This lesion is your worst nightmare. The peripheral margin is fairly well defined. The lesion started as a superficial spreading melanoma with large areas of regression at five, seven o'clock and eight o'clock within the confines of the original pigmented border. There is also a very dense, black, nodular melanoma with significant vertical growth and crusting over the surface. There is almost a bluish color to the base of nodule. This is a significant malignant melanoma with poor prognosis. The size of the blue nodule, obvious significant vertical growth phase, the ulceration on the top of it plus the large areas of regression, suggest a longstanding lesion and a poor prognosis despite our best efforts. The malignant melanoma is a very serious and aggressive form of skin cancer. It is responsible for approximately eight thousand deaths a year and appears as an irregularly shaped area of uneven coloring.
Addendum: This tumor was removed in 1991. When all of the clinical parameters were considered, this patient was not expected to live due to metastases from this tumor. Seventeen years later, in August of 2008, the patient was again seen for another problem. No evidence of recurrence had occurred since his original surgery. Lesson to be learned: Doctors are often mistaken in prognosticating the future outcome of patients with this type of cancer. Each melanoma appears to have its own destiny. The one fact remains; the sooner the tumor is detected and surgically removed, the better the chance of survival of the patient.
For more information about malignant melanomas and other forms of skin cancer, click here.
|Monday 14th of August 2006|