Cutaneous melanoma in the elderly

Abstract

The aim of this review was to analyze the difficulties in diagnosing and treating elderly patients with cutaneous melanoma. It focused on the main causes for late diagnosis and relatively poor prognosis in these patients. Early detection of melanoma is vital to reduce mortality in these patients and surgery is often curative. Adequate treatment of elderly patients with melanoma requires knowledge of the clinical features and histopathology of the disease, and the therapeutic options. This review also examined the main surgical procedures for primary melanoma and regional lymph node staging, and the curative and palliative procedures indicated for those elderly patients with advanced disease. It is expected that several molecular genetic factors will soon provide further prognostic information of possible benefit for elderly patients with melanoma.

Clinical and pathological melanoma differences in young and old people

“…The relationship of aging with the presence of regression and ulcerations remains unclear. 6 We found no differences in pathological patterns between age groups. However, the small sample and lack of data on mortality, survival and lymph node status in this study makes it difficult to identify whether the pathological features are associated with age or prognosis.…”

“…Deteriorating vision and development of cutaneous tumors in hard-to-see locations, the presence of seborrheic keratoses, loss of a partner and immunosenescence may also delay medical attention for melanoma. [4][5][6] Although the reliability of age as a prognostic factor has been questioned, 10 several authors suggest a more serious evolution and lower survival rates in aged cohorts.…”

“…2,3 Melanoma is often misdiagnosed in older people, including delayed diagnosis, inadequate staging, and suboptimal surgical/adjuvant therapies. [4][5][6] Some melanoma features seem to differ according to age, including prognosis markers and risk factors. 3,[5][6][7] This case series aimed to identify clinicopathological differences of MM between older and younger patients.…”

Um Melanoma “mascarado”

“…Os Cuidados de Saúde Primários, como primeiro contato da população com o Serviço Nacional de Saúde, revestem-se de uma importância fundamental, uma vez que a deteção precoce continua a ser o fator mais importante na redução da mortalidade por melanoma 6 .…”

“…Os tipos de melanoma nodular e acral lentiginoso são os mais prevalentes na população idosa, correspondendo este último a menos de 5% de todos os tipos de melanoma, surgindo tipicamente em locais onde a exposição solar é reduzida como as superfícies plantares, palmares e leito ungueal [5][6][7] .…”