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Pathology - Malignant Melanoma
linked to prolonged immunosuppression, fair skin, genetic predisposition (few occurrences are family), and extensive sun exposure.
Dysplastic nevus: Iymphocytic infiltrate in mild form, longitudinal fibrosis in the dermis, precursor lesion, nests of nevus cells exhibiting cellular atypia and anaplasia inside the epidermis.
Melanoma is a skin cancer that develops in two stages and is caused by melanocytes or nevus cells.
II. Vertical growth: nodular appearance, growth into underlying dermis, does metastasize, and metastatic probability is directly proportional to depth of invasion. (I) Radial growth: discolored macule, horizontal growth of nests of atypical cells within epidermis, lymphocytic infiltrate, and melanin-containing macrophages in dermis; does not metastasize.
displays a potentially itchy pigmented lesion that is asymmetrical, has an uneven border, and contains a variety of hues.
Clinical variants include: (1) superficial spreading, which is the most common form of the lesion with an irregular border and a predominant radial growth phase without dermal invasion; (2) nodular growth phase; and (3) lentigo maligna, which develops from a precursor lesion called Hutchinson freckle and can progress to spindle-cell melanoma or desmoplastic melanoma.
Results from the lab: S-100 tumor marker is present.
Handling
For stages lb and above, surgical excision along with sentinel lymph node biopsy; chemotherapy; if metastatic disease is suspected, consider IL-2 treatment.
Metastasis is common, primarily to the liver, esophagus, meninges, eyes, and intestinal serosa.
The prognosis is especially bad for nodular variant and metastatic illness.
linked to prolonged immunosuppression, fair skin, genetic predisposition (few occurrences are family), and extensive sun exposure.
Dysplastic nevus: Iymphocytic infiltrate in mild form, longitudinal fibrosis in the dermis, precursor lesion, nests of nevus cells exhibiting cellular atypia and anaplasia inside the epidermis.
Melanoma is a skin cancer that develops in two stages and is caused by melanocytes or nevus cells.
II. Vertical growth: nodular appearance, growth into underlying dermis, does metastasize, and metastatic probability is directly proportional to depth of invasion. (I) Radial growth: discolored macule, horizontal growth of nests of atypical cells within epidermis, lymphocytic infiltrate, and melanin-containing macrophages in dermis; does not metastasize.
displays a potentially itchy pigmented lesion that is asymmetrical, has an uneven border, and contains a variety of hues.
Clinical variants include: (1) superficial spreading, which is the most common form of the lesion with an irregular border and a predominant radial growth phase without dermal invasion; (2) nodular growth phase; and (3) lentigo maligna, which develops from a precursor lesion called Hutchinson freckle and can progress to spindle-cell melanoma or desmoplastic melanoma.
Results from the lab: S-100 tumor marker is present.
Handling
For stages lb and above, surgical excision along with sentinel lymph node biopsy; chemotherapy; if metastatic disease is suspected, consider IL-2 treatment.
Metastasis is common, primarily to the liver, esophagus, meninges, eyes, and intestinal serosa.
The prognosis is especially bad for nodular variant and metastatic illness.
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