Malignant Melanoma Flashcards Preview

Cancer Care > Malignant Melanoma > Flashcards

Flashcards in Malignant Melanoma Deck (84)
Loading flashcards...
1

What is a malignant melanoma?

Cancerous growth of melanocytes

2

Where do malignant melanomas arise from?

The vast majority arise from skin, but malignant melanomas have been described in nearly every organ of the body

3

Where are normal melanocytes found?

In the basal layer of the epidermis

4

Are more melanocytes found in black or white skin?

The same

5

How do melanocytes differ in black and white skin?

Melanocytes in black skin produce much more melanin

6

What do non-cancerous growths of melanocytes result in?

Moles and freckles

7

What mutation is associated with malignant melanoma?

BRAF mutations

8

What is BRAF?

A serine/threonine protein kinase activating the MAP kinase/ERK-signalling pathway

9

What % of melanomas have activating BRAF mutations?

50%

10

What has BRAF V600 been implicated in?

Different mechanisms underlying the development of melanomas

11

What are the types of malignant melanomas?

- Superficial melanoma
- Nodular melanoma
- Lentigo maligna melanoma
- Acral lentiginous malignant melanoma

12

What are the characteristics of superficial melanomas?

Large, flat, irregularly pigmented lesion which grows laterally before vertical invasion develops

13

What is the most invasive type of malignant melanoma?

Nodular

14

How do nodular melanomas present?

Rapidly growing pigmented nodule which bleeds or ulcerates

15

What is a lentigo maligna?

Melanoma in situ

It is not the same as a lentigo maligna melanoma

16

What is a lentigo maligna melanoma?

When a patch of lentigo maligna develops a papule or nodule, signally an invasive tumour

17

How does acral lentiginous malignant melanoma present?

Pigmented lesions on palm, sole, or under the nail

18

When does acral lentiginous malignant melanoma present?

Late

19

What are the risk factors for malignant melanoma?

- Previous primary invasive melanoma
- Naevi
- Sun exposure
- Pale Caucasian skin
- Family history of melanoma
- Past pesticide exposure
- Higher socio-economic group

20

What % of people with malignant melanoma will develop a further lesion, or a different type of skin cancer?

3-5%

21

What kind of sun exposure in particular increases the risk of malignant melanoma?

- Sharp, short bursts of acute exposure in childhood
- Severe sunburn in childhood
- Past sunbed use, especially before age 30

22

What features of pale skin indicate an increased risk of malignant melanoma?

- Poor ability to tan
- Freckled complexion

23

What are the features of the appearance of malignant melanoma?

- Asymmetrical
- Irregular border
- Irregular colour
- Diameter greater than 7mm
- Evolving

24

When should people be referred under the 2WW for malignant melanoma?

If they have a suspicious pigmented skin lesion with a weighted 7-point checklist score of 3 or more

25

How is a persons 7-point checklist score determined?

Major features score 2 points each, and minor features score 1 point each

26

What are the major features on the 7-point checklist score for malignant melanoma?

- Change in size
- Irregular shape
- Irregular colour

27

What are the minor features on the 7-point checklist score for malignant melanoma?

- Largest diameter 7mm or more
- Inflammation
- Oozing
- Change in sensation

28

What are the primary investigations for malignant melanoma?

- Visual inspection
- Removal for histology where necessary

29

How is a diagnosis of malignant melanoma made?

Excisional biopsy

30

What further investigations may be done in malignant melanoma once a diagnosis is established?

- Sentinel lymph node biopsy
- CXR and liver ultrasound, or CT scan of chest, abdomen, and pelvis
- Blood tests
- Bone scan