Cutaneous Malignant Melanomas with Other Coexisting Neoplasms: A True Association?

Abstract

In the past, several authors described an association of cutaneous malignant melanoma (MM) with other neoplasms. As their results were not conclusive, we designed this study with the aim to determine whether the frequency and spectrum of coexisting neoplasms in patients with cutaneous MM are either a significant or a random event. Therefore, the histories of 623 patients with primary MM from our clinic have been evaluated by a direct questionnaire. Diagnosis of MM has been established by histologic examination after excisional biopsy. The male/female (M/F) ratio was 240/383, the mean age 52.5 years (range 14–93). The distribution of risk groups yielded 277 patients (M/F = 90/187) for low risk (Breslow < 0.75 mm trunk, < 1.50 mm extremities), 245 patients (M/F =105/140) for intermediate risk (Breslow 0.76–3.00 and 1.51–5.00 mm, respectively), 101 patients (M/F = 45/56) for high risk (Breslow > 3.00 and > 5.00 mm, respectively). 64 patients (10.3%) had associated primary carcinomas including 7 patients with 2 primary carcinomas compared to a control group (n = 313) with 12 carcinomas (3.8%). 50% of the carcinomas were diagnosed before the diagnosis of melanoma. The M/F ratio of this group was 25/39, the mean age at diagnosis of MM 62.7 years (range 28–91), the mean age at diagnosis of carcinoma 55.6 years (range 29–90). In the female group, breast cancer predominated (18/39), followed by uterus (7/39) and basal cell carcinoma (7/39); in the male group, basal cell carcinoma (10/25) was followed by prostate cancer (6/25). The frequency of breast cancer in the female group (n = 383) was 4.7% compared to a female control group (n = 171) with 1.2%.

The association between malignant melanoma and noncutaneous malignancies

“…Both increased and decreased incidences of subsequent cancer in patients with malignant melanoma have been documented in various reports. [1][2][3][4][5][6][7][8][9][10] A higher incidence of cutaneous malignancies, such as basal cell carcinoma, squamous cell carcinoma, and second melanoma, can be attributed to the same risk factors as those that caused the original melanoma: excessive sun exposure, immunosuppression, or genetic factors. 7,8,11,12 The documented noncutaneous malignancies occurring in patients with melanoma include hematopoietic and lymphoproliferative malignancies, 7,[13][14][15][16][17][18] tumors of neuroectodermal origin, 7,8 bladder carcinoma, 10 pancreatic cancer, 19 gastrointestinal cancer, 20 and sex-or hormone-related cancer, such as breast carcinoma, 2,3,6 ovarian carcinoma, 2 endometrial cancer, 8 prostate carcinoma, 9 and testicular carcinoma.…”

Risk of second primary malignancies following cutaneous melanoma diagnosis: A population-based study

“…2 Because case fatality has declined in recent decades, 3 more individuals with a CM diagnosis will survive to develop a second primary malignancy (SPM). Patients with melanoma have been reported previously to have increased relative risk for particular SPMsenamely, second primary melanomas (standardized incidence ratio [SIR] range, 4.7-33.8), 4-7 nonmelanoma skin cancer (SIR range, 3.10-4.40), 4,8,9 lymphoma (SIR range, 1.42-16.1), 4,10,11 and cancers of the breast (SIR range, 1.10-6.6), 4,[12][13][14] thyroid (SIR range, 2.1-3.6), 4,15 pancreas (SIR range 0.6-1.76), 4,16-18 bladder (SIR range, 0.9-3.30), 4,19 prostate (SIR range, 1.50-2.10), 4,8,13,19 central nervous system (SIR range, 1.1-1.57, 4,20 and gastrointestinal tract (SIR range, 1.1-1.33). 4,21 However, reported SIRs have not been consistent across studies.…”

Elevated risk of second primary cancer in patients with cutaneous malignant melanoma: A nationwide cohort study in Taiwan

“…In studies conducted in Europe and North America, most CMM patients were within the range of 40-70 years old; the mean age at diagnosis ranged between 40 and 60 years old [6,14,[38][39][40]. Our studies therefore indicate that CMM tends to occur later in Taiwanese than in the white population.…”