Melanoma is a highly malignant tumor that occurs mostly in the skin. It occurs in adults and elderly people over 30 years of age. It is rare in children.
The etiology is not fully understood, but is generally believed to be related to the following factors.
1. Racial inheritance: the incidence is higher in Caucasians than in Yellow and Black people. Some malignant blacks have a family history of inheritance in an autosomal dominant manner. The risk of melanoma is higher in children with a high risk family history of multiple, very large, moles whose pigmentation borders are irregular in texture. Moles on the scalp and non-sun-exposed areas should be of particular concern, and the development of these moles must be carefully monitored at least during their adolescent years.
2.Trauma and irritation: Trauma and irritation can cause malignant transformation of benign pigmented skin disease.
3.Sunlight: It is an important factor for the occurrence of this disease.
4.Immunity: The occurrence and prognosis of this disease are closely related to immunity.
Clinical manifestations
The early manifestation of malignant melanoma is the appearance of black damage on normal skin, or the recent expansion of the original melanocytic nevus with deepening pigment. The surface is elevated in the form of plaques or nodules, or may be myxoid or cauliflower-shaped, and the surface is easily broken and bleeding. There may be irregular haloes of pigmentation or loss of pigmentation around the nevus. It may appear as a subcutaneous nodule or mass, and satellite damage may also occur.
Diagnosis
Some malignant nevi originate from the malignant transformation of nevus cells and often have the following signs.
1. significant and rapid enlargement of the nevus cell nevus.
2. deepening and brightening of the color and surrounding redness.
3. surface crusting.
4. frequent bleeding and rupture of the affected area
5, enlargement of nearby lymph nodes.
6. the occurrence of satellite damage around it.
When the disease is highly suspected, all small lesions should be excised for biopsy, and all large lesions should be excised and implanted.
Treatment
Early surgery and, if necessary, lymph node dissection. Radiotherapy and immunotherapy.
The relationship between congenital pigmented nevus and malignant melanoma
Congenital pigmented nevi are pigmented macules or plaques that appear mostly after birth or a few months after birth. Giant congenital pigmented nevi over 20 cm in diameter, of which 2-10% are at risk for melanoma, have malignant changes most often occurring within 3-15 years after birth. Prophylactic surgical excision is recommended for pigmented nevi in palmoplantar stress areas, under the nail, and friction areas to avoid cancer.
Some other points to note
A rare cause of melanoma in childhood is the transmission of maternal melanoma through the placenta. Therefore, a history of melanoma in the mother and careful examination and follow-up of the newborn are essential. For mothers who have given birth to infants with melanoma, careful examination is needed to look for signs of melanoma.