Online consultations with MCSC doctors n. a. A. S. Loginov

Skin melanoma

What is skin melanoma?

Melanoma is a malignant tumor that arises from melanocytes-cells containing the dark pigment melanin.  In 90% of cases, melanoma is localized on the skin.  Melanoma is one of the most aggressive forms of malignant tumors in humans, with rapid growth and a high potential for metastasis. The incidence of skin melanoma in the Russian Federation and in the world is increasing, according to WHO, by 2025, an increase in skin melanoma is expected by 25%!

What are the main causes of skin melanoma?  

1. Ultraviolet radiation of the skin (sunburn in southern countries up to 1-2 times a year, tanning, sunburn), especially in people with light skin (blondes, redheads)!!!

2.The presence of congenital or acquired dysplastic pigmented nevi (growing moles) on the skin.

3. Chronic trauma of the nevus (mole) – when wearing uncomfortable shoes, when rubbing clothes, with regular shaving and with frequent epilation.

4. Hereditary factors (the presence of multiple dysplastic nevus syndrome of the skin, the presence of a history of skin melanoma in a close relative)

How to recognize melanoma in the early stages?

You should know that early diagnosis is the key to a complete cure for skin melanoma-a tumor visible to the eye!!!  For timely detection, it is necessary to periodically independently inspect the skin, especially if they have nevi (moles) and observe the change in their shape, color, edges and growth dynamics.  For early diagnosis of melanoma, you can use the international ABC rule. letters: - asymmetry of the neoplasm; B – roughness of the edges of the tumor (indentation); C – color change (one to another or multicolored, i.e. the presence of black, brown, pink and blue colors in one formation); D – the diameter of the formation is more than 6 mm; E-dynamic changes over time (growth, elevation). If the above signs appear, you should immediately contact an oncologist, a specialist in the diagnosis and treatment of skin tumors.  

What is included in the mandatory examination for the detection of skin melanoma?

 

First of all, it is an oncologist's examination of the primary tumor and the skin near it, as well as examination and palpation of regional lymph nodes and collection of anamnesis. After that, it is necessary to conduct a mandatory ultrasound examination of the peripheral lymph nodes, abdominal organs, retroperitoneal space, pelvis and chest X-ray for the absence or presence of metastases. If necessary (according to indications), it is possible to supplement the examination by performing computed tomography (CT) of these areas with the use of contrast agents or positron emission tomography (PET) in the "whole body"mode.  If enlarged peripheral lymph nodes are detected (if metastases are suspected), a fine needle aspiration puncture biopsy with cytological examination should be performed on the patient.   If patients have neurological symptoms: complaints of headache, dizziness, changes in gait, vision and handwriting, etc.), it is necessary to conduct magnetic resonance imaging (MRI) of the brain with intravenous contrast.

 

What clinical forms of skin melanoma occur?

1. Surface-spreading skin melanoma – the most common (up to 70%) of all skin melanomas.  A relatively slow-growing tumor (3-7 years old), has a horizontal growth phase. 

2. Nodular melanoma of the skin-occurs in 20-25% of cases, a fast-growing tumor, has a vertical growth type. 

 

3. Melanoma of the type of malignant lentigo – a slow-growing tumor (10-15 years), most often occurs in the elderly and in the elderly on the skin of the face in 5-10% of cases.

 

4. Acral melanoma (subungual form) occurs in 5% of cases under the nail plate and on the skin of the fingertips and toes.

5. Mucosal melanoma is a very rare tumor. It is found on the mucous membranes of the lip, oral cavity, rectum, bronchi, etc. 

How to treat melanoma?

 

1. For local forms of skin melanoma, surgical removal of the tumor is performed by excision with a scalpel, possibly on an outpatient basis under local anesthesia (for small melanoma sizes).

2. In the presence of metastases of melanoma in the regional lymph nodes, the affected lymph nodes are removed (lymphadenectomy), then, as a rule, outpatient immunotherapy with interferon-a is performed during the year to prevent the progression of the tumor. 

3. If the patient has distant metastases (in the skin, subcutaneous tissue, intra-thoracic and intraperitoneal lymph nodes, lungs, liver, brain, etc.), systemic antitumor therapy (chemotherapy, chemoimmunotherapy, immunotherapy, targeted therapy) is prescribed, if necessary, radiation therapy is also performed.

REMEMBER: that only early and timely diagnosis will allow you to carry out radical treatment and completely rid you of this terrible cancer!  

 

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