Palacios-Diaz Rodolfo David, de Unamuno-Bustos Blanca, Abril-Pérez Carlos, Pozuelo-Ruiz Mónica, Sánchez-Arraez Javier, Torres-Navarro Ignacio, Botella-Estrada Rafael
Department of Dermatology, Hospital Universitari i Politècnic La Fe, 46026 Valencia, Spain.
Department of Medicine, Universitat de València, 46010 Valencia, Spain.
J Clin Med. 2022 Apr 22;11(9):2355. doi: 10.3390/jcm11092355.
Multiple primary melanomas (MPM) refer to the occurrence of more than one synchronous or metachronous melanoma in the same individual. The aim of this study was to identify the frequency of MPM and describe the clinical and histopathologic characteristics of patients with MPM. An observational single-center retrospective study was designed based on a cohort of melanoma patients followed in a tertiary care hospital. Fifty-eight (8.9%) patients developed MPM. Most patients were men (65.5%) and the median age at the time of diagnosis of the first melanoma was 71 years old. The median time of diagnosis of the second melanoma from the first melanoma was 10.9 months, and 77.6% of second melanomas were diagnosed within the first 5 years. In total, 29 (50%) and 28 (48.3%) first and second melanomas were located in the trunk, respectively. Concordance of anatomic site between primary and subsequent melanoma was found in 46.6% of the patients. Proportion of in situ melanomas was increasingly higher in subsequent melanomas (from 36.21% of first melanomas to 100% of fifth melanomas). An increasing rate of melanomas with histological regression was observed within subsequent melanomas (from 60.3% of first melanomas to 80% of third melanomas). Our results support the importance of careful long-term follow-up with total body examination in melanoma patients.
多发性原发性黑色素瘤（MPM）是指同一个体中出现一个以上同时性或异时性黑色素瘤。本研究的目的是确定MPM的发生率，并描述MPM患者的临床和组织病理学特征。基于一家三级护理医院随访的黑色素瘤患者队列，设计了一项单中心观察性回顾性研究。58例（8.9%）患者发生了MPM。大多数患者为男性（65.5%），首次诊断黑色素瘤时的中位年龄为71岁。第二次黑色素瘤诊断距首次黑色素瘤诊断的中位时间为10.9个月，77.6%的第二次黑色素瘤在头5年内被诊断出来。首次和第二次黑色素瘤分别有29例（50%）和28例（48.3%）位于躯干。46.6%的患者原发性和后续黑色素瘤的解剖部位一致。原位黑色素瘤在后续黑色素瘤中的比例越来越高（从首次黑色素瘤的36.21%增至第五次黑色素瘤的100%）。在后续黑色素瘤中观察到组织学消退的黑色素瘤比例不断增加（从首次黑色素瘤的60.3%增至第三次黑色素瘤的80%）。我们的结果支持对黑色素瘤患者进行仔细的长期全身检查随访的重要性。
