WHAT IS A Nodular MELANOMA?
Nodular Melanomas often demonstrate several features. They can display a superficial spreading component (as can be seen from the wild asymmetry and highly irregular borders in the first case study).
Nodular Melanomas can also display central nodular component which can also display amelanotic features (not containing any of the normal brown pigment).
The greatest risk to this patient is from a second Melanoma in the first 2 years after diagnosis - and the second lesion is usually more aggressive than the first.
Breslow refers to the skin depth of the melanoma. The Breslow Stage is used as a prognosis factor as it ranks how deeply the tumor cells have invaded. Breslow's depth was divided into 5 stages.
Nodular MELANOMA CASE STUDY
This is a (1.8mm Breslow) Nodular Melanoma appearing on the forearm of a 27 year old male.
This lesion originated from a pre-existing mole that had a history of change over 18 months.
It was widely excised
The patient is alive and well and is receiving 3 monthly checks for the first 2 years after diagnosis.
Invasive Nodular MELANOMA CASE STUDY
This is an Invasive Nodular Melanoma arising from a Superficial Spreading Melanoma on the back of a 71 year old female. It’s Breslow thickness (tumour depth) was 2mm.
It grew from a pre-existing mole that changed rapidly over a period of just 5 months.
The patient underwent a wide-area excision - and due to several aggressive features noted on pathology and the rate of growth a nodal clearance was performed close to the date of the original diagnosis.
The patient subsequently went on to develop a solitary Melanoma metastasis in her liver 18 months later which was successfully removed surgically.
She is alive and well and has regular digital monitoring of her skin lesions.