Workup and Staging of Malignant Melanoma

Kauffmann, Rondi M.; Chen, Steven L.

doi:10.1016/j.suc.2014.07.001

Cited by 17 publications

(16 citation statements)

References 37 publications

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“…Once a concerning lesion is thoroughly assessed, the remaining cutaneous surfaces (i.e., scalp, perineum, interdigital space, genitalia, and subungual regions) should be closely inspected for the presence of any additional lesions of suspicion. All lesions with a benign appearance should be documented and all lymph node basins should be palpated for lymphadenopathy (14). …”

Section: Physical Examination Findingsmentioning

confidence: 99%

“…Alternatively, partial biopsy may be performed and is typically completed via a punch or shave technique. A punch biopsy, if properly positioned, may be advantageous since the provision of a full-thickness sample is possible (14). However, this technique often requires suture-based closure, which lengthens the encounter.…”

Section: Diagnostic Strategiesmentioning

confidence: 99%

“…Despite its frequent use among dermatologists and primary care physicians, partial biopsy performed via the shave technique has previously raised doubts regarding staging accuracy and histologic interpretation due to its ability to transect a segment of the lesion in question. Despite historical resistance, a properly performed shave biopsy is easy to execute, typically does not require cutaneous suturing, and can be quickly completed in a busy outpatient setting (14,16). A recently published, multi-institutional, retrospective study of 600 patients challenged decades of surgical dogma.…”

Section: Diagnostic Strategiesmentioning

confidence: 99%

“…Diagnostic confirmation involves routine histologic analysis by the receiving pathology department (14). Microscopic findings including cytologic atypia, amplified cellularity, and the number of dermal mitotic figures should be noted in …”

Section: Histologic Confirmationmentioning

confidence: 99%

“…Desmoplastic melanomas are uncommon lesions that are typically seen in elderly patients and feature limited spindle or atypical cells. Possibly the most challenging subtype in terms of diagnosis, amelanotic melanomas have a characteristic absence of pigmentation and are considered rare (14).…”

Section: Disease Types and Prognostic Factorsmentioning

confidence: 99%

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Clinical Presentation and Staging of Melanoma

Ward

Lambreton

Goel

et al. 2017

Cutaneous Melanoma: Etiology and Therapy

101

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Cutaneous melanoma is responsible for the vast majority of skin cancer-related deaths in the United States. Known risk factors include genetic defects, environmental exposures, and a combination of both. Among environmental risks, exposure to ultraviolet rays is the most important and the most modifiable risk factor. Several genetic syndromes involve increased risk of melanoma, including xeroderma pigmentosum, familial atypical multiple moles and melanoma syndrome, BRCA2 mutation, and congenital melanocytic nevi. Although the necessity of implementation remains controversial, the most effective melanoma screening technique is the whole-body skin examination. Typically, melanoma lesions are incidentally discovered during routine skin examination using the "ABCDE" mnemonic. Once suspected, questions pertaining to the sites of potential metastasis should be asked and excisional or partial biopsy should be considered. The primary histologic subtypes of melanoma include superficial spreading, lentigo maligna, nodular, acral lentiginous, desmoplastic, and amelanotic. Melanoma staging is completed via clinical and histologic assessment using the American Joint Committee on Cancer TNM system. Delayed or deficient elements of initial melanoma evaluation can limit patient outcomes and increase disease-related mortality. Clinicians involved in the diagnosis or treatment of cutaneous melanoma must be familiar with the available screening options, key steps of diagnosis, and the staging ramifications of disease discovery.

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Section: Physical Examination Findingsmentioning

confidence: 99%

Section: Diagnostic Strategiesmentioning

confidence: 99%

Section: Diagnostic Strategiesmentioning

confidence: 99%

Section: Histologic Confirmationmentioning

confidence: 99%

Section: Disease Types and Prognostic Factorsmentioning

confidence: 99%

See 3 more Smart Citations

Clinical Presentation and Staging of Melanoma

Ward

Lambreton

Goel

et al. 2017

Cutaneous Melanoma: Etiology and Therapy

101

View full text Add to dashboard Cite

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Malignancy in pregnancy: Multimodality imaging and treatment

Nguyen

Bhosale

Cassia³

et al. 2023

Cancer

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The diagnosis of cancer is increasingly made in the pregnant population, thought to be from the increasing average age of pregnancy and the use of prenatal fetal noninvasive screening techniques, leading to incidental detection of cancer in the mother. Complex challenges are associated with imaging, diagnosis, staging, and treatment of cancers in this patient population, which require highly specialized interdisciplinary management. This report discusses the use of multimodality imaging and safety considerations in pregnant patients, reviews the current guidelines for ionizing radiation imaging techniques, and presents a series of commonly and uncommonly encountered cancers in pregnancy with current diagnostic imaging guidelines. The authors also discuss the role of multidisciplinary management and treatment options and provide an overview of therapy‐related considerations in the age of novel anticancer therapies. Plain Language Summary The diagnosis and management of pregnant patients who have cancer are actively evolving as novel imaging techniques and anticancer therapies are being developed. Radiologically, there are inherent difficulties in balancing the minimization of fetal ionization while acquiring diagnostic quality imaging necessary for the diagnosis, staging, and treatment of maternal disease. Standardized imaging protocols are still being developed, with evolving imaging guidelines coupled with rapidly expanding research and development of novel anticancer therapies, which come with their side effects and complications. Caring for this patient population is especially challenging and requires specialized multidisciplinary attention.

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