（黑色素瘤）课件.ppt

Melanoma Xiezhe Content Case and questions Introduction Types Risk factors Diagnosis Treatement Case During a routine physical examination of a 30-year-old man , you discover a 1.5-cm, pigmented skin lesion on the posterior aspect of his left shoulder. This lesion is nonindurated ,has ill-defined borders, and is without surrounding erythema. Questions What is the most likely diagnosis? What is your next step? What is the best treatment for this problem? Introduction Melanoma is a malignant tumor of melanocytes which are found predominantly in skin but also in the bowel and the eye. It is one of the less common types of skin cancer but causes the majority (75%) of skin cancer related deaths Types Superficial spreading Nodular sclerosis Lentigo maligna Acral lentiginous Risk Factors Genetic Fair skin (2.1) Red hair (3) Caucasian (5-10) More than 20 nevi on body (3.4) Blus eyes (4.5) Easily burned and unable to tan (4.5) Familial cases (4-10) Prior history of melanoma (900) Diagnosis Symptoms A popular method for remembering the signs and symptoms of melanoma is the mnemonic “ : Diagnosis Treatement Surgery Complete surgical excision radical lymph node dissection Adjuvant treatment a year of high-dose interferon treatment Chemotherapy and immunotherapy dacarbazine (DTIC) interleukin-2 (IL-2) or interferon (IFN) Questions What is the most likely diagnosis? What is your next step? What is the best treatment for this problem? Thank you for your attention ! * * * * According to the patient’s wife, this skin lesion has been present for the past several months, and she believes that it has increased in size and become darker during this time. The patient is otherwise healthy. Examination of the patient’s left axilla and neck reveals no identifiable abnormalities. No other pigmented skin lesions are observed during your thorough physical examination. Environmental Fact