Retrospective Analysis of Clinicopathological Characteristics of Pregnancy Associated Melanoma

Fábián, Melinda; Tóth, Veronika; Somlai, Beáta; Hársing, Judit; Kuroli, Enikő; Rencz, Fanni; Kuzmanovszki, Daniella; Szakonyi, József; Tóth, Béla; Kárpáti, Sarolta

doi:10.1007/s12253-015-9961-4

Cited by 13 publications

(4 citation statements)

References 30 publications

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“…The alterations of the immune system during pregnancy mirror those seen in malignancies, where regulatory T cells proliferate and Th1 immune response changes to Th2 immune response 44–46 . In a prior retrospective case–control study of 34 PAM, no differences were found in tumour thickness or other histological parameters, but interestingly, PAM showed more marked inflammation around the tumour compared with non‐PAM 13 . As it is becoming standard of care to initiate immunotherapy for resected early stage melanoma, 47,48 the impact of pregnancy on the immune microenvironment of melanoma warrants further study.…”

Section: Discussionmentioning

confidence: 88%

“…Initial reports suggested that pregnancy promotes malignant transformation, growth and metastatic potential of melanoma 3–5 . Since then, various studies have shown mixed results on the characteristics and prognosis of pregnancy‐associated melanoma (PAM) defined as melanoma diagnosed during antepartum and post‐partum periods, with a limited number of large population‐based studies showing no evidence of worsened prognosis of PAM 3,6–14 …”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Melanoma in women of childbearing age and in pregnancy in California, 1994–2015: a population‐based cohort study

Kiuru

Zhu

et al. 2022

Acad Dermatol Venereol

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Background Melanoma is one of the most common malignancies during pregnancy. There is debate regarding the impact of pregnancy on the prognosis of melanoma. Recent large population‐based studies from the United States are lacking. Objectives To determine the characteristics and survival of women with pregnancy‐associated melanoma. Methods This population‐based, retrospective cohort study used California Cancer Registry data linked with state‐wide hospitalization and ambulatory surgery data to identify 15–44‐year‐old female patients diagnosed with melanoma in 1994–2015, including pregnant patients. Multivariable logistic regression compared demographic and clinical characteristics between pregnant and non‐pregnant women with melanoma. Multivariable cox proportional hazards regression models assessed melanoma‐specific and overall survival. Results We identified 13 108 patients, of which 1406 were pregnant. Pregnancy‐associated melanoma was more frequent in Hispanic compared to non‐Hispanic White women. Melanoma occurring post‐partum was associated with greater tumour thickness (2.01–4.00 vs. 0.01–1.00 mm, odds ratio 1.75, 95% confidence interval: 1.03–2.98). There were otherwise no significant differences between pregnant and non‐pregnant women. Worse survival was associated with Asian, Black and Native American race/ethnicity (vs. non‐Hispanic White), lower neighbourhood socio‐economic status, public insurance, tumour site, greater tumour thickness and lymph node involvement, but not pregnancy. Conclusions Melanoma occurring post‐partum was associated with greater tumour thickness, but pregnancy status did not affect survival after melanoma. Race/ethnicity, socio‐economic status and health insurance impacted survival, emphasizing the importance of reducing health disparities.

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Section: Discussionmentioning

confidence: 88%

Section: Introductionmentioning

confidence: 99%

Melanoma in women of childbearing age and in pregnancy in California, 1994–2015: a population‐based cohort study

Kiuru

Zhu

et al. 2022

Acad Dermatol Venereol

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“…There are many different reports, often contradictory. Some of them support the thesis of an increased risk of melanoma in pregnancy and its negative impact on the development of this malignant tumor, 10–13 including single case reports 14 . In contrast, other more recent reports suggest different views 15–18 …”

mentioning

confidence: 86%

Melanoma During Pregnancy as a Complicated Medical Problem

Kościelecka¹,

Kubik-Machura²,

Kuć³

et al. 2023

Obstetrical &Amp; Gynecological Survey

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ImportancePregnancy-associated melanomas (PAMs)—this is how melanomas identified during the childbearing years or up to 1 year after birth have been defined, accounting for one third of women in whom it is diagnosed. The exact epidemiology of melanoma is difficult to determine. However, its incidence is undoubtedly increasing, most likely related to the increasing age of mothers.ObjectiveThe purpose of this study was to review the prognosis, diagnosis, and treatment; the effect of melanoma on pregnancy; and the effect of pregnancy on melanoma and melanocytic lesions.Evidence AcquisitionAn extensive manual search of major electronic databases was conducted in January 2022. The following literature review provides comprehensive coverage of PAMs.ResultsAny new nevus detected during pregnancy and changes in the nevus regarding color, diameter, symmetry, or lesion border require medical evaluation. New therapies for malignant melanoma, such as immunotherapy and targeted therapy, have improved overall survival and progression-free survival, but their use is often contraindicated in pregnant patients. Melanoma is considered to be the neoplasm most commonly involving the fetus and placenta.ConclusionsThere are reports where immunotherapy and targeted therapy used in the patient were not associated with serious consequences for the fetus, being a therapeutic option for the patient. The described cases of pregnancy outcome during modern melanoma treatment are extremely important and may allow to shape the optimal therapeutic regimen in pregnant women with melanoma.RelevanceEducation of pregnant women in the context of observation of skin lesions as well as maintenance of oncological vigilance by physicians seem to be an important element in limiting difficult decisions related to therapy of more advanced disease. Further large-scale studies using modern treatment in pregnant women with melanoma are needed.Target AudienceObstetricians and gynecologists, family physicians.Learning ObjectivesAfter completing this activity, the learner should be better able to describe the importance of oncologic vigilance in the context of developing melanoma in a pregnant woman; discuss the need for further research on the use of immunotherapy and targeted therapy in pregnant women with melanoma; and explain the need for oncologic vigilance in the context of melanoma in children of mothers who developed melanoma during pregnancy.

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“…There are conflicting reports of the effects of pregnancy on melanoma. Large studies of pregnancy-associated cutaneous melanoma suggest that pregnancy has no adverse effect on melanoma diagnosed during pregnancy [3], although more recent reports suggest otherwise [4,5,6]. Conjunctival melanoma (CM) is a rare tumour, with an incidence of less than 1 per million per year [7,8].…”

Section: Introductionmentioning

confidence: 99%

Conjunctival Melanoma during Pregnancy

et al. 2016

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Purpose: To describe the clinical and histopathological features of a conjunctival melanoma (CM) during early pregnancy. Procedures: A 37-year-old, 20-week pregnant primigravida was referred to the Sheffield Ocular Oncology Service with a rapidly growing lesion arising from the right superior conjunctival fornix, noted from the first trimester of pregnancy. This was associated with pain and bloody discharge. Incisional biopsy confirmed the clinical suspicion of invasive CM. She was treated by primary surgical excision and cryotherapy under local anaesthesia. Results: Histology of the excised specimen showed an invasive malignant melanoma with surrounding in situ conjunctival changes arising from a naevus. The melanoma was 10.5 mm thick, focally necrotic, and had a mitotic count of 11/mm² focally. The patient responded well to surgical treatment. She gave birth to a healthy boy, and the placenta showed no evidence of metastatic melanoma. There has been no recurrence or distant metastasis during 5 years of follow-up. Conclusion: CM during pregnancy is extremely rare. Because of possible transformation to malignant melanoma, we recommend close monitoring of females known to have pigmented conjunctival lesions of the conjunctiva during pregnancy.

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Retrospective Analysis of Clinicopathological Characteristics of Pregnancy Associated Melanoma

Cited by 13 publications

References 30 publications

Melanoma in women of childbearing age and in pregnancy in California, 1994–2015: a population‐based cohort study

Melanoma in women of childbearing age and in pregnancy in California, 1994–2015: a population‐based cohort study

Melanoma During Pregnancy as a Complicated Medical Problem

Conjunctival Melanoma during Pregnancy

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