Malign Melanoma: Risk Factors and Major Clinical Findings

Abstract

Malign melanom (MM) insidansı en hızlı artan kanser türlerinden biridir ve deri kanserlerine bağlı ölümlerin önde gelen nedenidir. Buna karşın deri melanomu hastanın erken dikkatini çekerek hekime ulaşması durumunda çoğunlukla erken aşamada ortadan kaldırılır ve hastanın normal yaşamını sürmesi sağlanabilir. Melanom herkeste görülebilmekle birlikte açık ten rengi, yoğun ultraviyole maruziyeti, belirli bir genetik zemin (CDKN2A gen mutasyonu) bulunması, çok sayıda melanositik nevus bulunması ve displastik nevus varlığı başta olmak üzere bazı risk faktörleri olanlarda daha sıktır. Risk faktörleri olan hastalara farklı bir yaklaşım sergilenmesi ve bu hastaların hekime düzenli ve hızlı ulaşmalarının sağlanması melanomun morbiditesinin azaltılması açısından önem taşır. Hastanın hayatta kalması öncelikle erken tanı konarak metastazın önüne geçilmesi ile ilişkilidir. Günümüzde biyopsi öncesi melanom şüphesinde hekimlere yardımcı olan bazı görüntüleme yöntemleri olmakla birlikte ilk melanom kuşkusu hastalığın evresine göre değişmekte olan temel klinik özelliklere dayanmaktadır. Bu makalede ilk önce deri melanomunun risk faktörlerine değinilecek, sonrasında erken klinik tanı için bazı ipuçları üzerinde durulacaktır. Malignant melanoma (MM) shows rapid increase in the incidence and it is the most common cause of death due to skin cancer. On the other hand, MM can completely be removed in patients noticing the lesions early and applying to physicians on time. Thus the life expectancy of these patients is not altered. Although MM can occur in every individual, it is more common in patients with some of the established risk factors such as fair skin, increased sun exposure, genetic basis (CDKN2A mutation), and existence of increased number of melanocytic nevi and/or dysplastic nevi. A specialized care of patients with risk factors and their regular follow-up is critical to lower the mortality and morbidity in MM. Early diagnosis of MM prevents metastasis and decreases mortality rate. Nowadays, there are many newly developed imaging methods to help the clinicians before biopsy. However, the suspicion of MM should initially be based upon major clinical findings of the lesion subject to changes during the evolution of the tumor. In this review, risk factors of MM will be summarized and clues for early diagnosis of this dangerous tumor will be discussed.

Diagnostic and Prognostic Significance of Carboxypeptidase A4 (CPA4) in Breast Cancer

“…The primary risk factors include advanced age and a familial history of BC [5,6], and the accordingly implemented strategies of screening and early diagnosis have been associated with a reduced need for invasive intervention, increased overall survival, and decreased mortality [7,8]. The multiphase oncogenesis involves changes at the chromosomal level, polymorphism, angiogenesis, and uncontrolled cell growth that results in a tumor [9,10], with ongoing genetic mutations leading to invasion, metastasis, and resistance to treatment [11]. During all these phases, specific compounds are released from the cancerous cells in markedly increased amounts.…”

Investigation of skin self-examination and sunscreen use in adolescents in northern Cyprus

“…It is crucial for patients with risky nevi to have periodic dermatologic follow-ups. Additionally, it is especially important that these patients be instructed on how to perform SSE [ 8 ].…”

“…CDKN2A, a tumour suppressor, and melanocortin-1 gene defects have been shown to cause genetic predisposidegree relatives of patients diagnosed with melanoma is very important for early diagnosis. It should be noted that familial melanomas may occur at an earlier age [8]. In a survey study investigating the frequency of screening among children of parents with a family history of melanoma, 28% of parents reported that children had received a skin exam by a healthcare provider in the past 6 months [16].…”

Malignant melanoma types and treatment

“…[4] Other risk factors include: skin type (fair skin), environmental factors (ultraviolet exposure), genetic basis (CDKN2A gene mutation), large number of previous melanocytic nevi, dysplastic nevus, and previous history of melanoma. [5] Types and clinical characteristics Incidence of mucosal melanoma, which originates from melanocytes located in mucosa lining the respiratory, gastrointestinal, and urogenital regions, is only about 1.4% among all melanomas. [6] Mucosal melanomas have relatively higher mortality rates compared to cutaneous melanomas.…”

“…The first phase, known as the tumor's radial growth phase (in situ period) is followed by the vertical growth phase (invasive period) in which neoplastic cells cross the dermoepidermal junction and spread to the papillary dermis. [5] Nodular melanoma is accepted as having no radial growth phase and only vertical growth phase. [1] Superficial spreading malignant melanoma subtype is most common in fair-skinned individuals and accounts for 70% of all malignant melanomas.…”