Nine primary melanomas in a young female patient and a review of the literature
This case study presents the history of a 34 year old female with nine primary melanomas since the age of eighteen. The Queensland Cancer Registry reports that melanoma is the most common form of cancer diagnosed in young Queenslanders. Furthermore, Australians with a primary invasive melanoma are thought to have a 6-7 fold increase in the probability of developing a second invasive melanoma when compared to the general population.1 In patients with multiple primary melanoma the risk of developing a second primary melanoma is estimated at 4-9%, however the risk for the development of subsequent melanomas is 1% per year and remains unchanged. This risk is also highest in the first year following diagnosis of the first primary melanoma. 2 The patient in this case had her first melanoma diagnosed at the age of 18, then during her first pregnancy, 16 years later, she developed her second melanoma. Over the ensuing 18 months the patient went on to present with a further 7 histologically confirmed cutaneous melanomas. The patient's risk factors include; dysplastic naevus syndrome, type one skin and living in tropical Australia since birth. The relationship of melanoma development to her pregnancy will be discussed, together with a review of the literature and the results of her genetic profile.
1. Cancer Council Queensland. Available from URL: https://cancerqld.org.au/?s=melanoma (Accessed 30th of March 2016.)
2. Moore MM, Geller AC, Warton EM, et al. Multiple primary melanomas among 16,570 patients with melanoma diagnosed at Kaiser Permanente Northern California, 1996 to 2011. Am Acad Dermatol J. 2015; 73(4):630-636.
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Dr. Agnieszka Adams
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