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İLERLEMİŞ PALMOPLANTAR MELANOMUN CERRAHİ TEDAVİSİ

Year 2023, Volume: 62 Issue: 4, 531 - 535, 18.12.2023
https://doi.org/10.19161/etd.1210162

Abstract

Amaç:

Palmoplantar melanom, malign melanomun nadir ve agresif bir alt tipidir. Diğer alt tiplerin aksine, güneş ışığı birincil etiyolojik faktör değildir. Nadir görülen ve ihmal edilen bu malign melanom alt tipi ile ilgili bilgileri genişletmeyi ve bulgularımızı literatüre eklemeyi amaçlıyoruz.

Materyal ve Metod:

2008-2020 yılları arasında hastanemize başvuran Malign Melanomlu hastalar retrospektif olarak incelendi. Yirmi yedi plantar ve bir palmar melanomlu hasta belirlenerek çalışmamıza dahil edildi. Cinsiyet, tanı yaşı, histopatolojik özellikler, sentinel lenf nodu lokalizasyonu, yapılan cerrahiler, sentinel lenf nodu biyopsisi (SLNB) ve bölgesel lenf nodu diseksiyon sonuçları, nüks, sağkalım süresi, primer tümör lokalizasyonu ve sistemik metastazlar ile ilgili veriler toplandı.

Sonuçlar:

Bu dönemde 26 plantar ve 1 palmar melanom hastası ameliyat edilmiştir. Takip sırasında altı hasta kaybedilmiştir. Yirmi üç hasta geniş eksizyonla, dördü amputasyonla tedavi edilmiştir. Eksizyon sonucu oluşan defekt, tüm olgularda deri grefti ile rekonstrükte edilmiştir. Preoperatif görüntülemede lenf nodu şüphesi olan 6 hastada tedaviye lenf nodu diseksiyonu eklenmiştir. Diğer hastalara sentinel lenf düğümü biyopsileri yapılmış ve metastatik bir lenf noduyla karşılaşılırsa tedaviye diseksiyonla devam edilmiştir.

Tartışma:

Bulgularımız güncel literatür ile uyumludur. Deri grefti, palmoplantar melanom takibinin başarısını artırabilir ve yakın takip gerektirir.

Supporting Institution

YOKTUR

Thanks

YOKTUR

References

  • 1. Bradford, Porcia T., et al. "Acral lentiginous melanoma: incidence and survival patterns in the United States, 1986-2005." Archives of dermatology 145.4 (2009): 427-34.
  • 2. Cho, Kenneth K., et al. "Melanomas and stress patterns on foot: A systematic review and meta-analysis." Journal of the American Academy of Dermatology 85.1 (2021): 256-8.
  • 3. Costello, Collin M., Mark R. Pittelkow, and Aaron R. Mangold. "Acral melanoma and mechanical stress on the plantar surface of the foot." New England Journal of Medicine 377.4 (2017): 395-6.
  • 4. Cozzani, Emanuele, et al. "Amelanotic acral melanoma mimicking a plantar wart." JAAD Case Reports 5.5 (2019): 424.
  • 5. Cress, Rosemary D., and Elizabeth A. Holly. "Incidence of cutaneous melanoma among non-Hispanic whites, Hispanics, Asians, and blacks: an analysis of California cancer registry data, 1988-93." Cancer causes & control 8.2 (1997): 246-52.
  • 6. Green, Adele, et al. "A case-control study of melanomas of the soles and palms (Australia and Scotland)." Cancer Causes & Control 10.1 (1999): 21-5.
  • 7. Gumaste, Priyanka, et al. "Acral lentiginous melanoma of the foot misdiagnosed as a traumatic ulcer. A cautionary case." Journal of the American Podiatric Medical Association 105.2 (2015): 189-94.
  • 8. Houdek, Matthew T., et al. "Utility of toe fillet flaps for reconstruct of the forefoot in cases of plantar melanoma." Journal of Surgical Oncology 123.4 (2021): 1088-91.
  • 9. Iglesias-Puzas, Álvaro, et al. "Plantar Reconstruction Using a Dermal Substitute: Description of 2 Cases." The International Journal of Lower Extremity Wounds 17.2 (2018): 120-4.
  • 10. Lee, Sanglim, et al. "Distally based abductor hallucis adipomuscular flap for forefoot plantar reconstruction." Annals of Plastic Surgery 75.3 (2015): 319-22.
  • 11. Jung, Ho Joo, et al. "A clinicopathologic analysis of 177 acral melanomas in Koreans: relevance of spreading pattern and physical stress." JAMA dermatology 149.11 (2013): 1281-8.
  • 12. Lallas, Aimilios, et al. "Palmar and plantar melanomas differ for sex prevalence and tumor thickness but not for dermoscopic patterns." Melanoma Research 24.1 (2014): 83-7.
  • 13. Lv, Jiaojie, et al. "Acral melanoma in Chinese: a clinicopathological and prognostic study of 142 cases." Scientific reports 6.1 (2016): 1-9.
  • 14. Minagawa, Akane, Toshikazu Omodaka, and Ryuhei Okuyama. "Melanomas and mechanical stress points on the plantar surface of the foot." New England Journal of Medicine 374.24 (2016): 2404-6.
  • 15. Oliver-Allen, Hunter, et al. "Immediate reconstruction for plantar melanoma: a paradigm shift." Annals of Plastic Surgery 78.5 (2017): S194-S198.
  • 16. Sheen, Yi-Shuan, et al. "A clinicopathological analysis of 153 acral melanomas and the relevance of mechanical stress." Scientific reports 7.1 (2017): 1-6.
  • 17. Somé, Ollo Roland, et al. "Inguinal lymph node dissection for advanced stages of plantar melanoma in a low-income country." Journal of Skin Cancer 2020 (2020).
  • 18. Stevens, Nancy G., Jonathan M. Liff, and Noel S. Weiss. "Plantar melanoma: is the incidence of melanoma of the sole of the foot really higher in blacks than whites?." International journal of cancer 45.4 (1990): 691-693.
  • 19. Thomas, Susan, et al. "A rare form of melanoma masquerading as a diabetic foot ulcer: a case report." Case Reports in Endocrinology 2012 (2012).
  • 20. Wang, Min, et al. "Surgical Management of Plantar Melanoma: a retrospective study in one center." The Journal of Foot and Ankle Surgery 57.4 (2018): 689-93.

SURGICAL TREATMENT OF ADVANCED PALMOPLANTAR MELANOMA

Year 2023, Volume: 62 Issue: 4, 531 - 535, 18.12.2023
https://doi.org/10.19161/etd.1210162

Abstract

Aim:
Palmoplantar melanoma is a rare and aggressive subtype of malignant melanoma. Not like other subtypes, sunlight is not the primary etiologic factor. We aim to expand the knowledge on this rare and neglected malignant melanoma subtype and add our findings to the literature.
Materials and Methods:
Malignant Melanoma patients admitted to our hospital between 2008 and 2020 were retrospectively analyzed. Twenty-seven patients with plantar and one with palmar melanoma were identified and included in our study. Data about gender, age at the diagnosis, histopathological features, sentinel lymph node localization, performed surgeries, sentinel lymph node biopsy (SLNB) and regional lymph node dissection results, recurrence, survival time, primary tumor localization, and systemic metastases were collected.
Results:
26 plantar and one palmar melanoma patients were operated on in this period. Six patients died during follow-up. Twenty-three patients were treated with wide excisions, and four were treated with amputations. The defect was reconstructed with a skin graft in all cases with excisions. In 6 patients with suspicious lymph nodes in the preoperative imaging, lymph node dissection was added to the treatment. Other patients had sentinel lymph node biopsies and continued with dissection if a metastatic node was encountered.
Conclusion:
Our findings are congruent with the current literature. Skin grafting may enhance the success of palmoplantar melanoma follow-up and demands attention.

References

  • 1. Bradford, Porcia T., et al. "Acral lentiginous melanoma: incidence and survival patterns in the United States, 1986-2005." Archives of dermatology 145.4 (2009): 427-34.
  • 2. Cho, Kenneth K., et al. "Melanomas and stress patterns on foot: A systematic review and meta-analysis." Journal of the American Academy of Dermatology 85.1 (2021): 256-8.
  • 3. Costello, Collin M., Mark R. Pittelkow, and Aaron R. Mangold. "Acral melanoma and mechanical stress on the plantar surface of the foot." New England Journal of Medicine 377.4 (2017): 395-6.
  • 4. Cozzani, Emanuele, et al. "Amelanotic acral melanoma mimicking a plantar wart." JAAD Case Reports 5.5 (2019): 424.
  • 5. Cress, Rosemary D., and Elizabeth A. Holly. "Incidence of cutaneous melanoma among non-Hispanic whites, Hispanics, Asians, and blacks: an analysis of California cancer registry data, 1988-93." Cancer causes & control 8.2 (1997): 246-52.
  • 6. Green, Adele, et al. "A case-control study of melanomas of the soles and palms (Australia and Scotland)." Cancer Causes & Control 10.1 (1999): 21-5.
  • 7. Gumaste, Priyanka, et al. "Acral lentiginous melanoma of the foot misdiagnosed as a traumatic ulcer. A cautionary case." Journal of the American Podiatric Medical Association 105.2 (2015): 189-94.
  • 8. Houdek, Matthew T., et al. "Utility of toe fillet flaps for reconstruct of the forefoot in cases of plantar melanoma." Journal of Surgical Oncology 123.4 (2021): 1088-91.
  • 9. Iglesias-Puzas, Álvaro, et al. "Plantar Reconstruction Using a Dermal Substitute: Description of 2 Cases." The International Journal of Lower Extremity Wounds 17.2 (2018): 120-4.
  • 10. Lee, Sanglim, et al. "Distally based abductor hallucis adipomuscular flap for forefoot plantar reconstruction." Annals of Plastic Surgery 75.3 (2015): 319-22.
  • 11. Jung, Ho Joo, et al. "A clinicopathologic analysis of 177 acral melanomas in Koreans: relevance of spreading pattern and physical stress." JAMA dermatology 149.11 (2013): 1281-8.
  • 12. Lallas, Aimilios, et al. "Palmar and plantar melanomas differ for sex prevalence and tumor thickness but not for dermoscopic patterns." Melanoma Research 24.1 (2014): 83-7.
  • 13. Lv, Jiaojie, et al. "Acral melanoma in Chinese: a clinicopathological and prognostic study of 142 cases." Scientific reports 6.1 (2016): 1-9.
  • 14. Minagawa, Akane, Toshikazu Omodaka, and Ryuhei Okuyama. "Melanomas and mechanical stress points on the plantar surface of the foot." New England Journal of Medicine 374.24 (2016): 2404-6.
  • 15. Oliver-Allen, Hunter, et al. "Immediate reconstruction for plantar melanoma: a paradigm shift." Annals of Plastic Surgery 78.5 (2017): S194-S198.
  • 16. Sheen, Yi-Shuan, et al. "A clinicopathological analysis of 153 acral melanomas and the relevance of mechanical stress." Scientific reports 7.1 (2017): 1-6.
  • 17. Somé, Ollo Roland, et al. "Inguinal lymph node dissection for advanced stages of plantar melanoma in a low-income country." Journal of Skin Cancer 2020 (2020).
  • 18. Stevens, Nancy G., Jonathan M. Liff, and Noel S. Weiss. "Plantar melanoma: is the incidence of melanoma of the sole of the foot really higher in blacks than whites?." International journal of cancer 45.4 (1990): 691-693.
  • 19. Thomas, Susan, et al. "A rare form of melanoma masquerading as a diabetic foot ulcer: a case report." Case Reports in Endocrinology 2012 (2012).
  • 20. Wang, Min, et al. "Surgical Management of Plantar Melanoma: a retrospective study in one center." The Journal of Foot and Ankle Surgery 57.4 (2018): 689-93.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Research Articles
Authors

Mehmet Emre YEĞİN 0000-0001-5788-0705

Vasif MAMMADOV 0000-0001-9847-6864

Nargiz İBRAHİMLİ 0000-0002-0767-8717

Ege TOPALOĞLU 0000-0001-5018-8652

Ersin GUR 0000-0003-4776-1934

Yiğit Özer TİFTİKCİOĞLU 0000-0002-9930-5802

Tahir GÜRLER 0000-0002-7544-3565

Project Number YOKTUR
Publication Date December 18, 2023
Submission Date December 1, 2022
Published in Issue Year 2023Volume: 62 Issue: 4

Cite

Vancouver YEĞİN ME, MAMMADOV V, İBRAHİMLİ N, TOPALOĞLU E, GUR E, TİFTİKCİOĞLU YÖ, GÜRLER T. SURGICAL TREATMENT OF ADVANCED PALMOPLANTAR MELANOMA. EJM. 2023;62(4):531-5.