Melanom

Melanom, or melanoma in English, is a malignant tumor arising from melanocytes, the pigment-producing cells located mainly in the skin but also in the eyes and mucous membranes. It is the most dangerous form of skin cancer and can spread rapidly to other parts of the body. Most melanomas occur on sun-exposed skin and are associated with ultraviolet light exposure, especially after intermittent intense sun exposure or sunburn. Other risk factors include fair or freckled skin, a history of sunburns, a high number of nevi (moles), a family history of melanoma, certain genetic mutations, and immunosuppression.

Typical warning signs are a new or changing mole or pigmented lesion. The ABCDE criteria describe asymmetry, irregular borders, multiple colors, diameter larger than 6 mm, and evolution over time. Diagnosis is established by clinical examination and confirmed by biopsy with histopathological analysis. Staging uses the TNM system and imaging as needed to assess spread.

Treatment depends on stage. Early-stage melanomas are usually treated with surgical excision with appropriate margins. Sentinel lymph node biopsy may be used for staging in some cases. Advanced or metastatic melanoma often requires systemic therapy, including immune checkpoint inhibitors (for example, anti-PD-1 antibodies) or targeted therapies for tumors with BRAF mutations, such as BRAF and MEK inhibitors. Radiation therapy may be used in select circumstances and clinical trials are common.

Prognosis varies with stage; localized disease has a favorable prognosis, while metastatic disease carries a poorer outcome even with modern therapies. Prevention focuses on sun protection, avoidance of tanning beds, and regular skin examinations, especially for those at higher risk.