Naevus-associated melanomas

Massi, Daniela; Carli, Paolo; Franchi, A; Santucci, Marco

doi:10.1097/00008390-199902000-00011

Cited by 68 publications

(68 citation statements)

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“…Previous studies have found, as we did, that superficial spreading melanoma was more likely than other histologic subtypes of melanoma to be N+ (19,21). In addition, many studies have reported a lower probability of finding an associated nevus with thicker melanomas (5,15,21,(27)(28)(29). That histologic type rather than thickness seemed to be the primary factor may indicate that superficial spreading melanoma is more likely to arise in a nevus than other types of melanoma and not simply that progressive horizontal expansion and vertical growth of melanoma obliterate an associated nevus.…”

Section: Discussionsupporting

confidence: 70%

“…Light-skinned people with many nevi are at high risk of cutaneous malignant melanoma (1)(2)(3)(4). Some 20% to 30% of melanomas have been reported to be in histologic contiguity with a nevus (5) and larger proportions of patients with melanoma give a history of an apparently stable precursor pigmented lesion at the site of the melanoma (6). The observation of a melanoma in histologic contiguity with a nevus does not seem to be simply coincidence (7)(8)(9); for example, in one study a histopathologic review of malignant skin lesions found nevi associated with 51% of reviewed melanomas but none of 40 basal cell carcinomas reviewed (9).…”

Section: Introductionmentioning

confidence: 99%

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Etiologic and Other Factors Predicting Nevus-Associated Cutaneous Malignant Melanoma

Purdue

From²,

Armstrong³

et al. 2005

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Cutaneous malignant melanomas with histologic evidence of an associated nevus (N+) may have a different risk factor profile from that of melanomas without it (NÀ). To address this question, a case-only analysis of 932 people with cutaneous malignant melanoma was done to identify etiologic and other factors associated with N+ melanoma. Evidence of an associated nevus was found in 36% of melanomas. N+ melanomas were thinner (P trend = 0.0009) and more likely to be of the superficial spreading type than other types of melanoma. Subjects with N+ melanomas were younger (P trend < 0.0001) and reported a higher nevus density on their skin than subjects with NÀ melanomas [odds ratio (OR), 3.1; 95% confidence interval (CI), 1.6-6.0, for high nevus density versus no nevi]. Indicators of high accumulated sun exposure were less prevalent among subjects with N+ melanomas (OR, 0.3; 95% CI, 0.2-0.4, for melanoma location on the head and neck versus location on trunk; OR, 0.2; 95% CI, 0.1-0.4, for severe solar elastosis adjacent to the melanoma versus no elastosis; OR, 0.2; 95% CI, 0.1-0.4, for lentigo maligna melanoma subtype versus superficial spreading subtype). With the exception of solar elastosis and age, all of the aforementioned variables remained significantly associated with N+ melanomas in multivariate analyses. No associations with self-reported measures of sun exposure, sunburn, or pigmentation phenotype were apparent. Our findings provide some support for the hypothesis of etiologically separate pathways for melanoma, with N+ melanomas appearing less likely to develop in the presence of characteristics suggesting high accumulated sun exposure than NÀ melanomas. However, it is possible that high UV exposure causes involution of nevi, thus reducing the density of nevi in exposed skin and thereby the probability of N+ melanoma. (Cancer Epidemiol Biomarkers Prev 2005;14(8):2015 -22)

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Section: Discussionsupporting

confidence: 70%

Section: Introductionmentioning

confidence: 99%

Etiologic and Other Factors Predicting Nevus-Associated Cutaneous Malignant Melanoma

Purdue

From²,

Armstrong³

et al. 2005

Cancer Epidemiology, Biomarkers &Amp; Prevention

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“…We can also modify DMN/CM on the basis of published figures. In series with at least 100 cases, the range of reported DMN/CM appears to fall between 0.05 27 and 0.34. 28 One potential source of disparity between these 2 DMN/CM figures is in the interpretation of the pathologic findings.…”

Section: Commentmentioning

confidence: 94%

The Transformation Rate of Moles (Melanocytic Nevi) Into Cutaneous Melanoma

Tsao

Bevona²,

Goggins³

et al. 2003

Arch Dermatol

286

195

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Background: Moles, or melanocytic nevi, are both markers of an increased risk of cutaneous melanoma and direct precursor lesions. Recent strategies to reduce the burden of advanced disease have focused on early detection and ongoing surveillance of moles for malignant degeneration. Inherent in this approach is the notion that moles exhibit a certain risk of transformation into melanoma; however, this risk is unknown.Objective: To estimate the risk of moles transforming into cutaneous melanoma. Design:We first constructed a model of transformation based on the assumption that the minimal number of moles turning into cutaneous melanoma per year is roughly equivalent to the number of melanomas diagnosed each year with associated nevic components. The annual risk was then calculated as the number of moleassociated melanomas diagnosed in 1 year (stratified by 10-year age groups) divided by the number of moles in a the same 10-year age group. We also estimated the cumulative risk during the lifetime of an individual mole by using a modification of the standard life table method.Results: The annual transformation rate of any single mole into melanoma ranges from 0.0005% or less (ie, Յ1 in 200000) for both men and women younger than 40 years to 0.003% (about 1 in 33000) for men older than 60 years. The rate is similar between men and women younger than 40 years but becomes substantially higher for men older than 40 years. For a 20-year-old individual, the lifetime risk of any selected mole transforming into melanoma by age 80 years is approximately 0.03% (1 in 3164) for men and 0.009% (1 in 10800) for women. Conclusions:The risk of any particular mole becoming melanoma is low, especially in younger individuals. However, since moles can disappear, ones that persist into old age have an increased risk of malignant degeneration. For young people with innumerable moles and no other associated risk factors, systematic excision of benignappearing lesions would be of limited benefit.

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“…Our study is one of the largest analyses to date documenting this effect, although smaller series have noted similar trends. 11,14,16,26 This age effect is likely due to the smaller numbers of nevi noted in older individuals, 27,28 which might result from a timerelated involution of nevi and fewer nevic precursors available from which melanomas may develop. Alternatively, melanomas in older individuals may result from cumulative solar damage to epidermal melanocytes, while melanomas in younger patients may be more prone to arise from an altered precursor substrate, such as a nevus.…”

mentioning

confidence: 99%