Histopathological characteristics of subsequent melanomas in patients with multiple primary melanomas. (6th December 2012)

• Record Type: Journal Article
• Authors: Vecchiato, A.; Pasquali, S.; Menin, C.; Montesco, M.C.; Alaibac, M.; Mocellin, S.; Campana, L.G.; Nitti, D.; Rossi, C.R.
• Is Part Of: Journal of the European Academy of Dermatology and Venereology. Volume 28:Number 1(2014:Jan.)
• Page Start: 58
• Page End: 64
• Publication Date: 2012-12-06
• Subjects: Dermatology -- Periodicals; Sexually transmitted diseases -- Periodicals; 616.5
• DOI: 10.1111/jdv.12055
• Languages: English
• ISSNs: 0926-9959

Abstract

<abstract abstract-type="main" xml:lang="en"> <title>Abstract</title> <p> <bold>Background </bold> Multiple primary melanomas (MPM) occur in up to 20% of melanoma patients, and subsequent tumours seem to have a favourable histopathological pattern.</p> <p> <bold>Objective </bold> A prospectively collected cohort of 194 patients with MPM was retrospectively reviewed to investigate clinical and histopathological features of first and subsequent melanomas.</p> <p> <bold>Methods </bold> Patients with MPM who were diagnosed at our Department (1985–2011) and who attended at least a follow‐up control yearly were identified.</p> <p> <bold>Results </bold> The number of nevi was <10, 10–50 and >50 in 8.7%, 41% and 50.3% of patients respectively. Histopathological dysplastic nevi have been diagnosed in 105 patients. During a median follow‐up of 58 months, 159 (81.9%), 24 (12.3%), 7 (3.6%) and 4 (2%) patients developed 2, 3, 4 and ≥5 melanomas, respectively. The median time to second primary melanoma was 45 months. The second primary melanoma was diagnosed within 1‐year and after 5‐year from the first melanoma in 36.6% and 17.3% of patients respectively. First and second primary melanomas were <italic>in situ</italic> in 41 (21%) and 104 (54%) patients respectively (<italic>P </italic>< 0.001). Among patients with ≥2 invasive melanomas (<italic>N </italic>= 80), median tumour thickness and ulceration of first and second primaries were 0.91 and 0.44 mm (<italic>P </italic>< 0.001), and 32% and 7.7% (<italic>P </italic>= 0.001) respectively.</p> <p> <bold>Conclusions </bold> Subsequent melanomas occurred within 1‐year from the appearance of the first melanoma in 36% of patients with MPM, while a late melanoma diagnosis was detected in 17% of cases. Second primary melanoma had favourable histopathological features. Our findings support long‐term skin surveillance to detect subsequent melanomas at an early stage.</p> </abstract>