Title: Unusual Presentation and Survival of Malignant Melanoma in Young Adult with Lymph Node, Lung, Liver, Brain, Bone and Adrenal Gland Metastases
Authors: Dr Sandip Barik MD, Dr Madhup Rastogi MD†, Dr Kiran P Malhotra MD, Dr Akash Agrawal MS, MCh, Dr Rohini Khorana MD, Dr Dinkar Kulshrestha MD DM
DOI: http://dx.doi.org/10.18535/jmscr/v3i10.19
Mortality rates from malignant melanoma (Mm) are high if not detected in early stages. Mm mostly metastasize to lymph nodes (73.5%), followed by lungs (71.3%), liver (58.3%), brain (54.6%), bone (48.6%) and adrenal glands (46.8%).Brain metastases has a grave complication and its clinical outcome is disappointing with survival averaging less than 6 months. Here we report an unusual case of a young adult who presented to us with wide spread metastatic malignant melanoma involving almost every organ of the body. The patient had a survival of 18 months with a mixed response to combination of treatment. The authors want to highlight that Mm can present in any unusual form and we should be having a high clinical acumen of suspicion. A thorough clinical examination should be a mandate. Timely and aggressive treatment can be beneficial to patients even with extensive metastases. 1. Slingluff C L Jr,Flaherty K,Rosenberg S A,Read PW.Cutaneous Melanoma.In Devita V TJr,Lawrence T S,Rosenberg S A,editors.Devita,Hellman,and Rosenberg’s Cancer Principles and Practice of Oncology,9th edition.Philadelphia:Lippincott Williams & Wilkins;2011.p.1643 2. BETH G. GOLDSTEIN, M.D., and ADAM O. GOLDSTEIN, M.D. Diagnosis and Management of Malignant Melanoma, AMERICAN FAMILY PHYSICIAN www.aafp.org/afp VOLUME 63, NUMBER 7 / APRIL 1, 2001,1359-1368. 3. Julie R. Lange, Bryan E. Palis, David C. Chang, Seng-Jaw Soong, et. Al Melanoma in Children and Teenagers: An Analysis of Patients From the National Cancer Data Base J Clin Oncol VOLUME 25, NUMBER 11, APRIL 10 2007:1363-1368. 4. Jerant AF, Johnson JT, Sheridan CD, Caffrey TJ . "Early detection and treatment of skin cancer". Am Fam Physician 62 (2):July 2000: 357–68, 375–6, 381–2 5. J. K. Patel, M. S. Didolkar, J. W. Pickren, and R. H. Moore,“Metastatic pattern of malignant melanoma: a study of 216 autopsy cases,”The American Journal of Surgery, vol. 135, no. 6,pp. 807–810, 1978. 6. GLOBOCAN 2012 (IARC) Section of Cancer Information . 7. Plym A, Ullenhag GJ, Breivald M, Lambe M, et.al, Clinical characteristics, management and survival in young adults diagnosed with malignant melanoma: A population-based cohort study. Acta Oncol. 2014 May;53(5):688-96. doi: 10.3109/0284186X.2013.854928. Epub 2013 Dec 26. 8. A. Jemal, R. Siegel, E.Ward et al., “Cancer statistics, 2008,” CA:A Cancer Journal for Clinicians, vol. 58, no. 2, pp. 71–96, 2008. 9. Kaufman DK, Kimmel DW, Parisi JE, Michels VV, A familial syndrome with cutaneous malignant melanoma and cerebral astrocytoma, Neurology. 1993 Sep;43(9):1728-31. 10. Carbone et al. Journal of Translational Medicine 2012, 10:179,BAP1 cancer syndrome: malignant mesothelioma,uveal and cutaneous melanoma, and MBAITs. 11. Azizi E1, Friedman J, Pavlotsky F, Iscovich J,et.al. Familial cutaneous malignant melanoma and tumors of the nervous system. A hereditary cancer syndrome, Cancer. 1995 Nov 1;76(9):1571-8. 12. Sampson, J.H.; Carter, J.H., Jr.; Friedman, A.H.; Seigler, H.F. Demographics, prognosis, and therapy in 702 patients with brain metastases from malignant melanoma. J. Neurosurg. 1998, 88, 11–20.Abstract
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