Melanoma in situ

What is it melanoma in the place?

Melanoma in situ is an early form of primary melanoma in which the evil one cells are confined to the tissue of origin, the epidermis. Also known as in the place melanoma and level 1 melanoma.

Since melanoma in situ has no associated mortality, early detection of melanoma in an in situ phase increases melanoma survival and leads to less morbidity and reduced costs compared to that associated with more advanced melanoma [1].

Melanoma management is evolving. For updated recommendations, see Australia Cancer Council of clinical practice guidelines for the diagnosis and management of melanoma.

See more images of melanoma in situ.

Classification of melanoma in situ.

Melanoma in situ is classified by the site of the body and its clinic and histological features. It is the initial stage of melanoma subtypes that originate in the epidermis. The most common subtypes are:

• Lentigo evil

• Lentiginous melanoma in situ

• Superficial spreading melanoma in situ.

Rare forms of melanoma that may have an in situ phase include:

• Acral lentiginous melanoma
• Ungual melanoma
• Mucous membrane melanoma
• Ocular melanoma.

Who gets melanoma in situ?

There were 2,423 melanoma records in New Zealand in 2015. The New Zealand Cancer Registry does not publish melanoma in situ figures, but unpublished data suggests that approximately the same number of people are diagnosed with melanoma in situ as those diagnosed with invader melanoma [2].

The average age of diagnosis is 61 years, but melanoma in situ can also be diagnosed in young people. [3]. It is mainly diagnosed in people who have many melanocytic naevi or in older people with fair skin.

Patients with melanoma in situ may also have been diagnosed with other keratinocytic forms of skin cancer, such as basal cell carcinoma, actinic keratosis, intraepidermal scaly cell carcinoma and cutaneous squamous cell carcinoma.

What causes melanoma in situ?

Genetic mutations at DNA of melanocytes they are seen in melanoma in situ. These are mainly due to exposure to Ultraviolet radiation.

What are the clinical characteristics of melanoma in situ?

Typically melanoma in situ is an irregular pigmented patch Of skin often has the ABCDE criteria:

The body site and other clinical features of melanoma in situ depend on the melanoma subtype (see above). Generally speaking, melanoma in situ is macular (flat). However, in approximately 8% cases, melanoma in situ thickens and may be scaly due to reactive thickening of the epidermis [3].

What are the complications of melanoma in situ?

Without treatment, melanoma in situ slowly enlarges. Some on site melanomas developing foci (a center of a morbid process) or a potentially more dangerous form of invasive melanoma.

• Less than 5% from lentigo malignant and lentiginous melanoma are believed to become invasive melanoma.
• The risk that melanoma in situ will progress to invasive melanoma over time is greater in superficially spread melanoma, acral lentiginous melanoma, and other forms of melanoma, but the exact risk is unknown.

Which is the differential diagnosis melanoma in situ?

Differential diagnoses for melanoma in situ include invasive melanoma, other forms of skin cancer, and benign skin lesions, such as a melanocytic nevus or lentigo (these may have been clinically described as atypical nevus or atypical solar lentigo).

Note that melanoma that arises within the dermis it does not have an on-site phase. Dermal Melanoma subtypes include:

• Nodular melanoma
• Desmoplastic melanoma
• Metastatic melanoma.

How is melanoma in situ diagnosed?

Melanoma in situ can be suspected clinically or by dermoscopy.

The diagnosis is confirmed by histological examination of tumor and find malignant melanocytes confined to the epidermis and epidermal attached structures Breslow thickness not reported for melanoma in situ.

• Melanoma in situ is often reported as a Clark level 1 melanoma.
• Melanoma in situ is considered Stage 0 in the American Joint Committee on Cancer (AJCC) Staging Guidelines.

Multiple sections of the sample should be examined to ensure that there are no areas of invasive disease. Immunohistochemical stains, such as micropthalmia-associated transcription factor (MITF) and Sry-related HMG-BOX gene 10 (SOX10), can aid diagnosis [4].

• On sun-damaged skin, it can be difficult to differentiate benign forms of atypical melanocytes. hyperplasia and lichenoid inflammation melanoma in situ.
• the morphology It may differ between melanoma subtypes.
• An initial diagnosis of melanoma in situ can be overshadowed by invasive melanoma by evaluating the deepest sections of a excision shows.

How is melanoma in situ treated?

Melanoma in situ is treated by excision biopsy. A special tissue preservation technique can be used for large melanoma in situ, such as Mohs micrographic surgery or stage mapping splits [2].

When the surgical margins are narrow, a second surgical procedure, including a clinical margin of 5 to 10 mm from normal skin, is performed to ensure complete removal of the melanoma. This is known as wide local excision.

Non-surgical options may be considered in selected cases of melanoma in situ where surgery is contraindicated, including imiquimod cream (off-label), intralesional interferon alpha, radiotherapyAND To be therapy. Reappearance rates are high with these second-line treatments.

What is the monitoring of melanoma in situ?

Most patients with melanoma in situ will be advised to have follow-up exams with their specialist or general practitioner. The main focus will be a total body skin exam, because patients with melanoma in situ are eight times more likely to develop another primary melanoma in situ or invasive compared to matched individuals without melanoma in situ.

What is the result for melanoma in situ?

Patients with melanoma in situ have the same life expectancy as the general population. Other problems are rare due to melanoma in situ because malignant cells within the epidermis have no metastatic potential. However, a small focus of invasive disease may have been lost due to the impracticality of evaluating each part of a large skin. injury.

Melanoma in situ occasionally recurs at the same site, requiring additional surgery.

Melanoma management is evolving. For updated recommendations, see the Australian Cancer Council's Clinical Practice Guidelines for the Diagnosis and Treatment of Melanoma..