Malignant Melanoma Flashcards
what cells does malignant melanoma arise from
melanocytes, the pigment forming cells scattered along the basal layer of the skin
how does the behaviour of melanoma differ to that of keratinocyte skin carcinoma
melanoma much more likely to metastasise
what site and gender are melanoma more common in
most common at sun exposed areas; scalp, face, neck, arms, legs, trunk
more common in females(2:1)
(can arise anywhere)
what clinical features raise suspicion of malignant melanoma
change in shape, new pigmented lesion in adult, irregular pigmentation, bleeding, ulceration, development of satellite nodules
what is the ABCDE rule used in melanoma assessment
Asymmetry Border Colour Diameter Evolution
what are the different types of malignant melanoma
superficial spreading, acral/mucosal lentiginous, lentigo maligna, nodular
in what type(s) of melanoma are both RPG and VPG seen
superficial spreading, acral/mucosal lentiginous and lentigo maligna melanoma
(all but nodular)
in what type(s) of melanoma is only VPG seen, no RPG
nodular melanoma
describe what Radial growth phase(RGP) is in melanoma formation
RGP = when tumour grows as macules when either entirely in-situ or with dermal microinvasion
describe what Vertical growth phase(VGP) is in melanoma formation
VGP = when eventually melanoma cells invade the dermis forming an expansile mass with mitosis
what type of growth phase must a melanoma be in in order to metastasise
VGP
what is Breslow thickness and what is it used for
Breslow = deepest tumour from granular layer in mm
used for prognosis of melanoma
what are the different ways in which melanoma can metastasise
local dermal lymphatics(satellite deposits), regional lymph nodes mets, blood spread(lungs, brain, liver etc.)
what is the main treatment of melanoma
primary excision to give clear margins, size of excision depends on depth(Breslow) and if invasive
some melanoma patients receive sentinel node biopsy, what treatment is used if this is positive
regional lymphadenectomy
