Document Detail


Pregnancy and hormonal influences on malignant melanoma.
MedLine Citation:
PMID:  3819162     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Halo cutaneous melanoma developed in a 30-year-old woman. Following wide excision of the melanoma, she remained clinically free of tumor for 5 years. In a subsequent pregnancy, she developed metastases to the liver which became evident in the immediate postpartum period. Long-term survival associated with cutaneous hypopigmentation has been reported and occurred in our patient. The interaction between hormonal and immunologic factors and melanoma is explored.
This article presents the case of a 30-year-old woman who developed halo cutaneous melanoma. She had been taking oral contraceptives (Norinyl) for about 5 years before diagnosis. Following wide excision of the melanoma, the patient remained clinically free of tumor for 5 years. However, in a subsequent pregnancy, she developed metastases to the liver that became evident in the immediate postpartum period. Long-term survival associated with cutaneous hypopigmentation has been reported and occurred in this patient. There is considerable debate as to whether oral contraceptives or pregnancy can influence the occurrence and course of melanoma. Also unclear is whether oral contraceptive use or a subsequent pregnancy in women with a history of melanoma will accelerate the growth of latent metastases, stimulate a benign pigmented lesion to become malignant, or cause a previously removed melanoma to recur and metastasize. Given the lack of uncertainty in this area, it is recommended that women with a history of melanoma use a nonhormonal method of contraception. Frequent follow up and thorough physical examinations during pregnancy are essential, and any suspicious skin lesions should be biopsied early. To better answer the questions raised by cases such as this, establishment of an organized mechanism for the registry of patients with melanoma who subsequently become pregnant is suggested. A cooperative prospective melanoma study could accumulate the necessary data on tumor site and thickness, staging, parity, and the use of hormonal contraception.
Authors:
B K Schwartz; S J Zashin; S K Spencer; L E Mills; A J Sober
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  The Journal of dermatologic surgery and oncology     Volume:  13     ISSN:  0148-0812     ISO Abbreviation:  J Dermatol Surg Oncol     Publication Date:  1987 Mar 
Date Detail:
Created Date:  1987-04-06     Completed Date:  1987-04-06     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7707501     Medline TA:  J Dermatol Surg Oncol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  276-81     Citation Subset:  IM; J    
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MeSH Terms
Descriptor/Qualifier:
Adult
Contraceptives, Oral, Hormonal / adverse effects
Female
Humans
Liver Neoplasms / secondary
Melanoma / complications,  pathology*,  secondary
Pigmentation Disorders / etiology
Pregnancy
Pregnancy Complications, Neoplastic / pathology*
Skin Neoplasms / complications,  pathology*
Chemical
Reg. No./Substance:
0/Contraceptives, Oral, Hormonal

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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