Abstract
Background An 18-year-old female presented to her General Practitioner with a bleeding mole on her back. The mole had been present since childhood but had started to bleed in the past month. She was otherwise asymptomatic with no relevant previous medical history. Physical examination revealed a 1.5 cm × 1.7 cm pigmented lesion on the left aspect of the patient's upper back. There was no palpable lymphadenopathy.
Investigations Physical examination, excision biopsy, sentinel lymphnode biopsy, CT scan of chest, abdomen and pelvis.
Diagnosis Stage IIIB (T3bN2aM0) focally ulcerated, nodular malignant melanoma (Breslow depth 2.5 mm, Clark's level IV).
Management Wide re-excision, completion dissection of the left axillary lymph node, adjuvant high-dose interferon with maintenance interferon.
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References
Eggermont A et al. (2001) Cutaneous malignant melanoma. Oxford Textbook of Oncology, edn 2 Vol 1 Chapter 8.1, 1175–1211
Balch C et al. (2001) Final version of the American Joint Committee on Cancer staging system for cutaneous melanoma. J Clin Oncol 19: 3635–3648
Thomas J et al. (2004) Excision margins in high-risk malignant melanoma. N Engl J Med 350: 757–766
Cascinelli N et al. (1998) Immediate or delayed dissection of regional nodes in patients with melanoma of the trunk: a randomized trial. WHO Melanoma Programme. Lancet 351: 793–796
Morton D et al. (2005) Sentinel node biopsy for early stage-melanoma: accuracy and morbidity in MSLT-I, an international multicenter trial. Ann Surg 242: 302–311
Puleo C et al. (2005) Sentinel node biopsy for thin melanomas: which patients should be considered? Cancer Control 12: 230–235
Reintgen D et al. (2004) National trials involving lymphatic mapping for melanoma: the Multicenter Selective Lymphadenectomy Trial, the Sunbelt Melanoma Trial, and the Florida Melanoma Trial. Semin Oncol 31: 363–373
Kretschmer L et al. (2004) Patients with lymphatic metastasis of cutaneous malignant melanoma benefit from sentinel lymphadenectomy and early excision of their nodal disease. Eur J Cancer 40: 212–218
Kirkwood JM et al. (1996) Interferon alfa-2b adjuvant therapy of high-risk resected cutaneous melanoma: the Eastern Co-operative Oncology Group trial EST 1684. J Clin Oncol 14: 7–17
Kirkwood JM et al. (2000) High and low dose interferon alfa-2b in high-risk melanoma: first analysis of intergroup trial E1690/S9111/C9190. J Clin Oncol 18: 2444–2458
Kirkwood JM et al. (2001) High-dose interferon alfa-2b significantly prolongs relapse free and overall survival compared with the GM2-KLH/QS-21 vaccine in patients with resected stage IIb-III melanoma: results of intergroup trial E1694/S9512/C509801. J Clin Oncol 19: 2370–2380
Kirkwood JM et al. (2004) A pooled analysis of eastern cooperative oncology group and intergroup trials of adjuvant high-dose interferon for melanoma. Clin Cancer Res 10: 1670–1677
Gogas H et al. (2004) Tolerability of adjuvant high-dose interferon alfa-2b: 1 month versus 1 year: a Hellenic Cooperative Oncology Group study. Anticancer Res 24: 1947–1952
Von Wussow P and Mohr P (2003) Adjuvant intermittent high dose interferon α-2b therapy in stage IIC/III malignant melanoma: a phase II study [abstract #2912]. Proc Am Soc Clin Oncol 22: 724
Demierre M et al. (2005) Vaccine therapy of melanoma: an update. Curr Canc Ther Rev 1: 115–125
Atkins M et al. (2000) High-dose recombinant interleukin-2 therapy in patients with metastatic melanoma: long-term survival update. Cancer J Sci Am 6 (Suppl 1): S11–S14
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Khan, O., Middleton, M. High-risk melanoma with nodal involvement in a young woman. Nat Rev Clin Oncol 3, 517–521 (2006). https://doi.org/10.1038/ncponc0582
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DOI: https://doi.org/10.1038/ncponc0582
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