MALIGNANT MELANOMA

A neoplasm of epidermal melanocytes and third most common cancer of skin.

▪️Arises in preexisting mole. Appearance – Large, flat, spreading lesion; deeply pigmented Nodule

🔹Precursor Lesions:

(i) Congenital Nevi

https://dentowesome.wordpress.com/2020/05/18/oral-nevi/

(ii) Dysplastic Nevi (Atypical Mole)

(iii) Lentigo Maligna: Also called as Hutchinson’s freckle, is a tan or black on the skin that looks like a freckle.

  • Grows slowly
  • Dark, thick, nodular, mottled
  • Seen on one side of the face of an older adult who had a large amount of sun exposure.

🔹Etiology:

• Genes in the development of Melanoma:

• Phases in the growth of Melanoma:

  1. Radial
  2. Vertical

🔹Classification:

1. Superficial spreading Melanoma:

  • most common type (65%)
  • Radial growth phase – premalignant melanosis/pagetoid melanoma in situ
  • Vertical growth phase – Increase in size, color, nodularity/ulceration
  • Lesions are usually flat, scaly or crusty & 2 cm in diameter
  • Found in trunk & back of Men; Legs of women
  • Median age of occurrence – 50’s

2. Lentigo Maligna Melanoma:

  • Least serious form
  • More in women
  • Macular lesion on malar skin of middle-aged and elderly

3. Nodular Melanoma:

  • Exhibits only vertical growth phase
  • Sharply delineated nodule, may be pink/black
  • Occur in men on skin of head, neck & trunk
  • Looks like blood blister

4. Acral Lentiginous:

  • Also called muco-cutaneous Melanoma
  • Less common with fair skin
  • Palms of hands, soles of feet, mucous membrane, nail beds
  • Median age of occurrence – in 50’s & 60’s

Assessing the ABCDE’s of Moles

Image Source: IG|medical.docs

🔹Oral Manifestations:

  • Age: 55 yrs
  • Sex: M>F
  • Site: Palate/Gingiva
  • Appearance: Deeply pigmented area; ulcerated/haemorrhagic; ⬆️ size
  • Amelanotic melanomas: 5-35% of oral cases

Melanoma stages 5 years survival rates:

  • Stage 0: Melanoma in situ ( Clark level I), 99.9% survival
  • Stage I/II: Invasive melanoma, 85-99% survival
  • Stage II: High risk Melanoma, 40-85% survival
  • Stage III: Regional Metastasis, 25-60% survival
  • Stage IV: Distant Metastasis, 9-15% survival

🔹Treatment depends on stage:

➡️ Metastases that cause symptoms but cannot be removed may be treated with radiation, immunotherapy, targeted therapy, or chemotherapy.

Dr. Mehnaz Memon🖊


References: Shafer’sTextbook Of Oral Pathology; Textbook Of Surgery by S.Das

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s