Abstract
Abstract Introduction: melanoma is a very aggressive cancer, with increasing incidence, and is currently the fifth most common cancer in men and the sixth most common in women in the United States. Melanoma is not unusual in pregnancy, with an estimated occur-rence rate of 1:1.000. Although not the most common cancer in pregnancy, melanoma is the tumor with the highest incidence ofplacenta and fetus metastases. Description: a 29-year-old lady, 4 weeks after conception underwent resection of an atypical pigmented lesion after a diagnosis of stage T4b melanoma. At 16 weeks she underwent a broad local excision and sentinel lymph node (SLN) biopsy. SLN was evaluated histologically and tested positive for melanoma. A radical axillary lymphadenectomy was performed on the patient without evidence of metas-tasis in any other LN. In the 40th week of pregnancy, labor was induced and a healthy newborn was deli-vered via cesarean. Discussion: melanoma management in pregnancy is more complex and requires multidisciplinary coor-dination, as well as extensive discussion with the patient and her family. We present a case report description in which treatment recommendations are established according to no pregnancy experience.
Highlights
Cutaneous melanoma is a serious medical condition that is a growing problem around the world
We present a case report description in which treatment recommendations are established according to no pregnancy experience
It was widely held that the prognosis of melanoma was worse during pregnancy and that subsequent pregnancies increase the risk of recurrence.[5]
Summary
Cutaneous melanoma is a serious medical condition that is a growing problem around the world. Initial biopsy showed nodulation with recurrent melanoma of approximately 4 mm in Breslow thickness, Clark level IV, with compromised margin, mitotic index of 7 mitoses per mm[2], ulcerated and staged as pT4aNXMX. The case was discussed with the patient and her family and the decision was made to perform a wide margin enlargement and Sentinel Lymph Node Biopsy (SLNB) under local anesthesia and venous sedation. Nuclei enlarged and rounded or oval, often with prominent nucleoli and mitotic figures; (B) shows the area of margin expansion with neoplastic niche in the deep dermis infiltrating to the subcutaneous tissue The cells have the same appearance as on the first biopsy and may indicate a deep residual tumor or a microscopic satellite; (C) histological examination of the sentinel lymph node showing several niches of intramedullary and sub-capsular melanoma
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