Difference between revisions of "Malignant melanoma"

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325 bytes added ,  00:51, 29 August 2012
(→‎Skin: margin assessment)
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====Margin assessment====
====Margin assessment====
{{Main|Surgical margin}}
{{Main|Surgical margin}}
Margin assessment is notoriously difficult as there are numerous mimics of melanoma in situ:<ref name=pmid21549242>{{Cite journal  | last1 = Trotter | first1 = MJ. | title = Melanoma margin assessment. | journal = Clin Lab Med | volume = 31 | issue = 2 | pages = 289-300 | month = Jun | year = 2011 | doi = 10.1016/j.cll.2011.03.006 | PMID = 21549242 }}</ref>
=====General=====
*Melanocytic hyperplasia (considered to be on a continuum with melanoma) may be due to:
*Adequate distance dependent on tumour stage - ''see [[Surgical_margins#Adequate_margins_by_tumour|surgical margin]]'' article.
**Light exposure.
*Margin assessment is notoriously difficult as there are numerous mimics of melanoma in situ:<ref name=pmid21549242>{{Cite journal  | last1 = Trotter | first1 = MJ. | title = Melanoma margin assessment. | journal = Clin Lab Med | volume = 31 | issue = 2 | pages = 289-300 | month = Jun | year = 2011 | doi = 10.1016/j.cll.2011.03.006 | PMID = 21549242 }}</ref>
**Peritumoral-effect.
*#Melanocytic hyperplasia (considered to be on a continuum with melanoma) may be due to:
**Previous biopsy.
*#*Light exposure.
*Solar lentigo.
*#*Peritumoral-effect.
*Lichenoid reaction.
*#*Previous biopsy.
*#Solar lentigo.
*#Lichenoid reactions.


=====Microscopic=====
Features of [[MIS]]:<ref name=pmid21549242/>
Features of [[MIS]]:<ref name=pmid21549242/>
#Pagetoid spread of melanocytes.
#Pagetoid spread of melanocytes.
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#Adenxal involvement.
#Adenxal involvement.


=====Margin adequacy=====
Lame mnemonic ''MARGIN'':
:''See [[Surgical_margins#Adequate_margins_by_tumour]]''.
*'''M'''arked cytologic atypia.
*'''A'''dnexal involvement.
*'''R'''ow of melanocytes.
*'''G'''ravity defying melanocytes (Pagetoid spread).
*'''I'''ncreased basal melanocytes.
*'''N'''ests of melanocytes.


====Subtypes====
====Subtypes====
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