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
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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