Malignant Melanoma

Question 1

Malignant Melanoma Mutation

Answer 1

-BRAF in 50%

Question 2

Malignant Melanoma Types

Answer 2

• Superficial spreading (60-70%, grows outwards rather than down most common on trunk or legs)
• Nodular (15-30%, grows downwards, raised area of skin)
• Lentigo maligna (5-15%, slow growing coloured patches of skin)
• Acral lentiginous (5-10% usually found on hands and soles, can grow under nails, most common type in dark skinned people)

Question 3

Malignant Melanoma Common Metastasis Sites

Answer 3

Lymph nodes, liver, lung, bone, brain

Question 4

Malignant Melanoma Epidemiology

Answer 4

• More common in women than in men

- Much less common than non-melanoma

Question 5

Malignant Melanoma RFs

Answer 5

• PHx
• Naevi (strong predictor, individual with more than 100 naevi has high risk)
• Sun exposure

Question 6

Malignant Melanoma Presentation

Answer 6

• Weighted 7 point checklist

- Or ABCDE

Question 7

Malignant Melanoma Referral

Answer 7

-Refer for suspected cancer pathway (2 week wait) if scoring 3 or more on weighted 7 point checklist

Question 8

Malignant Melanoma Investigations

Answer 8

• Dermatoscopy
• Biopsy
• SLNB
• FBC, LFTs, LDH

Question 9

Malignant Melanoma Staging

Answer 9

-TNM

Question 10

Malignant Melanoma Management

Answer 10

• Wide local excision
• Lymph node clearance if spread
• Radiotherapy and chemotherapy