Melanoma - BCOP Exam Questions with Correct Answers| Latest Update Guaranteed Success
Histologic subtypes: Superficial spreading (70%)
Nodular (15-30%)
Lentigo maligna
Acral lentiginous
Mucosal
Uveal
Superficial spreading melanoma Most common type of cutaneous melanoma
Usually evolves from preexisting nevus
Early in development melanoma is flat
Develops into irregular and asymmetrical lesion
Common mutations: BRAF V600, NRAS, TP53
Nodular melanoma 2nd most common
Pure vertical growth-phase disease
Aggressive, fast growing
Dark blue-black lesions often uniform color
Common mutations: BRAF, NRAS
Lentigo maligna melanoma Rare
Does not normally metastasize
Commonly seen in elderly w/ sun-exposed or damaged skin
Acral lentiginous melanoma Seen on palms of hands, soles of feet, under nails
Common in AA, Asians, Hispanics
Mutations: KIT, NRAS, BRAF V600
, Mucosal melanoma Arise from melanocytes
Seen in head & neck region
May see in GI and genital tracks
Mutations: NRAS, KIT, TP53, BRAF V600
Uveal melanoma Rare
Most common primary intraocular tumor
Mutations: GNA11, GNAQ
ABCDEs of melanoma Asymmetric
Irregular borders
Color (varies)
Diameter (>6mm)
Evolving characteristics of lesion
Surgery Provides best chance for cure
Sentinel LN mapping Stage IA, 0.76-1mm
Stage IB or II, 0.76-1mm and ulceration
Stage IB or II mitotic rate of >/=1/mm2 & >1mm thick
RT Limited role
Adjuvant tx to prevent RL in high-risk pts
Commonly for palliative disease
Stage IB or IIA (early stage) adjuvant tx clinical trial or observation
Histologic subtypes: Superficial spreading (70%)
Nodular (15-30%)
Lentigo maligna
Acral lentiginous
Mucosal
Uveal
Superficial spreading melanoma Most common type of cutaneous melanoma
Usually evolves from preexisting nevus
Early in development melanoma is flat
Develops into irregular and asymmetrical lesion
Common mutations: BRAF V600, NRAS, TP53
Nodular melanoma 2nd most common
Pure vertical growth-phase disease
Aggressive, fast growing
Dark blue-black lesions often uniform color
Common mutations: BRAF, NRAS
Lentigo maligna melanoma Rare
Does not normally metastasize
Commonly seen in elderly w/ sun-exposed or damaged skin
Acral lentiginous melanoma Seen on palms of hands, soles of feet, under nails
Common in AA, Asians, Hispanics
Mutations: KIT, NRAS, BRAF V600
, Mucosal melanoma Arise from melanocytes
Seen in head & neck region
May see in GI and genital tracks
Mutations: NRAS, KIT, TP53, BRAF V600
Uveal melanoma Rare
Most common primary intraocular tumor
Mutations: GNA11, GNAQ
ABCDEs of melanoma Asymmetric
Irregular borders
Color (varies)
Diameter (>6mm)
Evolving characteristics of lesion
Surgery Provides best chance for cure
Sentinel LN mapping Stage IA, 0.76-1mm
Stage IB or II, 0.76-1mm and ulceration
Stage IB or II mitotic rate of >/=1/mm2 & >1mm thick
RT Limited role
Adjuvant tx to prevent RL in high-risk pts
Commonly for palliative disease
Stage IB or IIA (early stage) adjuvant tx clinical trial or observation