engleski

Frequency of lentigo maligna melanoma in two Croatian regions

Lentigo maligna melanoma accounts for 5 to 10% of all primary skin melanomas and occurs mainly in the elderly ; it is an invasive melanoma that arises from preinvasive lesion lentigo maligna confined within the epidermis. Sir John Hutchinson first described lentigo maligna in 1890 ; the disease continues to be called Hutchinson melanotic freckle on occasion. The aim of our study was to analyze lentigo maligna melanoma subtype during a 7-year period (1999-2005) among the biopsy specimens in the General Hospital Zadar and Sestre milosrdnice University Hospital Zagreb. We used data bases from the Department of Pathology, General Hospital Zadar and the computerized Tumor Registry Thanatos from Ljudevit Jurak University Department of Pathology, Sestre milosrdnice University Hospital Zagreb. We compared clinical parameters (sex, age and localization) and histological parameters (Clark, Breslow level of invasion, and pT classifications) of lentigo maligna melanoma between the two climatically different regions. Lentigo maligna and lentigo maligna melanoma accounts for 7.9 % of all diagnosed primary skin melanomas in Zadar and for 8% in Zagreb. Generally, patients with lentigo maligna melanoma are older than 40 years. Mean age at time of diagnosis of lentigo maligna melanoma in Zadar was 61.3 years and in Zagreb 62.5 years (in both hospitals average age for all types of primary skin melanomas was 59.2 years). Preinvasive lesion, lentigo maligna was diagnosed more frequently in Zagreb with mean age of 68.5 years in both hospitals. F/M ratio was 2.3/1 amongst Zadar patients compared to 2.8/1 amongst Zagreb patients. Lentigo maligna melanoma most commonly affects the sun-exposed skin of the head and neck, with a predilection for the nose and cheek and skin of lower extremities. Clark/ Breslow stages and pT classification among the patients in both Hospitals were distributed equally (in majority of the cases Clark and Breslow stage II and pT1). The overall incidence of cutaneous melanoma is increasing faster than any other neoplasm. Increased exposure to ultraviolet radiation and long-term cumulative ultraviolet injury has been a major risk factor for lentigo maligna melanoma. The incidence of lentigo maligna and lentigo maligna melanoma increases in sunnier climates. They often present with a prolonged phase of slow growth but once the invasion has occurred the prognostic features are identical to all other melanoma subtypes. In our study distribution of analyzed parameters of lentigo maligna melanoma subtype were similar for costal and continental part ; except for more frequently diagnosed preinvasive lesions of lentigo maligna in the Zagreb hospital. Many patients with lentigo maligna melanoma have a history of multiple actinic lesions and non-melanoma skin cancers. Education plays an integral role in earlier recognition and follow-up care of patients with lentigo maligna melanoma.

lentigo maligna melanoma; frequency

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