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Volume 2, Issue 3 2017 Journal of Medical Oncology and Therapeutics Dermatologists & Melanoma 2017
August 31-September 01, 2017
Page 66
&
2nd Euro-Global Congress on
August 31-September 01, 2017 London, UK
12th Global Dermatologists Congress
Melanoma and Skin Diseases
Primary dermal melanoma (PDM): Experience and insights from a large, single surgeon's series in
a tertiary center
Zamir H1, Feinmesser M 2,3 and Gutman H2,3
1Rambam Health Care Campus and the Bruce Rappaport Faculty of Medicine, Israel
2Rabin Medical Center, Israel
3Tel Aviv University, Israel
Background: PDM is a rare variant of melanoma. It is confined to the dermis and/or subcutis without epidermal component.
Hence, histologically alone, it cannot be distinguished from a melanoma metastasis. Careful clinical history, examination and
proper imaging are required to exclude metastatic disease. Diagnosing such a lesion as PDM or as a metastasis has significant
impact on the proper management and on the prognosis. Our experience and insights cast some light on this problematic
clinical situation.
Methods: We retrieved all 36 clinically diagnosed PDM patients from our prospectively collected database of 1600 melanoma
patients surgically treated in a tertiary melanoma center between 1995 and 2015. Strict focused pathology revision excluded
23 patients who failed to meet all criteria for PDM set forth by Swetter et. al. Thirteen0 patients were in-depth investigated
regarding clinical, histopathological parameters, surgical treatment and outcome.
Results: 13 PDMs, median "thickness" – 5.5 (range 2 to 11) mm, median mitotic rate 4 (range 0 to 17)/mmsq, formed this
series. Eleven patients (84.6%) are still alive after median follow up of 56 (range 12 to 120) months. Three of 13 patients had a
positive sentinel lymph node followed by completion dissection.
Discussion: It seems that when PDM is diagnosed, it can be successfully treated as a primary melanoma (rather than a
metastasis) including Sentinel node sampling and completion dissection. The actual "thickness" of these melanomas, as well as
their mitotic rates, are associated with better prognosis than same-thickness cutaneous melanomas.
Conclusions: Diagnosing PDM demands careful clinical and histological reviews. PDM has favorable outcome compared to
primary cutaneous same –thickness melanoma. Wide local excision and Sentinel lymph node biopsy seem appropriate and
worthwhile, once these lesions are deemed primary melanomas.
Biography
Hadas Zamir,Working at Department of Dermatology at Rambam Health Care Campus , Bruce Rappaport Faculty of Medicine, Haifa, Israel. Hadas Zamir has
Published journals in reputed sites. His Intrests in Dermatology & Melanoma research are currently going on.
Zamir H et al., J Med Oncl Ther 2017, 2:3