Naslov
Surgical and histologic pitfalls in the management of lentigo maligna melanoma

Autori
Šitum, Mirna ; Buljan, Marija

Izvornik
Giornale Italiano di dermatologia e venereologia (0392-0488) 147 (2012), 1; 21-27

Vrsta, podvrsta i kategorija rada
Radovi u časopisima, članak, znanstveni

Ključne riječi
lentigo maligna melanoma ; lentigo maligna ; surgery

Sažetak
Lentigo maligna melanoma (LMM) is a malignancy with increasing incidence, accounting for about 4% to 15% of all melanomas. Lentigo maligna (LM) is LMM in situ, usually presenting an irregular tan colored or brownish pigmented macular lesion persisting for years on chronically sun-exposed skin. Left untreated, LM may evolve into invasive form of LMM. Histologic evaluation of LM/LMM can be difficult due to widespread atypical melanocytes that are present in the area chronically sun damaged skin. It has been shown that chronically sun-damaged non-lesional skin can display some atypical features even in the absence of a melanocytic neoplasm. It is important for dermatopathologists to be aware of these findings so that such features are interpreted appropriately when making a histological assessment that may ultimately influence therapy and outcome. LMM is characterized by significant subclinical lesion extension which makes the treatment another challenge. Nowadays, a variety of therapeutic options are available in the treatment of LMM. Surgery remains the mainstay of LMM therapy, however the treatment of LM remains controversial subject in the literature. Non- surgical treatment modalities for LM include: destructive procedures such radiotherapy, cryotherapy, curettage, laser, electro-destruction and immunotherapy with the topical application of 5% imiquimod cream. These treatment options should be considered for a subset of patients with LM, especially in elderly patients with extensive or unresectable disease in difficult areas on the face or, as a second-line therapy if surgery is contraindicated. Surgical options include simple excision and margin-control techniques such as staged excision and Mohs micrographic surgery.In this article, authors are reviewing the latest diagnostic and therapeutic advances in the management of LMM.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

POVEZANOST RADA