Malignant Melanoma Flashcards
What is melanoma?
A type of malignant cancer that arises from the melanocyte layer of the skin.
What are the three growth phases of melanoma?
- in situ (epidermis)
- invasive (epidermis and dermis)
- metastatic (other tissues)
What is the most common type of melanoma?
Superficial spreading melanoma.
Describe the growth pattern of superficial spreading melanoma.
Initially grows horizontally, may grow vertically as it progresses.
What characterizes nodular melanoma?
Most aggressive type, invades vertically, often bleeds or ulcerates.
Where does acral lentiginous melanoma originate?
On palms, soles, or under nails.
What are some risk factors for melanoma?
- hx. skin cancer, melanoma, or atypical naevi
- family hx. melanoma
- pale skin (Fitzpatrick type 1 or 2)
- red or light-coloured hair
- high freckle density
- light coloured eyes
- history of sunburn
- sun exposure or sun bed use
- large amounts of moles
- increasing age
- immunosuppression
- outdoor occupation
- genetic syndromes with skin cancer predisposition (e.g. xeroderma pigmentosum)
What does the ABCDE criteria for melanoma include?
- Asymmetrical shape
- Border irregularity
- Colour change and variation
- Diameter of mole (>6mm)
- Evolving (size, shape, colour change)
What are some differential diagnoses for melanoma?
- benign naevus (mole)
- lentigines
- seborrhoeic keratoses
- dermatofibroma
- pigmented BCC
What imaging techniques are used to look for metastasis in melanoma?
CT or MRI.
What is Breslow thickness in the context of melanoma?
A histological staging that guides treatment decisions.
What are the surgical management options for melanoma?
- wide local excision
- re-excision
- sentinel lymph node biopsy
What are some medical treatment options for melanoma?
- targeted therapy (e.g. dabrafenib)
- immunotherapy (e.g. nivolumab + ipilimumab)
- chemotherapy (supportive in advanced stages)
