Malignant Melanoma

Malignant Melanoma: Or something else? Differential Diagnosis

Skin and subcutaneous (L00-L99). Lentigo senilis (senile spot). Neoplasms – tumor diseases (C00-D48) Angiokeratoma (blood wart) Angiosarcoma – malignant vascular change: sarcoma, i.e., a malignant tumor of supporting and connective tissues originating from the endothelium of blood vessels Benign juvenile melanoma – benign skin tumor that occurs mainly in young children. Glomus tumor – malignant … Malignant Melanoma: Or something else? Differential Diagnosis

Malignant Melanoma: Complications

The following are the most important diseases or complications that may be contributed to by malignant melanoma (MM): Neoplasms – Tumor diseases (C00-D48). Paraneoplastic syndrome (concomitant symptoms of cancer not primarily due to the neoplasm (solid tumors or leukemias)): Degeneration of the cerebellum, Guillain-Barré syndrome, limbic encephalitis (meningitis), and chronic inflammatory demyelinating polyneuropathy (diseases of … Malignant Melanoma: Complications

Malignant Melanoma: Examination

A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height; further: Inspection (viewing). Skin and mucous membranes including use of a dermatoscope (reflected light microscope) [Leading symptoms: pigment moles that change (ABCD(E) rule according to Stolz): Asymmetry Boundary: irregular boundary Color (color): … Malignant Melanoma: Examination

Malignant Melanoma: Test and Diagnosis

1st order laboratory parameters – obligatory laboratory tests. Small blood count Differential blood count Inflammatory parameters – CRP (C-reactive protein) or ESR (erythrocyte sedimentation rate). LDH (lactate dehydrogenase) – initial at ≥ 4 mm tumor thickness, with ulceration (examination in stage IIC and III). AP (alkaline phosphatase) 5-Cysteinyldopa (tumor marker; biochemical marker for malignant melanoma) … Malignant Melanoma: Test and Diagnosis

Malignant Melanoma: Drug Therapy

Therapeutic targets Improvement of prognosis Palliative Therapy recommendations [S3 guideline] First-line therapy: excision in toto (surgical removal of the tumor in its entirety, i.e., maintaining a safe distance). Therapy for locoregional metastasis (stage III) [S3 guideline]. Satellite and in-transit metastases (regional tumor metastases formed at a distance of more than 2 cm from the primary … Malignant Melanoma: Drug Therapy

Malignant Melanoma: Diagnostic Tests

Mandatory medical device diagnostics. Dermoscopy (reflected-light microscopy; increases diagnostic accuracy)Note: Early detection of malignant melanoma that does not have specific dermoscopic malignancy criteria can be improved during follow-up by sequential digital dermoscopy (SDD, storage and digital analysis of the image material).In high-risk collectives, whole-body photography is an option for early detection of malignant melanoma. Lymph … Malignant Melanoma: Diagnostic Tests

Malignant Melanoma: Surgical Therapy

Note: In patients with early-stage melanoma of the skin, delaying surgery after biopsy (tissue removal) potentially increased mortality (death rate): patients who did not have surgery until between 90 and 119 days after biopsy or even later had an increased risk of mortality (hazard ratio [HR]: 1.09 and 1.12, respectively): compared with patients who had … Malignant Melanoma: Surgical Therapy

Malignant Melanoma: Prevention

To prevent malignant melanoma, attention must be paid to reducing individual risk factors. Behavioral risk factors UV exposure (especially: UV-B radiation; solariums?)Note: Moderate solarium use should not lead to an increased risk of melanoma. In men: overweight (BMI ≥ 25; obesity). Environmental pollution – intoxications (poisonings). Radon UV light Prevention factors (protective factors) Genetic factors: … Malignant Melanoma: Prevention

Malignant Melanoma: Medical History

Medical history (history) represents an important component in the diagnosis of malignant melanoma (MM). Family history Are there frequent tumors of the skin in your family? Social anamnesis Current medical history/systemic history (somatic and psychological complaints). What changes have you noticed? Have any individual nevi changed in shape, color, or texture? Do these skin lesions … Malignant Melanoma: Medical History

Malignant Melanoma: Radiotherapy

As a primary treatment, radiotherapy (radiotherapy; radiatio) is given for malignant melanoma only when surgery cannot be performed. Radiotherapy of the primary tumor is indicated for [S3 guideline]: Lentigo-maligna melanomas that are not suitable for surgical therapy because of extension, location, and/or age of the patient. Inoperable R1- or R2-resected primary tumors (microscopically or macroscopically … Malignant Melanoma: Radiotherapy

Malignant Melanoma: Symptoms, Complaints, Signs

The following symptoms and complaints may indicate malignant melanoma (MM): Leading symptoms Pigmentary moles that change (ABCD(E) rule): Asymmetry Irregular boundary Irregular color (Color) Diameter > 5 mm Sublimity > 1 mm Associated symptoms Bleeding Rapid growth Ulceration (ulceration) Incrustations Localization In Europeans, the changes occur preferentially on the chest, back or extremities. Most often … Malignant Melanoma: Symptoms, Complaints, Signs

Malignant Melanoma: Causes

Pathogenesis (disease development) The factors leading to the development of malignant melanoma (MM) are unclear. It is thought that UV exposure causes mutations in the pigment system to accumulate. This is also seen in the development of melanocytic nevi (liver spots).Note: The risk of melanoma increases almost linearly with the number of melanocytic nevi. See … Malignant Melanoma: Causes