Melanoma

Question 1

what does malignant melanoma arise from?

Answer 1

melanocytes

Question 2

what genes is melanoma associated with?

Answer 2

CDKN2A (tumour suppressor)

CDK4 (oncogene)

Question 3

different types of malignant melanoma

Answer 3

superficial spreading
acral/ mucosal lentiginous
lentigo maligna
nodular

Question 4

where is superficial spreading most commonly found?

Answer 4

trunk and limbs

Question 5

where is acral/mucosal lentiginous most commonly found?

Answer 5

acral and mucosal sites

Question 6

where is lentigo maligna most commonly found?

Answer 6

sun damaged areas such as face, neck and scalp

Question 7

presentation of nodular melanoma

Answer 7

slow growing pearly nodule with telangiectasia

commonest

Question 8

presentation of malignant melanoma

Answer 8

Asymmetry
ill-defined border
two or more colours
wide diameter/ non-symmetrical/ non-circular
evolution- speed of change

Question 9

diagnosis

Answer 9

Breslow thickness

biopsy of skin and lymph nodes

Question 10

what is Breslow thickness?

Answer 10

prognostic indicator which measures the deepest part of the tumour to the granular layer (0.5mm is good and >4mm is bad)

Question 11

management for melanoma

Answer 11

sun protection measures
target genetic therapies= vemurafenib and dabrafenib
excision +/- lymphadenectomy, chemotherapy/radiotherapy