Melanoma Lecture Note

University:
The University Of Western Ontario
Course:
ANAT 2200B | Systemic Anatomy of the Human Body
Academic year:

2022
Views:

99

Pages:

2
Author:

Kyuwon J.

Melanoma ● Pathology ○ Transformation of melanocytes ■ Local invasions + lymphatic, and haematogenous spreads ● Breslow thickness ● Ulcerations ● Tumour stage ○ Clonicopathological types ■ Superficial spreading melanoma ● ~70% ● Slow and radial growth ○ Metasasize later on ● Better prognosis ○ Nodular melanoma ■ Nodular melanoma ● 10-15% ● Vertical growth ○ Invasion on deep skin ○ Metastasizes early ○ Amelanotic ■ Not dark does not mean its not melanoma ■ Acral melanoma ● Palms ● Soles ● Subungual regions ■ Lentigo maligna melanoma ● From pre-existing lentigo maligna Spotting ● Change in pigmented lesions ● New lesion in adults ○ Odd one out moles ● Screening heuristics ○ ABCDE ■ Asymmetry ■ Border irregularity ■ Colour variation ■ Diameter ■ Evolving ○ Ugly duckling sings ● Amelanotic nodular lesions ○ Pink and red firm papules and nodules ○ May not look melanoma-like Dx ● ● ● ● ● Skin exam Regional lymphatic node exam Dermascopy for assessment Exact diagnosis needs histology Biopsy principle ○ Suspicious lesion when feasible ○ Breslow depth can be measured ● Depth drive management shall be discussed Mx ● Urgent excision for earlier stages ● Metastatic ○ Systemic immunotherapy ■ Nivolumab + ipilimumab ■ PD-1 and CTLA-4