|
|
10th
International Inter University Scientific Meeting
Academy of Studenica
PERSPECTIVES
IN MELANOMA MANAGEMENT
& NANOTECHNOLOGY IN BIOMEDICINE
Organizers:
Institute of Oncology
Sremska Kamenica; Union of Cancer Prevention
Societies of Vojvodina, Novi Sad; Clinic of Oncology, Nis; Institute
for Oncology and Radiology of Serbia, Belgrade Center for Bioengineering,
Faculty of Mechanical Engineering, University of Belgrade
President:
Vladimir Baltic Vice-presidents: Zlata
Janjic, Radan Dzodic, Borislava Nikolin; Djuro Koruga
|
|
|
| |
NEW
ASPECT ON MALIGNANT MELANOMA
Katić V, *Trenkić S, Al Jundi M, Petrović
A, Pashalina M.
Institute
of Pathology, Medical Faculty Niš, Niš, Serbia and Montenegro
* Surgical Clinic, Clinical Center Niš, Niš, Serbia and Montenegro
|
|
| |
ABSTRACT
Malignant
melanoma (MM) is a malignant tumor of melanocytes, cells that are
derived from the neural crest. It is the third most common skin
cancer and represents from 3% to 5% of cutaneous malignancies. The
average age of persons affected by MM is 50-55 years. The tumor
exhibits a slight male predilection. Melanoma in women occurs more
commonly on the extremities and in men on the trunk or head and
neck, but it can arise from any site on the skin surface. The incidence
of cutaneous malignant melanoma is increasing rapidly throughout
the world. The reasons for this increase are unclear, but may be
related to the reduction in the ozone layer and to increased exposure
to ultraviolet radiation from sunlight. Prognosis is affected by
clinical and histological factors and by anatomic location of the
lesion. Thickness and or level of invasion of the melanoma, mitotic
index, presence of tumor infiltrating lymphocytes, number of regional
lymph nodes involved, and ulceration or bleeding at the primary
site affect the prognosis. Early signs in a nevus that would suggest
malignant change include darker or variable discoloration, itching,
and increase in size, or the development of satellites. Ulceration
or bleeding are later sings. A biopsy, preferably by local excision,
should be performed for any suspicious lesions, and the specimens
should be examined by an experienced pathologist to allow for microstaging.
To this day, prevention, by sun avoidance, the use of sunscreens
and early recognition of the clinical characteristics for an early
diagnosis and treatment are still the best weapons against melanoma.
Four common forms of MM have been described: Superficial spreading
melanoma (SSM) with radial (horizontal) and vertical growth phases;
Nodular Melanoma (NM); Acral Lentiginous Melanoma (ALM); Lentigo
Malignant Melanoma (LMM); Lentigo Malignant or Hutchinson's freckle;
A variant of MM is the amelanotic or nonpigmented melanoma and represents
only about 2% of melanomas. For the histologic classification of
cutaneous melanoma, Clarc's classification (the anatomic level of
local invasion), Breslow's classification (histologic examination
by the vertical thickness of the lesion in millimeters) and TNM
classification have been also studied. The treatment of MM usually
consists of excision. A l cm margin is usually considered adequate
for small melanomas (those with a histologic depth of invasion less
than 1 mm). For larger lesions, or those with a histologic depth
of invasion greater than 1.24mm, surgical removal of regional lymph
nodes is recommended by some sources. Chemoterapy, radiation therapy,
and immunotherapy do not appear to have a significant impact on
survival of metastatic MM. |
-
|
|
