Superficial Spreading Type

TYPES OF MELANOMA

Superficial Spreading

70% of all Melanomas

Spreads along surface, before invading deeper

Irregular shaped, flat or elevated, multiple colors

Trunk, legs and upper back - most commonly involved areas

Lentigo Maligna

Older age group

Very early Melanoma, with a good prognosis

Face, upper trunk and arms

Nodular

Black nodule, usually invading deeply

Acral

Found on the palms of hands, soles of the feet and under the nails

Desmoplastic

Lacks pigment and can be a very aggressive Melanoma

INCIDENCE

Highest in fair skin individuals & those with sun exposure

PROGNOSIS

Pathological Classification by depth of penetration into the skin

Clark's levels of penetration

Level I - confined to Epidermis

Level II - penetrates the upper dermis or Papillary layer

Level III - fills the upper dermis or Papillary layer

Level IV - penetrates the lower dermis or Reticular layer

Level V - invades deeply into the fat

Breslow's Classification based on Invasion Depth into the Skin

0.75mm or less

0.76mm to 1.50mm

1.51mm to 4.0mm

4.0mm or greater

0.75mm or less = almost 100% survival for 10 years
> 3.0mm = Poor Prognosis

TREATMENT

Surgical excision - wide, based on the depth of penetration

1-2-3 Rule

Remove a 1cm cuff of normal tissue on all sides of the Melanoma for penetration 1mm or less

Remove a 2cm cuff of normal tissue on all sides of the Melanoma for penetration 2mm or less

Remove a 3cm cuff of normal tissue on all sides of the Melanoma for penetration greater than 2mm

Sentinel Lymph Node Removal or Lymphadenectomy

Biopsy of lymph node(s) - First dye is injected into the skin surrounding the Melanoma to find the lymph node drainage. Then the 1st node in the chain is removed and analyzed

Lymphadenectomy (removal of all lymph nodes in the area) is done if there is involvement of the Sentinel node(s)

Radiation Therapy ( generally done to relieve tumor symptoms )

Chemotherapy ( systemic or local - used to control tumor spread )

Biological or Immunotherapy

Agents used to stimulate the Immune System

Block blood vessel formation

Directly attack the tumor cells

BCG ( Bacillus-Calmette-Guerin, TB strain ) or Vaccine

Interleukin 2 ( Lymphokines )

Melanoma Skin Cancer Thousand Oaks Skin Cancer Thousand Oaks, Beverly Hills, Los Angeles, Encino, Calabasas, Camarillo, Ventura. Doctor Christopher Costanzo MD, Skin Cancer Surgeon performs skin cancer removal and reconstruction for Melanoma, Basal Cell Carcinoma, Squamous Cell Carcinoma and other skin cancers for men and women in Thousand Oaks, Beverly Hills, Los Angeles, Encino, Sherman Oaks, Woodland Hills, Tarzana, West Hills, Canoga Park, Chatsworth, Calabasas, Westlake Village, Thousand Oaks, Oxnard, Moorpark, Simi Valley, Camarillo, Ventura and Santa Barbara.

For More Information on Melanoma
Skin Cancer