Melanoma in pregnancy: Diagnosis and management in early-stage and advanced disease

Carter, Thomas J.; George, Christina; Harwood, Catherine A.; Nathan, Paul

doi:10.1016/j.ejca.2022.02.016

Cited by 22 publications

(31 citation statements)

References 101 publications

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“…It is unclear whether the pregnancy is an independent risk factor for the development of melanoma or aggravates its progression during pregnancy. Current understanding is that melanoma in pregnant women does not carry a significantly poorer prognosis than in the nonpregnant state [6].…”

Section: Discussionmentioning

confidence: 99%

“…Like BRAF-directed therapy, immunotherapy is not recommended for use in pregnancy, especially given uncertainty over the role that immune checkpoint molecules have on immune homeostasis during pregnancy [12]. Although data are lacking, the general recommendation for women with PAM stage IV is the termination of pregnancy or early induction to facilitate optimal management of the mother [6].…”

Section: Discussionmentioning

confidence: 99%

“…The risk of metastasis to the placenta and fetus is higher in patients with widely metastatic melanoma. The placentas of women with the suspected or known disseminated disease should be examined thoroughly [6].…”

Section: Discussionmentioning

confidence: 99%

“…For patients with advanced disease, there are few conclusive data to support the use of either immunotherapy or BRAF-directed treatments during pregnancy due to the possibility of teratogenic and embryotoxic effects [6]. A few case reports have been published and consist of patients who wished to continue their pregnancy, or who became pregnant while on treatment [8][9][10][11].…”

Section: Discussionmentioning

confidence: 99%

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Adrenal metastatic melanoma first identified during pregnancy: a diagnostic challenge

et al. 2022

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Adrenal nonadenomatous tumors (NAT) first identified during pregnancy are very rare and pose a diagnostic and therapeutic dilemma with significant risks for the mother and fetus. The aim of this study is to report a case of a large adrenal NAT identified in pregnancy and literature review. A literature search was conducted, and data were summarized. A 37-year-old primigravida woman, with a history of melanoma, excised 12 years before presentation without recurrence, presented at 35 weeks gestation due to intractable right flank pain. MRI demonstrated an eight cm, heterogeneous, septate, right adrenal mass suspected to be either pheochromocytoma/paraganglioma (PPGL), adrenocortical carcinoma or metastasis. Blood metanephrines were sent urgently to enable a safe delivery and were within normal range, as were cortisol and androgen levels. A biopsy was taken from a palpable breast mass as well as from an ovarian mass during the operation. At 36 weeks gestation, she was delivered by cesarean section. PET computed tomography performed after delivery revealed the extensive metastatic spread of recurring melanoma including the right adrenal gland. Timely diagnosis and management by a multidisciplinary team are important to avoid a catastrophic outcome. There is no consensus on optimal management and timing of delivery. PPGL should be ruled out before delivery.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Adrenal metastatic melanoma first identified during pregnancy: a diagnostic challenge

et al. 2022

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“…The first reference of ovarian melanoma in primigravida has also been reported [ 20 ]. Further research shows [ 21 ] that about one-third of diagnosed melanoma patients are of childbearing age. The annual incidence of melanoma has increased steadily over the past four decades, resulting in a rise in the number of pregnant and postpartum women diagnosed with the disease.…”

Section: Main Findings Of the Literature (Review) Questmentioning

confidence: 99%

Intra-Abdominal Malignant Melanoma: Challenging Aspects of Epidemiology, Clinical and Paraclinical Diagnosis and Optimal Treatment—A Literature Review

et al. 2022

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According to European consensus-based interdisciplinary guidelines for melanoma, cutaneous melanoma (CM) is the most deadly form of dermatological malignancy, accounting for 90% of the deaths of skin cancer patients. In addition to cutaneous melanoma, mucosal melanoma occurs in four major anatomical sites, including the upper respiratory tract, the conjunctiva, the anorectal region, and the urogenital area. As this cancer type metastasizes, a classification used in the current medical literature is the distinction between secondary lesions and primary malignant melanoma of the abdominal cavity. Given that malignant melanoma is the most common cancer that spreads to the gastrointestinal tract, different imaging modalities compete to diagnose the phenomenon correctly and to measure its extension. Treatment is primarily surgery-based, supported by immunotherapy, and prolongs survival, even when performed at stage IV illness. In the end, special forms of malignant melanoma are discussed, such as melanoma of the genito-urinary tract and amelanotic/achromic melanoma. The importance of this present literature review relies on yielding and grouping consistent and relevant, updated information on the many aspects and challenges that a clinician might encounter during the diagnosis and treatment of a patient with intra-abdominal melanoma.

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„Red flags“ in der Schwangerschaft – Hautsymptome und ihre Ursachen in der Schwangerschaft

Bohne,

Langen,

Gläser

2024

Dermatologie

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Melanoma in pregnancy: Diagnosis and management in early-stage and advanced disease

Cited by 22 publications

References 101 publications

Adrenal metastatic melanoma first identified during pregnancy: a diagnostic challenge

Adrenal metastatic melanoma first identified during pregnancy: a diagnostic challenge

Intra-Abdominal Malignant Melanoma: Challenging Aspects of Epidemiology, Clinical and Paraclinical Diagnosis and Optimal Treatment—A Literature Review

„Red flags“ in der Schwangerschaft – Hautsymptome und ihre Ursachen in der Schwangerschaft

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