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Melanoma

MedGen UID:
9944
Concept ID:
C0025202
Neoplastic Process
Synonyms: Malignant Melanoma; Malignant Melanomas; Melanoma, Malignant; Melanomas; Melanomas, Malignant
SNOMED CT: Malignant melanoma (372244006); Melanosarcoma (372244006); MM - malignant melanoma (1162635006); Malignant melanoma (1162635006)
 
Related genes: XRCC3, TERT, STK11, MITF, MC1R, CDKN2A, CDK4, BRAF
 
HPO: HP:0002861
Monarch Initiative: MONDO:0005105
Orphanet: ORPHA411533

Definition

Melanoma is a type of skin cancer that begins in pigment-producing cells called melanocytes. This cancer typically occurs in areas that are only occasionally sun-exposed; tumors are most commonly found on the back in men and on the legs in women. Melanoma usually occurs on the skin (cutaneous melanoma), but in about 5 percent of cases it develops in melanocytes in other tissues, including the eyes (uveal melanoma) or mucous membranes that line the body's cavities, such as the moist lining of the mouth (mucosal melanoma). Melanoma can develop at any age, but it most frequently occurs in people in their fifties to seventies and is becoming more common in teenagers and young adults.

Most melanomas affect only the outermost layer of skin (the epidermis). If a melanoma becomes thicker and involves multiple layers of skin, it can spread to other parts of the body (metastasize).

Melanoma may develop from an existing mole or other normal skin growth that becomes cancerous (malignant); however, many melanomas are new growths. Melanomas often have ragged edges and an irregular shape. They can range from a few millimeters to several centimeters across. They can also be a variety of colors: brown, black, red, pink, blue, or white.

A large number of moles or other pigmented skin growths on the body, generally more than 25, is associated with an increased risk of developing melanoma. Melanoma is also a common feature of genetic syndromes affecting the skin such as xeroderma pigmentosum. Additionally, individuals who have previously had melanoma are nearly nine times more likely than the general population to develop melanoma again. It is estimated that about 90 percent of individuals with melanoma survive at least 5 years after being diagnosed. [from MedlinePlus Genetics]

Term Hierarchy

Conditions with this feature

DE SANCTIS-CACCHIONE SYNDROME
MedGen UID:
75550
Concept ID:
C0265201
Disease or Syndrome
A rare autosomal recessive inherited syndrome. It is characterized by xeroderma pigmentosum, mental retardation, dwarfism, hypogonadism, and neurologic abnormalities.
Xeroderma pigmentosum group A
MedGen UID:
82775
Concept ID:
C0268135
Disease or Syndrome
Xeroderma pigmentosum (XP) is characterized by: Acute sun sensitivity (severe sunburn with blistering, persistent erythema on minimal sun exposure) with marked freckle-like pigmentation of the face before age two years; Sunlight-induced ocular involvement (photophobia, severe keratitis, atrophy of the skin of the lids, ocular surface neoplasms); Greatly increased risk of sunlight-induced cutaneous neoplasms (basal cell carcinoma, squamous cell carcinoma, melanoma) within the first decade of life. Approximately 25% of affected individuals have neurologic manifestations (acquired microcephaly, diminished or absent deep tendon stretch reflexes, progressive sensorineural hearing loss, progressive cognitive impairment, and ataxia). The most common causes of death are skin cancer, neurologic degeneration, and internal cancer. The median age at death in persons with XP with neurodegeneration (29 years) was found to be younger than that in persons with XP without neurodegeneration (37 years).
Xeroderma pigmentosum, group D
MedGen UID:
75656
Concept ID:
C0268138
Disease or Syndrome
Xeroderma pigmentosum (XP) is characterized by: Acute sun sensitivity (severe sunburn with blistering, persistent erythema on minimal sun exposure) with marked freckle-like pigmentation of the face before age two years; Sunlight-induced ocular involvement (photophobia, severe keratitis, atrophy of the skin of the lids, ocular surface neoplasms); Greatly increased risk of sunlight-induced cutaneous neoplasms (basal cell carcinoma, squamous cell carcinoma, melanoma) within the first decade of life. Approximately 25% of affected individuals have neurologic manifestations (acquired microcephaly, diminished or absent deep tendon stretch reflexes, progressive sensorineural hearing loss, progressive cognitive impairment, and ataxia). The most common causes of death are skin cancer, neurologic degeneration, and internal cancer. The median age at death in persons with XP with neurodegeneration (29 years) was found to be younger than that in persons with XP without neurodegeneration (37 years).
Neurocutaneous melanocytosis
MedGen UID:
154259
Concept ID:
C0544862
Congenital Abnormality
Neurocutaneous melanosis, or neuromelanosis, is characterized by the presence of melanin-producing cells within the brain parenchyma or leptomeninges, which may lead to clinically apparent neurologic signs and symptoms, such as seizures. Other neurologic abnormalities, including hydrocephalus, arachnoid cysts, tumors, and syringomyelia, may also occur. The disorder is a rare but severe manifestation of congenital melanocytic nevus syndrome (CMNS; 137550). Some patients with neurocutaneous melanosis or CMNS may develop malignant melanoma. The incidence of neurologic involvement, development of malignant melanoma, and death is significantly associated with the projected adult size of the largest congenital melanocytic nevus, particularly those greater than 40 cm (summary by Kinsler et al., 2008; Kinsler et al., 2013).
Melanoma-pancreatic cancer syndrome
MedGen UID:
325450
Concept ID:
C1838547
Disease or Syndrome
Melanoma-pancreatic cancer syndrome is an inherited cancer predisposition syndrome in which mutation carriers have an increased risk of developing malignant melanoma and/or pancreatic cancer. Mutation carriers within families may develop either or both types of cancer (summary by Harinck et al., 2012). For background and phenotypic information on malignant melanoma and pancreatic cancer, see 155600 and 260350, respectively.
Xeroderma pigmentosum, group E
MedGen UID:
341219
Concept ID:
C1848411
Congenital Abnormality
Xeroderma pigmentosum (XP) is characterized by: Acute sun sensitivity (severe sunburn with blistering, persistent erythema on minimal sun exposure) with marked freckle-like pigmentation of the face before age two years; Sunlight-induced ocular involvement (photophobia, severe keratitis, atrophy of the skin of the lids, ocular surface neoplasms); Greatly increased risk of sunlight-induced cutaneous neoplasms (basal cell carcinoma, squamous cell carcinoma, melanoma) within the first decade of life. Approximately 25% of affected individuals have neurologic manifestations (acquired microcephaly, diminished or absent deep tendon stretch reflexes, progressive sensorineural hearing loss, progressive cognitive impairment, and ataxia). The most common causes of death are skin cancer, neurologic degeneration, and internal cancer. The median age at death in persons with XP with neurodegeneration (29 years) was found to be younger than that in persons with XP without neurodegeneration (37 years).
Melanoma, cutaneous malignant, susceptibility to, 9
MedGen UID:
767488
Concept ID:
C3554574
Finding
Malignant melanoma is a neoplasm of pigment-producing cells called melanocytes that occurs most often in the skin, but may also occur in the eyes, ears, gastrointestinal tract, leptomeninges, and oral and genital mucous membranes (summary by Habif, 2010). For a discussion of genetic heterogeneity of malignant melanoma, see 155600.
Melanoma, cutaneous malignant, susceptibility to, 10
MedGen UID:
862913
Concept ID:
C4014476
Finding
POT1 tumor predisposition (POT1-TPD) is characterized by an increased lifetime risk for multiple cutaneous melanomas, chronic lymphocytic leukemia (CLL), angiosarcoma (particularly cardiac angiosarcomas), and gliomas. Additional cancers (e.g., colorectal cancer, thyroid cancer, breast angiosarcomas) have been reported in individuals with POT1-TPD but with very limited evidence. The age of onset for first primary cutaneous melanoma ranges from 15 to 80 years. The majority of POT1 associated cancers are diagnosed in adulthood.
Pancreatic cancer, susceptibility to, 5
MedGen UID:
1684838
Concept ID:
C5231459
Finding
Susceptibility to pancreatic ductal adenocarcinoma (PDAC) may be conferred by mutation in RABL3. Other cancers, including melanoma, breast cancer, and colon cancer, have been reported in RABL3 mutation-carrying individuals, with or without PDAC (Nissim et al., 2019). For background, phenotypic description, and a discussion of genetic heterogeneity of pancreatic carcinoma, see 260350.

Professional guidelines

PubMed

Garbe C, Amaral T, Peris K, Hauschild A, Arenberger P, Basset-Seguin N, Bastholt L, Bataille V, Del Marmol V, Dréno B, Fargnoli MC, Forsea AM, Grob JJ, Höller C, Kaufmann R, Kelleners-Smeets N, Lallas A, Lebbé C, Lytvynenko B, Malvehy J, Moreno-Ramirez D, Nathan P, Pellacani G, Saiag P, Stratigos AJ, Van Akkooi ACJ, Vieira R, Zalaudek I, Lorigan P; European Dermatology Forum (EDF), the European Association of Dermato-Oncology (EADO), and the European Organization for Research and Treatment of Cancer (EORTC)
Eur J Cancer 2022 Jul;170:236-255. Epub 2022 May 12 doi: 10.1016/j.ejca.2022.03.008. PMID: 35570085
Darnell EP, Mooradian MJ, Baruch EN, Yilmaz M, Reynolds KL
Curr Oncol Rep 2020 Mar 21;22(4):39. doi: 10.1007/s11912-020-0897-9. PMID: 32200442
Davis LE, Shalin SC, Tackett AJ
Cancer Biol Ther 2019;20(11):1366-1379. Epub 2019 Aug 1 doi: 10.1080/15384047.2019.1640032. PMID: 31366280Free PMC Article

Curated

UK NICE Guideline NG14, Melanoma: assessment and management, 2022

Suggested Reading

Recent clinical studies

Etiology

Bobos M
Ital J Dermatol Venerol 2021 Jun;156(3):300-321. Epub 2021 May 13 doi: 10.23736/S2784-8671.21.06958-3. PMID: 33982546
Pavri SN, Clune J, Ariyan S, Narayan D
Plast Reconstr Surg 2016 Aug;138(2):330e-340e. doi: 10.1097/PRS.0000000000002367. PMID: 27465194
Read J, Wadt KA, Hayward NK
J Med Genet 2016 Jan;53(1):1-14. Epub 2015 Sep 3 doi: 10.1136/jmedgenet-2015-103150. PMID: 26337759
Rastrelli M, Tropea S, Rossi CR, Alaibac M
In Vivo 2014 Nov-Dec;28(6):1005-11. PMID: 25398793
Abbas O, Miller DD, Bhawan J
Am J Dermatopathol 2014 May;36(5):363-79. doi: 10.1097/DAD.0b013e31828a2ec5. PMID: 24803061

Diagnosis

Olla D, Neumeister MW
Clin Plast Surg 2021 Oct;48(4):707-711. Epub 2021 Jul 7 doi: 10.1016/j.cps.2021.05.010. PMID: 34503731
Bobos M
Ital J Dermatol Venerol 2021 Jun;156(3):300-321. Epub 2021 May 13 doi: 10.23736/S2784-8671.21.06958-3. PMID: 33982546
Gong HZ, Zheng HY, Li J
Melanoma Res 2019 Jun;29(3):221-230. doi: 10.1097/CMR.0000000000000571. PMID: 30672881
Pavri SN, Clune J, Ariyan S, Narayan D
Plast Reconstr Surg 2016 Aug;138(2):330e-340e. doi: 10.1097/PRS.0000000000002367. PMID: 27465194
Rastrelli M, Tropea S, Rossi CR, Alaibac M
In Vivo 2014 Nov-Dec;28(6):1005-11. PMID: 25398793

Therapy

Rantala ES, Hernberg MM, Piperno-Neumann S, Grossniklaus HE, Kivelä TT
Prog Retin Eye Res 2022 Sep;90:101041. Epub 2022 Jan 6 doi: 10.1016/j.preteyeres.2022.101041. PMID: 34999237
Randic T, Kozar I, Margue C, Utikal J, Kreis S
Cancer Treat Rev 2021 Sep;99:102238. Epub 2021 May 29 doi: 10.1016/j.ctrv.2021.102238. PMID: 34098219
Amaria RN, Menzies AM, Burton EM, Scolyer RA, Tetzlaff MT, Antdbacka R, Ariyan C, Bassett R, Carter B, Daud A, Faries M, Fecher LA, Flaherty KT, Gershenwald JE, Hamid O, Hong A, Kirkwood JM, Lo S, Margolin K, Messina J, Postow MA, Rizos H, Ross MI, Rozeman EA, Saw RPM, Sondak V, Sullivan RJ, Taube JM, Thompson JF, van de Wiel BA, Eggermont AM, Davies MA; International Neoadjuvant Melanoma Consortium members, Ascierto PA, Spillane AJ, van Akkooi ACJ, Wargo JA, Blank CU, Tawbi HA, Long GV
Lancet Oncol 2019 Jul;20(7):e378-e389. doi: 10.1016/S1470-2045(19)30332-8. PMID: 31267972
Weiss SA, Wolchok JD, Sznol M
Clin Cancer Res 2019 Sep 1;25(17):5191-5201. Epub 2019 Mar 28 doi: 10.1158/1078-0432.CCR-18-1550. PMID: 30923036Free PMC Article
Russell SJ, Peng KW, Bell JC
Nat Biotechnol 2012 Jul 10;30(7):658-70. doi: 10.1038/nbt.2287. PMID: 22781695Free PMC Article

Prognosis

Miller KD, Fidler-Benaoudia M, Keegan TH, Hipp HS, Jemal A, Siegel RL
CA Cancer J Clin 2020 Nov;70(6):443-459. Epub 2020 Sep 17 doi: 10.3322/caac.21637. PMID: 32940362
Siegel RL, Miller KD, Jemal A
CA Cancer J Clin 2020 Jan;70(1):7-30. Epub 2020 Jan 8 doi: 10.3322/caac.21590. PMID: 31912902
Miller KD, Nogueira L, Mariotto AB, Rowland JH, Yabroff KR, Alfano CM, Jemal A, Kramer JL, Siegel RL
CA Cancer J Clin 2019 Sep;69(5):363-385. Epub 2019 Jun 11 doi: 10.3322/caac.21565. PMID: 31184787
Ferlay J, Colombet M, Soerjomataram I, Mathers C, Parkin DM, Piñeros M, Znaor A, Bray F
Int J Cancer 2019 Apr 15;144(8):1941-1953. Epub 2018 Dec 6 doi: 10.1002/ijc.31937. PMID: 30350310
Zaorsky NG, Churilla TM, Egleston BL, Fisher SG, Ridge JA, Horwitz EM, Meyer JE
Ann Oncol 2017 Feb 1;28(2):400-407. doi: 10.1093/annonc/mdw604. PMID: 27831506Free PMC Article

Clinical prediction guides

Wells A, Patel S, Lee JB, Motaparthi K
J Cutan Pathol 2021 Aug;48(8):1061-1068. Epub 2021 Jan 26 doi: 10.1111/cup.13954. PMID: 33421167
Scolyer RA, Rawson RV, Gershenwald JE, Ferguson PM, Prieto VG
Mod Pathol 2020 Jan;33(Suppl 1):15-24. Epub 2019 Nov 22 doi: 10.1038/s41379-019-0402-x. PMID: 31758078
McLaughlin J, Han G, Schalper KA, Carvajal-Hausdorf D, Pelekanou V, Rehman J, Velcheti V, Herbst R, LoRusso P, Rimm DL
JAMA Oncol 2016 Jan;2(1):46-54. doi: 10.1001/jamaoncol.2015.3638. PMID: 26562159Free PMC Article
Nikolić J, Loncar-Turukalo T, Sladojević S, Marinković M, Janjić Z
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Lancet 1991 Aug 10;338(8763):351-2. PMID: 1677705

Recent systematic reviews

Alonso-Belmonte C, Montero-Vilchez T, Arias-Santiago S, Buendía-Eisman A
Actas Dermosifiliogr 2022 Sep;113(8):781-791. Epub 2022 May 5 doi: 10.1016/j.ad.2022.04.015. PMID: 35526566
Nisi M, Izzetti R, Gennai S, Pucci A, Lenzi C, Graziani F
J Craniofac Surg 2022 May 1;33(3):830-834. Epub 2021 Jul 30 doi: 10.1097/SCS.0000000000008054. PMID: 34334749
Lopes FCPS, Sleiman MG, Sebastian K, Bogucka R, Jacobs EA, Adamson AS
JAMA Dermatol 2021 Feb 1;157(2):213-219. doi: 10.1001/jamadermatol.2020.4616. PMID: 33325988
Seth R, Messersmith H, Kaur V, Kirkwood JM, Kudchadkar R, McQuade JL, Provenzano A, Swami U, Weber J, Alluri KC, Agarwala S, Ascierto PA, Atkins MB, Davis N, Ernstoff MS, Faries MB, Gold JS, Guild S, Gyorki DE, Khushalani NI, Meyers MO, Robert C, Santinami M, Sehdev A, Sondak VK, Spurrier G, Tsai KK, van Akkooi A, Funchain P
J Clin Oncol 2020 Nov 20;38(33):3947-3970. Epub 2020 Mar 31 doi: 10.1200/JCO.20.00198. PMID: 32228358
Silva ESD, Tavares R, Paulitsch FDS, Zhang L
Eur J Dermatol 2018 Apr 1;28(2):186-201. doi: 10.1684/ejd.2018.3251. PMID: 29620003

Supplemental Content

Table of contents

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    Curated

    • NICE, 2022
      UK NICE Guideline NG14, Melanoma: assessment and management, 2022

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