Malignant melanoma

Question 1

Types of malignant melanoma

Answer 1

1. superficial spreading
2. nodular (most aggressive)
3. lentigo maligna
4. acral lentiginous

Question 2

Superficial spreading malignant melanoma

Answer 2

• 70% cases (most common)
• arms, legs, back, chest
• young people
• presents as growing mole

Question 3

Nodular malignant melanoma

Answer 3

• second most common
• sun exposed skin
• middle-aged people
• red or black lump and/or bleeds or oozes

Question 4

Lentigo maligna melanoma

Answer 4

• less common
• chronically sun exposed skin
• older people
• growing mole

Question 5

Acral lentiginous melanoma

Answer 5

• rarest form
• nails, palms, soles
• darker skin pigmentation
• subgungual pigmentation
• arise in areas not exposed to sun (palms, soles)

Question 6

Diagnostic features for melanoma

Answer 6

Major:
- change in size
- change in shape
- change in colour

Minor:
- diameter > =7mm
- inflammation
- oozing or bleeding
- altered sensation

Question 7

Treatments for malignant melanoma

Answer 7

• excision (Breslow thickness for margin size)
• biopsy of excised region
• sentinel lymph node mapping

Question 8

Breslow thickness/depth

Answer 8

• gives invasion depth of tumour
• single most important factor in determining prognosis
• < 0.75mm = 95-100% 5 year survival
• > 4mm = 50% 5 year survival