Study of 100 Cases of Malignant Melanoma

INTRODUCTION: Malignant Melanoma is a neoplasm arising from melanocytes. The great preponderance of melanomas arises in the skin, other sites of origin include the oral and anogenital mucosal surfaces, esophagus, meninges and the eye. AIMS AND OBJECTIVES: To Study demographics, site of primary tumour and site of metastasis of Malignant Melanoma& To Study the Role of Immunohistochemistry in diagnosis Malignant Melanoma REVIEW OF LITERATURE The Malignant Melanomas are the Most important group of skin cancers. Although less common than the familiar basal and squamous cell tumours of the skin, they are much more frequently fatal, due to their intrinsic tendency to lymphatic and haematogenic metastasis.5 Melanoma accounts for less than 2 % of skin cancer cases.6 Melanoma is one of the most important cancers when considered as a cause of loss of life as it is commonly diagnosed in relatively young people and can be fatal if untreated.9 Intermittent exposure to UVR (Ultraviolet rays) is the major environmental risk factor for melanoma, especially in combination with endogenous factors (skin types I and II, immune deficient status, genetic predisposition) Melanoma arises most commonly on the skin of the back in men and on the lower extremities in women in Western countries, whereas sole of foot is the most common site for melanoma among Indian patients.13 The most useful criteria for clinical diagnosis of melanoma are asymmetry and uneven pigmentation of the lesion, and have been integrated in the acronym �ABCD� (Asymmetry, irregular Border, uneven Colour, Diameter greater than 6 mm). The typical example of malignant melanoma is identified microscopically because of its junctional activity; prominent melanin pigmentation; invasion of the surrounding tissue; marked cytologic atypia; nuclear grooves, folds, and pseudoinclusions; large eosinophilic nucleoli; and abundant mitotic figures, some of them atypical. Melanoma is reactive for Melan-A, , S-100 protein, HMB-45, Vimentin, Tyrosinase. The treatment of choice of most malignant melanomas is wide excision of the primary lesion. MATERIALS AND METHODS This is a prospective+retrospective study conducted in the Department of Pathology of GCRI, Ahmedabad from August 2011 to October 2014. The data of 100 patients of histopathologically confirmed Malignant Melanoma was retrieved from case files. Surgically resected specimen material& biopsies were included in the study. RESULTS Median age overall: 53.57 years Male to Female Ratio: 1.7: 1 The most common site affected by Malignant Melanoma is Skin of Lower Limb.22 out of 100 Cases show Metstasis. Our Study shows almost 100 % positivity for Vimentin, S-100 and HMB-45. DISCUSSION � In the current study, 100 cases of Malignant Melanoma were studied. � Patients in our study belonged to the age group in the range of 22 to 84 years, with mean age being 53.57 years and a sex ratio of 1.7: 1. � Foot was the most common site for Malignant Melanoma in our study. � Study Shows Two cases of Malignant Melanoma in Liver which is a very rare site. SUMMARY& CONCLUSION � To conclude, the current 100 case study of Malignant Melanoma, has illustrated the characteristics of patients of Malignant Melanoma presenting at our institute. � Male predominance was seen over the Female. � The most common site of Malignant Melanoma was the Skin of Lower Limb. � The least common site of Malignant Melanoma was the Liver. � In IHC Study, Melan-A, HMB-45, S-100 and Vimentin Positivity& Negativity for AE1, EMA, LCA is helpful for Differentiating Malignant Melanoma from other Poorly Differentiated Tumors and Lymphoma and to arrive at definite diagnosis. � This is a Pilot study trying to understand this tumour entity. Further study is advisable on a larger population.