Malignant melanoma Flashcards
associated with what mutation
BRAF chromosome 7
what is a melanoma in situ
confined to epidermis
types of melanoma
- lentigo maligna melanoma. lentigo maligna is a precursor to melanoma. these cells are confined to dermis. grows v slowly. dx as malignant melanoma when cells have invaded into dermis
- superficial melanoma: large flat irregularly pigmented lesion grows laterally the vertically invades
- nodular melanoma: rapidly growing pigmented nodule which bleeds/ulcerates
- acral lentiginous malignant melanoma: arises as pigmented lesions on the palm, sole or under the nail and it usually presents late
common met sites
lymph nodes, liver, lung, bone, brain
ca occur virtually anywhere and at any time in stage of disease
common body sites?
anywhere. trunk males, leg females
risk factors
- naevi!!! powerful predictor
- sun exposure
- skin type 1 or 2
- genetics
- pesticide exposure
weighted 7 point checklist?
2 points each to: change in size, irregular shape, irregular colour
asymmetry
1 point to: diameter >7mm, inflammation, oozing, change in sensation
how to remember weighted 7 point checklist?
ABCDE asymmetrical border irregular colour irregular diameter >7mm evolving
ix
visual inspection
all pigmented lesions referred for assessment shoujld have dermoscopy (examination of skin using microscopes). can distinugish definitely not MM from possible MM
dx -> full thickness excisional biopsy
sentinel node biopsy
mets: cxr, liver USS, CT, MRI head
bloods: FBC, LFT, LDH (used for staging)
staging
TNM
things assessed in T of TNM staging
size, presence or ulceration and mitoses
rx if stage 0 (tumour in situ) if can’t operate
topical imiquimod
possible mets rx
radiotherapy, immunotherapy, chemo
