Clinico-pathological Study of Malignant Melanoma in A Tertiary Care Centre

Authors

  • Sushma Thapa Kathmandu University
  • Arnab Ghosh Kathmandu University
  • Dilasma Ghartimagar Kathmandu University
  • Tillotama Prasad
  • Raghavan Narasimhan Kathmandu University
  • OP Talwar Kathmandu University

DOI:

https://doi.org/10.31729/jnma.2888

Keywords:

Breslow thickness; Clark’s level; Malignant melanoma; Nodular melanoma.

Abstract

Introduction: Malignant melanoma, which causes three fourth of all deaths related to skin cancer, is more common in Caucasian population compared to Asian population. There is no reliable information about malignant melanoma in Nepal hence an effort has been made to assess the clinical and pathological features of melanoma patients.

Methods: This was a retrospective hospital based study done in the department of Pathology. All cases of malignant melanoma diagnosed on biopsy during a period of 13 years were retrieved, reviewed and collated.

Results: We had 35 cases with age range from 15 to 84 years with the mean of 51.4 years and M: F of 1.3:1. The predominant site was lower extremities. Most cases were less than 3 cm. Majority of histologic subtypes were nodular melanoma 29 (82.8%) followed by mucosal lentiginous melanoma 3 (8.6%), superficial spreading melanoma 2 (5.7%) and acral lentiginous melanoma 1 (2.9%). Half (50%) of the excisional biopsies were at Clark’s level IV and 75% were at high Breslow thickness.

Conclusions: The most frequent site in males and females were lower extremities and trunk respectively in contrast to Western studies where it is opposite. Nodular melanoma was the commonest histologic subtype while in other Asian studies and in Western studies majority were acral lentiginous melanoma and superficial spreading melanoma respectively.

Keywords: Breslow thickness; Clark’s level; malignant melanoma; nodular melanoma.

Author Biographies

Arnab Ghosh, Kathmandu University

Professor

Department of Pathology

Manipal Teaching Hospital

Phulbari , Pokhara

Dilasma Ghartimagar, Kathmandu University

Associate Professor

Department of Pathology

Manipal Teaching Hospital

Phulbari , Pokhara

Tillotama Prasad

Assistant Professor

Department of Pathology

Manipal Teaching Hospital

Phulbari , Pokhara

Raghavan Narasimhan, Kathmandu University

Professor

Department of Pathology

Manipal Teaching Hospital

Phulbari , Pokhara

OP Talwar, Kathmandu University

Head and Professor

Department of Pathology

Manipal Teaching Hospital

Phulbari , Pokhara

References

1. Hui SK, Lau KH, Leung CY, Tang WYM, Chong LY, Lo KK. Cutaneous melanoma: clinical features of 32 Hong Kong Chinese patients. Hong Kong J. Dermatol. Venereol. 2005;13:130-40.
2. Ferlay J, Soerjomataram I, Ervik M. World Health Organization GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 11 [Internet]. Lyon, France: International Agency for Research on Cancer. Available from:URL : http://globocan.iarc.fr.
3. Chen YJ, Wu CY, Chen JT, Shen JL. Nodular Melanoma-A Thirteen-Year Clinical Experience. Dermatol Sinica 1999;17:200-7.
4. Chang JWC. Cutaneous melanoma: Taiwan experience and literature review. Chang Gung Med J 2010;33(6):602-12.
5. Breslow A. Thickness, cross-sectional areas and depth of invasion in the prognosis of cutaneous melanoma. Ann Surg 1970;172:902-8.
6. Clark WH Jr. A classification of malignant melanoma in man correlated with histogenesis and biologic behavior. In: Montagna W, Hu F, editors. Advances in the biology of the skin, vol. VIII. New York: Pergamon Press; 1967. p. 621-47.
7. Ghosh A, Pradhan S, Swami R, KC SR, Talwar O. Primary malignant melanoma of vagina - a case report with review of literature. J Nepal Med Assoc 2007;46(168):203-5.
8. Nagore E, Oliver V, Botella-Estrada R, Moreno-Picot S, Guillen C, Fortea JM. Clinicopathological Analysis of 1571 Cutaneous Malignant Melanomas in Valencia, Spain: Factors Related to Tumour Thickness. Acta Derm Venereol 2006;86:50–6.
9. McDonald M, Hertz RP, Lowenthal SWP. Pfizer facts - The burden of cancer in Asia. USA: Pfizer Medical Division; 2008. Available from URL: http://www.pfizer.com/files/products/cancer_in_asia.pdf
10. Reddy SC, Darnal HK. Ocular malignant melanoma – a report of two cases. Nepal J Ophthalmol 2014;6(2):113-8.
11. Nepal A, Joshi RR, Chettri ST, Karki S. Patterns of sinonasal tumors in eastern Nepal. Nepalese J ENT Head Neck Surg 2010;1(2):9-11.
12. Laishram RS, Banerjee A, Punyabati P, Sharma LDC. Pattern of skin malignancies in Manipur, India: A 5-year histopathological review. J Pak Assoc Derma 2010;20:128-32.
13. Deo SV, Hazarika S, Shukla NK, Kumar S, Kar M, Samaiya A. Surgical management of skin cancers: experience from a regional cancer centre in North India. Ind J Cancer 2005;42:145-50.
14. Sharma K, Mohanti BK, Rath GK. Malignant melanoma: A retrorespective series from a regional cancer center in India. J Can Res Ther 2009;5:173-80.
15. Saxe N, Hoffman M, Krige JE, Sayed R, King HS, Hounsell K. Malignant melanoma in Cape Town, South Africa. Br J Dermatol 1998;138:998-1002.
16. Chang JWC, Yeh KY, Wang CH, Yang TS, Chiang HF, Wei FC. Malignant melanoma in Taiwan: a prognostic study of 181 cases. Melanoma Res 2004;14:537-41.
17. Krishnamurthy S, Yeole B, Joshi S, Gujarathi M, Jussawalla DJ. The descriptive epidemiology and trends in incidence of nonocular malignant melanoma in Bombay and India. Indian J Cancer 1994;31:64-71.
18. Vijaykumar DK, Kanan RR, Chaturvedi HK. Plantar acral melanoma- an experience from a regional cancer center, India. Indian J Cancer 1996;33:122-9.
19. MacKie RM. Melanocytic nevi and malignant melanoma. In: Champion RH, Burton JL, Burns DA, Breaathnach SM, editors. Textbook of Dermatology. Vol 2. 6th ed. Oxford, England: Blackwill Science Ltd; 1998. p. 1717-52.
20. Reed RJ: Acral lentiginous melanoma. In: Hartmann W, Reed R, editors. New concepts in surgical pathology of the skin. New York: Wiley; 1976. p. 89-90.
21. Barnhill RL, Mihm MC Jr, Fitzpatrick TB, and Sober AJ. Neoplasms: malignant melanoma. In: Fitzpatrick TB, Eisen AZ, Wolff K, Freedberg IM Austen KF, editors. Dermatology in General Medicine. 4th ed. New York: McGraw-Hill; 1993. p. 1078-115.

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Published

2017-03-31

How to Cite

Thapa, S., Ghosh, A., Ghartimagar, D., Prasad, T., Narasimhan, R., & Talwar, O. (2017). Clinico-pathological Study of Malignant Melanoma in A Tertiary Care Centre. Journal of Nepal Medical Association, 56(205), 132–136. https://doi.org/10.31729/jnma.2888

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