Malignant Melanoma: Our Experience at the University of Port Harcourt Teaching Hospital, Port Harcourt
Background: Malignant melanoma is a neoplasm of melanin producing cells of the body that develop from melanocytes. All humans have naevi as beauty spots on their bodies. Although, it was once considered uncommon, the annual incidence has increased dramatically over the past decades. Melanoma has been reported as the 19th most common cancer worldwide with estimated age standardized incidence rates of 2.8 – 3.1 per 100,000.
Exaggerated response to sun exposure e.g. sunburns, freckling, high risk skin types, excessive use of tanning beds, genetic predisposition and immunosuppression. Global warming and depletion of the ozone layer may contribute to its increase.
Aim: The study aims to create awareness of the potential hazards which can develop from naevi in the human body; to know the early clinical features of malignant transformation for early treatment.
Methods: This is a retrospective study of melanoma patients between 2011 and 2021. A total of 14 patients (9 females and 5 males) were examined and diagnosed for different types of melanoma (right and left foot) at University of Port Harcourt Teaching Hospital, Port Harcourt.
Results: 14 patients were diagnosed, males 5 and females 9.
Findings in this study showed increased number of melanoma in females (64.3%) than males (39.7%); mean age was 56.9 years.
Conclusion: Malignant melanoma though not a common skin cancer has recorded an increased incidence over the last couple of decades. Awareness of indicators of transformation from naevi to malignant melanoma is key to early detection and treatment for reduced morbidity and mortality.
Australian Institute of Health and Welfare & Australasian Association of Cancer Registries 2012. Cancer in Australia: an overview, 2012. Cancer series no. 74. Cat. no. CAN 70. Canberra: AIHW.
Chang AE, Kaell LH, Menck HR (1998). The National Cancer Report on Cutaneous and Non-Cutaneous Melanoma: A Summary of 84,836 Cases from the Past Decades. The American College of Surgeons Commission on Cancer and the American Cancer Society Cancer. 83:1664-1678
Michelle R Iannacone, Danny R Youlden, Peter D Baade, Joanne F Aitken, Adèle C Green. Melanoma incidence trends and survival in adolescents and young adults in Queensland, Australia. Int J Cancer. 2015; 136(3): 603–609
Ganiyu Oyediran Oseni, Peter Babatunde Olaitan, Akinwumi Oluwole Komolafe, Olaejirinde Olaniyi Olaofe, Hezekiah Adebola Morakinyo Akinyemi, Oreoluwa Adeola Suleiman. Malignant skin lesions in Oshogbo, Nigeria. Pan African Medical Journal 2015; 20(253) DOI:10.11604/pamj.2015.20.253.2441
T. L. Diepgen and V. Mahler, “The Epidemiology of Skin Cancer,” British Journal of Dermatology 2002; 61(S61):1-6.
Chalya P. L., Gilyoma J. M., Kanumba E. S., Mawala B., Masalu N., KahimaK. J., & Rambau P. Dermatological malignancies at a University teaching Hospital in Northwestern Tanzania: A retrospective review of 154 cases. Tanzania Journal of Health Research 2012; 14(1). https://doi.org/10.4314/thrb.v14i1.3.
Rowan M.Thomson, Keith M.Furutani, Jose S. Pulido, Scott L. Stafford. Modified COMS Plaques for 125I and Pd Iris Melanoma Brachytherapy. Oncology*Biology*Physics 2010; 78(4):1261-1269.
Mark J. Elwood, Janet Jopson. Melanoma and sun exposure: An overview of published studies. Int. J. Cancer 1997; 73:198–203.
Esther Erdei and Salina M Torres. A new understanding in the epidemiology of melanoma. Expert Rev Anticancer Ther. 2010; 10(11): 1811–1823. doi: 10.1586/era.10.170
B G Goldstein ; A O Goldstein Diagnosis and management of malignant melanoma. Am Fam Physician 2001; 63(7):1359-68, 1374.
Maria Bellenghi, Rosella Puglisiand and GianfrancomMattia. Sex and Gender Disparities in Melanoma. Cancers (Basel). 2020; 12(7):1819. doi: 10.3390/cancers12071819.
Stiff A., Trikha P., Wesolowski R., Kendra K., Hsu V., Uppati S., McMichael E., Duggan M., Campbell A., Keller K., et al. Myeloid-Derived Suppressor Cells Express Bruton’s Tyrosine Kinase and Can Be Depleted in Tumor-Bearing Hosts by IbrutinibTreatment. Cancer Res. 2016; 76:2125–2136. doi: 10.1158/0008-5472.CAN-15-1490.
Srivastava R., Geng D., Liu Y., Zheng L., Li Z., Joseph M.A., McKenna C., Bansal N., Ochoa A., Davila E. Augmentation of therapeutic responses in melanoma by inhibition of IRAK-1,-4. Cancer Res. 2012; 72:6209–6216. doi: 10.1158/0008-5472.CAN-12-0337.
Romano S., Xiao Y., Nakaya M., D’Angelillo A., Chang M., Jin J., Hausch F., Masullo M., Feng X., Romano M.F., et al. FKBP51 employs both scaffold and isomerase functions to promote NF-κB activation in melanoma. Nucleic Acids Res. 2015; 43:6983–6993. doi: 10.1093/nar/gkv615.
Touil Y., Segard P., Ostyn P., Begard S., Aspord C., El Machhour R., Masselot B., Vandomme J., Flamenco P., Idziorek T., et al. Melanoma dormancy in a mouse model is linked to GILZ/FOXO3A-dependent quiescence of disseminated stem-like cells. Sci. Rep. 2016; 6:30405. doi: 10.1038/srep30405.
Aydin E., Johansson J., Nazir F.H., Hellstrand K., Martner A. Role of NOX2-Derived Reactive Oxygen Species in NK Cell-Mediated Control of Murine Melanoma Metastasis. Cancer Immunol. Res. 2017; 5:804–811. doi: 10.1158/2326-6066.CIR-16-0382.
Arjen Joosse Gender differences in melanoma Survival:Female patients have a decreased risk of Metastasis: journal of Investigative Dermatology 2011; 131 (3):719-726.
Clark WH Jr, From L, Bernardino EA et al. The histogenesis and biologic behavior of primary human malignant melanomas of the skin. Cancer Res 1969; 29:705–27.
Courtenay WH. Constructions of masculinity and their influence on men’s well-being: a theory of gender and health. Soc Sci Med 2000; 50:1385–401.
Holman, C. D. J. Pigmentary traits, ethnic origin, benign nevi, and family history as risk factors for cutaneous malignant melanoma. Journal of the National Cancer Institute 1984; 72: 257-266.
Tanon A, Jaquet A, Ekouevi DK, Akakpo J, Adoubi I, Diomande I, et al. The Spectrum of Cancers in West Africa: Associations with Human Immunodeficiency Virus. PLoS ONE 2012; 7(10): e48108. doi:10.1371/journal.pone.0048108
Mulenga, M., Montgomery, N.D., Chagomerana, M. et al. Epidemiological and histopathological profile of malignant melanoma in Malawi. BMC Clin Pathol 2019; 19:5. https://doi.org/10.1186/s12907-019-0087-6
National Cancer Institute. SEER stat Facts sheet: Melanoma of the skin. Accessed August 23, 20116.
Delaunay M.M. Prognostic Factors in Melanoma. In: Kirkham N., Cotton D.W.K., Lallemand R.C., White J.E., Rosin R.D. (eds) Diagnosis and Management of Melanoma in Clinical Practice. Springer, 1992, London. https://doi.org/10.1007/978-1-4471-1925-8_8
Day, CL et al. Narrower margins for clinical stage. Malignant Melanoma: New England Journal of Medicine 1982; 306: 479-482.
Shah, G.D.; Chapman, P.B. Adjuvant therapy of melanoma. Cancer J. 2007; 13: 217–222.
Holman, C. D. J. Pigmentary traits, ethnic origin, benign nevi, and family history as risk factors for cutaneous malignant melanoma. Journal of the National Cancer Institute1984; 72: 257-266.
Greene, M. H. et al. Acquired precursors of cutaneous malignant melanoma. New England journal of medicine1985; 312: 91-97.
English, D. R. et al. The dysplastic naevus syndrome in patients with cutaneous malignant melanoma in Western Australia. Medical journal of Australia 1986; 145: 194-198.
Lodder JV, Simson W, Becker PJ. Malignant melanoma of the skin in black South Africans: A 15-year experience. S Afr Med J. 2010; 48(3):76–9.
Tokura Y, Bastian BC, Duncan L. Acral lentiginous-melanoma. In: PE LB, Burg G, Weedon D, Sarasin A, editors. WHO Classification of Tumours; Pathology and Genetics of Skin Tumours. 4th ed. Lyon: IARC press; 2006. p. 73–5.
Hudson DA, Krige JEJ. Plantar melanoma in black south Africans. Br J Surg. 1993; 80:992–4.
Bradford PT, et al. Acral lentiginous melanoma: incidence and survival patterns in the United States, 1986-2005. Arch Dermatol. 2009;145(4):427–34.
Desai A, Ugorji R, Khachemonne A. Acral melanoma foot lesions. Part I: epidemiology, aetiology and molecular pathology. Clin Exp Dermatol. 2017; 42:845–8.
Byrd KM, Wilson DC, Hoyler SS, Peck GL. Advanced presentation of melanoma in African Americans. J Am Acad Dermatol. 2004; 50:21–4.
Crowley NJ, Dodge R, Vollmer R, Seigler HF. Malignant melanoma in black Americans. Arch Surg. 1991; 126:1359–65.
Cress RD, Holly E. Incidence of cutaneous melanoma among non-Hispanic whites, Hispanics, Asians and blacks: an analysis of California Cancer registry data, 1988-93. Cancer Causes Control. 1997; 8:246–52.
Tishkoff SA, Reed FA, et al. The genetic structure and history of Africans and African Americans. Science 2009; 324(5930):1035–44.
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