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Malignant Melanoma

Malignant Melanoma
Malignant Melanoma

Introduction

Is a malignant neoplasm of melanocytes or a neoplasm of the cells that develop from melanocytes.

Management: Surgery is the primary treatment.

• Wide local excision and graft
• Amputation sometimes for advanced useless limb

Signs and Symptoms

Diagnostic criteria

History of a pre-existing naves which has changed recently –itching, colour change, increase in size, satellite lesions, elevated surface, ulceration and/or oozing.

Investigation

• CXR or CT Scan
• Abdominal pelvic CT Scan
• PET CT when available
• Excisional biopsy of suspicious lesion for histopathology

Staging: Clark’s or Breslow classifications are used. Tumour size closely correlates with prognosis. Detection/ prevention: Frequent self –check up or screening exercise and prompt treatment of naves

Treatment

  • Pharmacological

    Dacarbazne IV 250mg/m2 Day1–Day 5 every 3 weeks for 4 cycles
    OR
    Temozolomide (PO) 200mg/m2 Day 1–Day 5 every 4weeks

    Radiotherapy used for palliation if:
    • Lesion is inoperable. May use large fractions: 30Gy/6F/1 wk
    • Excision margins are involved or very close
    • Palliative intent (brain mets, fungation or profuse bleeding, bone pain etc)
  • Non-pharmacological

Prevention

Updated on,

5 Novemba 2020 10:11:52

References

1.STG
2.Mediscape. Malignant melanoma. https://emedicine.medscape.com/article/280245-overview. Accessed 5.11.2020

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