Marson Justin W, Chen Rebecca M, Huang Alisen, Wechter Todd, Khachemoune Amor
Drs. Marson, Chen, Huang, Wetcher, and Khachemoune are with the Department of Dermatology at SUNY Downstate Health Sciences University in Brooklyn, New York.
Additionally, Dr. Khachemoune is the Department of Dermatology at Veterans Affairs New York Harbor Healthcare System in Brooklyn, New York.
J Clin Aesthet Dermatol. 2024 Aug;17(8):44-49.
There is little consensus regarding the nomenclature and prognostic implications of synchronous melanomas. Here, we present a case of synchronous cutaneous melanoma and perform a systematic review of similar cases in the literature.
Pubmed and EMBASE databases were queried for relevant English-language articles published from inception until 2023. Cases of "multiple primary cutaneous melanomas" that occurred within a time frame of three months or less were included. Exclusion criteria included non-cutaneous melanomas and cases without specific time intervals or those occurring beyond a three-month period. Data including patient age, sex, risk factors, cutaneous melanoma (CM) anatomic location, CM clinicohistologic features, and prognosis were extracted from relevant articles.
Nineteen case reports/series documenting 22 patients with multiple primary melanomas (MPM) occurring within a three-month interval. Overall, 66 melanomas were diagnosed, with an average of three (SD±2.1, median: 2) per patient. A majority (63%) of patients had one or more risk factors for skin cancer. Subsequent CM found within three-month interval were thinner than the first found (index) CM, more likely to be melanoma (MMis) and have highest degree of anatomic concordance if the index lesion was first found on the trunk (50%). Two retrospective cohort studies (n=4,703; n=13) of melanomas occurring within three-month interval found similar results.
Limitations to our review included inconsistent reporting in the literature and use of terminology and a limited number of case reports and case series found in the literature.
Synchronous primary cutaneous melanomas are a heterogenous collection of terminologies that may limit the ability of dermatologists to accurately diagnose, prognosticate, and treat high-risk patients. Given lack of guidelines, we recommend the use of the term "synchronous" to delineate additional primary cutaneous melanomas found within a three-month interval.
关于同步性黑色素瘤的命名及预后意义，目前几乎没有共识。在此，我们报告一例同步性皮肤黑色素瘤病例，并对文献中类似病例进行系统综述。
检索PubMed和EMBASE数据库，查找从数据库建立至2023年发表的相关英文文章。纳入在三个月或更短时间内发生的“多发性原发性皮肤黑色素瘤”病例。排除标准包括非皮肤黑色素瘤以及无特定时间间隔或发生时间超过三个月的病例。从相关文章中提取患者年龄、性别、危险因素、皮肤黑色素瘤（CM）的解剖位置、CM临床组织学特征及预后等数据。
19篇病例报告/系列研究记录了22例在三个月内发生多发性原发性黑色素瘤（MPM）的患者。总体而言，共诊断出66例黑色素瘤，平均每位患者3例（标准差±2.1，中位数：2例）。大多数（63%）患者有一项或多项皮肤癌危险因素。在三个月内发现的后续CM比首次发现的（索引）CM更薄，如果索引病变首次发现于躯干，则后续CM更可能为黑色素瘤（MMis）且解剖一致性程度最高（50%）。两项关于在三个月内发生的黑色素瘤的回顾性队列研究（n = 4703；n = 13）也得到了类似结果。
我们综述的局限性包括文献报告不一致、术语使用不统一，以及文献中发现的病例报告和病例系列数量有限。
同步性原发性皮肤黑色素瘤是一组异质性术语，可能会限制皮肤科医生对高危患者进行准确诊断、预后评估和治疗的能力。鉴于缺乏相关指南，我们建议使用“同步性”一词来描述在三个月内发现的额外原发性皮肤黑色素瘤。
