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Malignant Melanoma

»	What is melanoma?
»	How common is malignant melanoma in the United States?
»	What causes melanoma?
»	What groups have a genetic predisposition to familial melanoma?
»	List the risk factors for melanoma.
»	List the high-risk groups for developing melanoma.
»	Do all melanomas develop from atypical nevi?
»	What are cancer stem cells?
»	Is melanoma a single disease?
»	What are the molecular pathways in melanoma?
»	Is there a host immune response to melanoma?
»	Describe the clinical appearance of melanoma.
»	What are the ABCDEs of melanoma?
»	What is dermoscopy?
»	Where on the body does melanoma most commonly arise?
»	Are there different types of melanoma?
»	What are Clark’s levels?
»	What is Breslow’s depth?
»	What other findings should be reported in the histopathologic diagnosis of melanoma?
»	What are the common immunohistochemical (IHC) markers utilized in the diagnosis of melanoma?
»	Are there other factors with prognostic impact in patients with melanoma?
»	How are patients with melanoma evaluated after the initial diagnosis?
»	What is the most current system for staging melanoma?
»	How is melanoma treated?
»	How wide should surgical margins be?
»	What is the most important risk factor for local recurrence of primary melanoma?
»	Does a biopsy of melanoma increase the risk of spreading tumor cells or causing metastases?
»	Describe the recommended follow-up for a patient with melanoma.
»	Which tests or examinations are conducted during the routine follow-up of patients who have had melanoma?
»	Does local tumor recurrence influence overall survival?
»	What is elective lymph node dissection (ELND)? When is it indicated?
»	What is sentinel lymph node biopsy? When is it indicated?
»	What is linear melanonychia?
»	What is Hutchinson’s sign?
»	What is Hutchinson’s freckle?
»	Are there any new ways to assess prognosis in patients with melanoma?
»	What forms of chemotherapy are used in the treatment of metastatic melanoma?
»	Is radiation therapy effective for melanoma?
»	How effective is immunotherapy in malignant melanoma?
»	Does gene therapy offer any better results?
»	How about local perfusion?
»	What are some newer targeted therapies for melanoma?

What groups have a genetic predisposition to familial melanoma?

Germline genetic mutations and polymorphisms can predispose to melanoma. The major high-penetrance melanoma susceptibility gene locus associated with familial melanoma is CDKN2A, which encodes p16 and p14^ARF; p16 and p14^ARF regulate retinoblastoma (Rb) nd p53 pathways, respectively. Germline CDKN2A mutations are observed in 25% of familial melanoma.

Meyle KD, Guldberg P: Genetic risk factors for melanoma, Hum Genet 126:499–510, 2009.