Melanoma: Difference between revisions
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===Classification=== | ===Classification=== | ||
The microstage of malignant melanoma is determined on histologic examination by the anatomic level of local invasion (Clark classification) and/or the vertical thickness of the lesion in millimeters (Breslow classification). Accurate microstaging of the primary tumor requires careful histologic evaluation of the entire specimen by an experienced pathologist. Estimates of prognosis should be modified by sex and anatomic site as well as by clinical and histologic evaluation.<ref>{{citation | The microstage of malignant melanoma is determined on histologic examination by the anatomic level of local invasion (Clark classification) and/or the vertical thickness of the lesion in millimeters (Breslow classification). Accurate microstaging of the primary tumor requires careful histologic evaluation of the entire specimen by an experienced pathologist. Estimates of prognosis should be modified by sex and anatomic site as well as by clinical and histologic evaluation.<ref>{{citation | ||
| http://www.cancer.gov/cancertopics/pdq/treatment/melanoma/healthprofessional/allpages | | url = http://www.cancer.gov/cancertopics/pdq/treatment/melanoma/healthprofessional/allpages | ||
| publisher = National Cancer Institute | | publisher = National Cancer Institute | ||
| title = PDQ: Melanoma treatment}}</ref> | | title = PDQ: Melanoma treatment}}</ref> |
Revision as of 16:39, 2 July 2010
A melanoma, frequently called a malignant melanoma, is an aggressively malignant cancer that develops in epithelial cells capable of producing melanin. It appears most often on the skin, but, also, in the eye, or, rarely, in the mucous membranes of the genitalia, anus, oral cavity, or other sites. Early detection is critical, as localized melanoma usually can be surgically excised, but metastatic disease has a poor prognosis.
It occurs mostly in adults and may originate de novo or from a pigmented nevus or malignant lentigo. Melanomas frequently metastasize widely, and the regional lymph nodes, liver, lungs, and brain are likely to be involved. The incidence of malignant skin melanomas is rising rapidly in all parts of the world.[1]
Etiology
Pathology
Recognition
Classification
The microstage of malignant melanoma is determined on histologic examination by the anatomic level of local invasion (Clark classification) and/or the vertical thickness of the lesion in millimeters (Breslow classification). Accurate microstaging of the primary tumor requires careful histologic evaluation of the entire specimen by an experienced pathologist. Estimates of prognosis should be modified by sex and anatomic site as well as by clinical and histologic evaluation.[2]
Clark Classification
The Clark Classification is qualitative.
- Level I: Lesions involving only the epidermis (in situ melanoma); not an invasive lesion.
- Level II: Invasion of the papillary dermis but does not reach the papillary-reticular dermal interface.
- Level III: Invasion fills and expands the papillary dermis but does not penetrate the reticular dermis.
- Level IV: Invasion into the reticular dermis but not into the subcutaneous tissue.
- Level V: Invasion through the reticular dermis into the subcutaneous tissue.
Breslow thickness
If the lesion is greater than 1.5mm thick, the Breslow thickness measurement is more reproducible and a better predictor of progress than the Clark classification.
TNM Definitions
The American Joint Committee on Cancer (AJCC) has designated staging by TNM classification to define melanoma.[3]
Treatment and prognosisReferences
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