of intermediate-thickness (1.2 to 3.5 mm) primary melanomas according to the results of sentinel-node biopsy provides important prognostic information and identifies patients with nodal metastases whose survival can be prolonged by immediate lymphadenectomy."

Size of sentinel node metastases predicts other nodal disease and survival in malignant melanoma. (Am J Surg. 2006)

The prognostic impact of the extent of lymph node dissection in patients with stage III melanoma. (Eur J Surg Oncol. 2006) "CONCLUSIONS: Our results suggest that the total number of lymph nodes excised in the dissection has impact on overall survival of stage III melanoma patients and should be considered in clinical assays."

The utility of magnetic resonance imaging in the detection of brain metastases in the staging of cutaneous melanoma. (Clin Oncol (R Coll Radiol). 2006)

Ultrasound mapping of lymph node and subcutaneous metastases in patients with cutaneous melanoma: results of a prospective multicenter study. (Dermatology. 2006)

Use of Sentinel Lymph Node Biopsy and High-dose Interferon in Pediatric Patients With High-risk Melanoma: The Hospital for Sick Children Experience. (J Pediatr Hematol Oncol. 2006)

Value of sentinel node status as a prognostic factor in melanoma: prospective observational study (BMJ 2006) "Conclusion Sentinel node status is a highly significant predictor of prognosis in melanoma and should be considered in adjuvant studies. However, it should not be regarded as a standard of care until mature data from ongoing randomised trials are available."

What motivates men age >/= 50 years to participate in a screening program for melanoma? (Cancer. 2006)

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