Natural history of invasive cutaneous melanoma in Styria,Austria 2001–2003

Background: Rising melanoma incidences have created the need of assessment of epidemiological and clinical data. Patients and methods: We investigated the natural history of invasive cutaneous melanoma in Styria, a province of Austria, in the years 2001–2003. 1082 patients, 511 men and 571 women, mean age 58.2 ± 16.7 years, were collected. Besides basic melanoma data, special histologic features such as regression structures, ulceration, microsatellites and vascular invasion were investigated. Furthermore, lymph node pathology in case of sentinel node biopsy and/or lymph node dissection was recorded. Results: Mean annual incidence (crude rate) was 28.6 per 100,000 inhabitants, age standardized rate 24.5 per 100,000 (95 % CI 22.4–26.6). Cumulative risk (0– 74 years) was 1.92, lifetime risk 1 in 52. Superficial spreading melanoma was the most common type in both sexes, men on the trunk and women on the extremities. Only 11 % of all melanomas were in easily visible areas. Median tumor thickness was 0.75 mm, ranging between 0.2 and 50.0 mm. Sentinel node biopsy was performed in 158 melanomas (14.6 %),and was positive in 22 %.Primary therapeutic lymph node dissection was performed in 19 patients, showing metastases in 18 patients. Conclusions: The investigation revealed an unclear high melanoma incidence for invasive melanomas in our province, requiring further investigation.     

Comparative analysis of incidence and clinical features of cutaneous malignant melanoma in Crete (Greece) and southern Germany (central Baden-Württemberg)

BACKGROUND: Comparative analysis of the incidence rates and epidemiological features of cutaneous malignant melanoma (CMM) between different ethnic groups exposed to varying environmental factors is critical for consideration of the causes of CMM but can also be utilized in a public health approach to control of the disease. OBJECTIVES: To compare incidence rates and clinical features of CMM in a Greek and a central European population (central Baden-Württemberg, Germany). METHODS: Incident cases of CMM were traced in all hospitals of the island of Crete for the period 1999-2002. Age-standardized incidence rates per 100 000 inhabitants per year for the European Standard Population were calculated based on the Cretan population statistics. A comparison was performed between the Cretan findings and those of southern Germany as registered by the hospital-based Central Malignant Melanoma Registry, which likewise documents more clinical features than normally recorded by population-based cancer registries. RESULTS: Mean incidence rates in Crete for 1999-2002 were 4.01 per 100 000 inhabitants per year for males and 4.05 for females as compared with 10.6 for males and 11.1 for females in southern Germany. There were striking differences in the clinical characteristics of CMMs, with significantly higher tumour thickness in Crete (median 1.4 mm vs. 0.7 mm in southern Germany). Correspondingly, significantly more nodular melanomas were observed in Crete (29%) as compared with southern Germany (11%). CONCLUSIONS: Incidence of CMM in Crete, with about four cases per 100 000 inhabitants per year, is clearly higher than previously estimated, and there is an urgent necessity for earlier recognition of CMM in Crete. However, the incidence of CMM in southern Germany is much higher.     

Characterization of KIT mutation in melanoma

Background/objectivesRecent studies have shown that the KIT mutational type appears to be a predictive marker for the efficacy of imatinib in treating melanoma. However, a wide range of KIT mutation rates was reported in different types of melanoma, suggesting that the mutation frequency of KIT may be associated with clinicopathological subsets of melanoma.MethodsTo characterize their relationship, we sequenced exons 11, 13, 17, and 18 of KIT in 80 of 85 melanomas collected from two hospitals and categorized KIT mutation by tumor type, age and sex of patients, and mutation hot spots of KIT.ResultsOur results showed that KIT mutation rates were 25%, 22%, and 8% in acral, mucosal, and cutaneous melanomas, respectively. Approximately 38% (5/13) of male patients with acral melanoma and 45% (5/11) of female patients with mucosal melanomas of the anorectal and genitourinary regions had a KIT mutation. Approximately 81% of KIT mutations occurred in L576P, K642E, V559A, and D820Y.ConclusionThis result shows that KIT mutation is enriched in a certain subset of melanoma patients and mutation hot spots do exist.     

孤立性真皮黑素瘤5例临床及组织病理分析

目的 分析孤立性真皮黑素瘤（SDM）的临床及组织病理特点。 方法 回顾性分析5例SDM患者的临床及组织病理学资料。 结果 SDM临床表现为黑色、肤色、红色的丘疹或结节,无特定好发部位。病理表现为局限性真皮/皮下孤立性结节,无明显包膜,具有恶性肿瘤的特征,表皮不受累。 结论 详细的临床资料以及皮肤组织病理学检查是正确诊断SDM的关键。     

Cutaneous melanoma: practical usefulness of the American Joint Committee on Cancer staging system

The 2002 American Joint Committee on Cancer melanoma staging classification is the first to be based on natural history. Although primarily for hospital tumor registrars, knowledge of the classification is of value to dermatologists in prognosticating for their patients and in selecting candidates for sentinel node biopsy and possible subsequent therapies.     

Desmoplastic malignant melanoma: a systematic review

BACKGROUND: Desmoplastic melanoma (DM) is an uncommonly encountered type of malignant melanoma. The clinical appearance of DM can be highly variable and thus, diagnosis of this tumour is difficult and very often may mislead the physician. OBJECTIVES: To make a critical review of the contemporary literature on DM, to pool the data from published studies and to evaluate the clinical and morphological characteristics of this neoplasm. METHODS: All studies or reports on DM including 10 or more participants with reported clinical and histological characteristics of the tumour were included. RESULTS: In the 17 studies that met the inclusion criteria a total of 856 patients with DM was reported. There was a male predilection, with a male/female ratio of almost 2 : 1 (63% of the lesions were diagnosed in males). The head and neck were the most common sites of DM for both sexes (53.2%). The data confirmed that DM usually has an advanced Breslow thickness at the time of presentation. Histopathological diagnosis of DM is sometimes difficult and the absence of pigmentation is probably the major cause for failure to recognize DM histologically. The pooled data from included studies showed that the incidence of nodal metastasis is lower in patients with DM than in patients with other forms of cutaneous melanoma. CONCLUSIONS: Prompt definitive surgical excision is the treatment of choice for DM. Improved knowledge of the clinical behaviour and histological features of DM is important for more effective management of patients with DM.     

孤立性真皮黑素瘤5例临床及组织病理分析

目的:分析孤立性真皮黑素瘤（SDM）的临床及组织病理特点。方法:回顾性分析5例SDM患者的临床及组织病理学资料。结果:SDM临床表现为黑色、肤色、红色的丘疹或结节,无特定好发部位。病理表现为局限性真皮/皮下孤立性结节,无明显包膜,具有恶性肿瘤的特征,表皮不受累。结论:详细的临床资料以及皮肤组织病理学检查是正确诊断SDM...     

原发皮肤恶性黑色素瘤细胞分子遗传学研究进展

本文综述了原发皮肤恶性黑色素细胞分子遗传学改变,染色体上的非随机改变主要发生在1、6、9、7及10号染色体上。