Malignant melanoma - Melanoma Leaga
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Se melanoma e tusa ma le 2.5cm (1 inisi) i le 1.5cm (0.6 inisi)
E ui lava o lenei mataupu na maua o le melanoma, o le sailiga vaaia e sili atu ona tutusa ma le hematoma fao. O fao hematomas e masani ona mou atu i totonu o le tasi i le lua masina pe a tulei i fafo. O le mea lea, afai e faʻaauau pea le manua mo se taimi umi, e ono masalomia le melanoma ma e tatau ona faia se biopsy.
References
O le melanoma o se ituaiga tuma e tupu pe a o'o ina leaga le melanocytes. Melanocytes e afua mai i le neural crest. O lona uiga e le gata e mafai ona atiaʻe le melanoma i luga o le paʻu ae faʻapea foʻi i isi nofoaga e feoaʻi ai sela o le neural crest, e pei o le gastrointestinal tract ma le faiʻai. O tagata mama'i e maua i le stage 0 melanoma e 97% e ola ai le lima tausaga, ae o i latou e maua i le fa'ama'i tulaga IV e na'o le 10%.
A melanoma is a tumor produced by the malignant transformation of melanocytes. Melanocytes are derived from the neural crest; consequently, melanomas, although they usually occur on the skin, can arise in other locations where neural crest cells migrate, such as the gastrointestinal tract and brain. The five-year relative survival rate for patients with stage 0 melanoma is 97%, compared with about 10% for those with stage IV disease.
A melanoma is a tumor produced by the malignant transformation of melanocytes. Melanocytes are derived from the neural crest; consequently, melanomas, although they usually occur on the skin, can arise in other locations where neural crest cells migrate, such as the gastrointestinal tract and brain. The five-year relative survival rate for patients with stage 0 melanoma is 97%, compared with about 10% for those with stage IV disease.
Cutaneous melanoma (CM) ose ituaiga tumo pa'u e sili ona mata'utia, e nafa ma le 90% o maliu ile kanesa o le pa'u. Ina ia fa'atalanoaina lenei mea, sa galulue fa'atasi tagata popoto mai le the European Dermatology Forum (EDF) , the European Association of Dermato-Oncology (EADO) , and the European Organization for Research and Treatment of Cancer (EORTC) .
Cutaneous melanoma (CM) is a highly dangerous type of skin tumor, responsible for 90% of skin cancer deaths. To address this, experts from the European Dermatology Forum (EDF), the European Association of Dermato-Oncology (EADO), and the European Organization for Research and Treatment of Cancer (EORTC) had collaborated.
Cutaneous melanoma (CM) is a highly dangerous type of skin tumor, responsible for 90% of skin cancer deaths. To address this, experts from the European Dermatology Forum (EDF), the European Association of Dermato-Oncology (EADO), and the European Organization for Research and Treatment of Cancer (EORTC) had collaborated.
Melanoma, o se ituaiga o kanesa o le pa'u, e tu matilatila mo lona sootaga vavalalata ma le tino puipuia. E iloa lea i le faateleina o le tupu i tagata e vaivai le puipuiga o le tino, o le i ai o sela puipuia i totonu uma o le tino muamua ma lo latou sosolo atu i isi vaega o le tino, ma le mea moni e mafai e le immune system ona iloa ni polotini o loo maua i sela o le melanoma. O le mea taua, o togafitiga e fa'aleleia ai le puipuiga o le tino ua fa'aalia ai le folafolaga i le tauina o le melanoma. E ui o le faʻaogaina o togafitiga faʻamalosia i le togafitia o le melanoma maualuga o se atinaʻe lata mai, o suʻesuʻega talu ai nei ua faʻaalia ai o le tuʻufaʻatasia o nei togafitiga ma le chemotherapy, radiotherapy, poʻo togafitiga mole mole e mafai ona faʻaleleia atili ai taunuuga. Ae ui i lea, o ia immunotherapy e mafai ona faʻaosoina ai le tele o aʻafiaga e aʻafia ai le puipuiga e aʻafia ai totoga eseese, e ono faʻatapulaʻaina lona faʻaogaina. I le va'ai i luma, o le lumana'i mo le togafitia o le ma'i ma'i e ono aofia ai togafitiga e fa'atatau i siaki fa'apitoa e puipuia ai e pei o le PD1, po'o vaila'au e fa'alavelave i ala mole mole e pei ole BRAF ma MEK.
Melanoma is one of the most immunologic malignancies based on its higher prevalence in immune-compromised patients, the evidence of brisk lymphocytic infiltrates in both primary tumors and metastases, the documented recognition of melanoma antigens by tumor-infiltrating T lymphocytes and, most important, evidence that melanoma responds to immunotherapy. The use of immunotherapy in the treatment of metastatic melanoma is a relatively late discovery for this malignancy. Recent studies have shown a significantly higher success rate with combination of immunotherapy and chemotherapy, radiotherapy, or targeted molecular therapy. Immunotherapy is associated to a panel of dysimmune toxicities called immune-related adverse events that can affect one or more organs and may limit its use. Future directions in the treatment of metastatic melanoma include immunotherapy with anti-PD1 antibodies or targeted therapy with BRAF and MEK inhibitors.
Melanoma is one of the most immunologic malignancies based on its higher prevalence in immune-compromised patients, the evidence of brisk lymphocytic infiltrates in both primary tumors and metastases, the documented recognition of melanoma antigens by tumor-infiltrating T lymphocytes and, most important, evidence that melanoma responds to immunotherapy. The use of immunotherapy in the treatment of metastatic melanoma is a relatively late discovery for this malignancy. Recent studies have shown a significantly higher success rate with combination of immunotherapy and chemotherapy, radiotherapy, or targeted molecular therapy. Immunotherapy is associated to a panel of dysimmune toxicities called immune-related adverse events that can affect one or more organs and may limit its use. Future directions in the treatment of metastatic melanoma include immunotherapy with anti-PD1 antibodies or targeted therapy with BRAF and MEK inhibitors.
O le mafuaaga autu o le melanoma o le malamalama o le ultraviolet i latou e maualalo le maualuga o le paʻu o le melanin (paʻepaʻe paʻepaʻe). O le moli UV atonu e sau mai le la po'o masini tanning. O i latou e tele nevus, o se tala'aga o le melanoma o tagata o le aiga, ma le le lelei o le puipuiga o le tino e sili atu ona lamatia i le melanoma.
O le fa'aaogaina o le la ma le aloese mai le malamalama o le UV e ono puipuia ai le melanoma. O togafitiga e masani lava ona aveese e ala ile taotoga. I latou e maua i le kanesa teisi lapopoa, e mafai ona su'eina pona lymph lata ane mo le sosolo (metastasis). O le tele o tagata e faʻamalolo pe a le tupu se metastasis. Mo i latou ua sosolo i ai le melanoma, immunotherapy, bioc therapy, radiation therapy, poʻo le chemotherapy e mafai ona faʻaleleia atili le ola. Faatasi ai ma togafitiga, o le lima tausaga o le ola i le Iunaite Setete e 99% i latou e maua i faʻamaʻi, 65% pe a sosolo le faʻamaʻi i lymph nodes, ma le 25% i latou e mamao mamao.
Melanoma o le ituaiga sili ona mata'utia o le kanesa o le pa'u. O Ausetalia ma Niu Sila o lo'o i ai le maualuga maualuga o le melanoma i le lalolagi. Ole maualuga ole melanoma e tupu foi i Europa i Matu ma Amerika i Matu. Melanoma e tupu tele i Asia, Aferika, ma Amerika Latina. I le Iunaite Setete, o le melanoma e tupu pe a ma le 1.6 taimi sili atu i alii nai lo tamaitai.
○ Faailoga ma faailoga
O faʻailoga muamua o le melanoma o suiga i foliga poʻo le lanu o nevus o loʻo iai. I le tulaga o le nodular melanoma, o le foliga mai o se paʻu fou i luga o le paʻu. I la'asaga mulimuli ane o le melanoma, e ono magese le nevi, pala, pe tafe toto.
[A-Asymmetry] Asymmetry o foliga
[B-Borders] Tua'oi (e le masani ai pito ma tulimanu)
[C-Color] Lanu (ese'ese ma fa'aletonu)
[D-Diameter] Diamita (sili atu nai lo le 6 mm = 0.24 inisi = e tusa ma le lapo'a o se solo penitala)
[E-Evolving] Evolve i le taimi
cf) Seborrheic keratosis e mafai ona ausia nisi po'o vaega uma o le ABCD, ma e mafai ona o'o atu ai i fa'ailo sese.
Metastasis o le vave melanoma e mafai, ae e seasea; e itiiti ifo i le tasi vaelima o melanomas e vave iloa ua avea ma metastatic. O fa'ama'i o le fai'ai e taatele i tagata mama'i e maua i le metastatic melanoma. O le metastatic melanoma e mafai foi ona sosolo i le ate, ponaivi, manava, poʻo le mamao ole lymph nodes.
○ Su'esu'ega
O le va'ava'ai i le vaega o lo'o fesiligia o le auala sili lea ona taatele o le masalomia o le melanoma. Nevus e le masani i lanu poʻo foliga e masani ona togafitia o ni sui o le melanoma.
E masani ona su'esu'e e foma'i mole uma, e aofia ai mole e itiiti ifo i le 6 mm le lautele. A fa'aogaina e tagata tomai fa'apitoa, e sili atu le fesoasoani o le dermoscopy e iloa ai manu'a leaga nai lo le fa'aogaina na'o le mata le lava. Ole su'esu'ega e ala ile biopsy o so'o se manu'a o le pa'u e iai fa'ailoga e ono mafai ona kanesa.
○ Togafiti
#Mohs surgery
E mafai e lau foma'i ona fautuaina le immunotherapy aemaise lava pe a iai sau la'asaga 3 po'o le la'asaga 4 o le melanoma e le mafai ona aveese i se taotoga.
#Ipilimumab [Yervoy]
#Pembrolizumab [Keytruda]
#Nivolumab [Opdivo]