The diagnosis of melanoma involves the visually recognition of this characteristic tumor first. Here are melanoma pictures (thanks to www.ariyan.com for this link). Most of the tumors are located on the skin, so it is easy for a dermatologist to diagnose it. The average family doctor may not see enough cases and may be mis-diagnosing this tumor, which could be devastating. However, if the family doctor errs on the cautious side and removes all suspicious lesions and sends them to the pathologist for analysis, then there is a good probability that nothing is missed and the diagnosis is made accurately.
How is melanoma diagnosed?
The definite test for melanoma is a SKIN BIOPSY
to get a HISTOLOGICAL DIAGNOSIS.
There is a very small percentage of melanomas that occur on the mucosa of the oral cavity, in the genital region (genital mole), in rectal mucosa (rectal melanoma), in the bowel wall, in the lung (lung melanoma) and in the brain (melanoma of the brain). Tests are being developed where a monoclonal antibody against a group melanoma antigen is being tested as a simple blood test to screen for these hidden melanomas. It could be a few years before this is specific and sensitive enough and also affordable to be used as a mass screening test. Right now it is still in the research stages.
Without a skin biopsy the diagnosis can not be established. The treating physician needs to know whether it is melanoma and then, if it is, which of the four types it is. The pathologist’s report will tell the doctor what stage the tumor is in. This will determine whether or not any further therapy is necessary. After removal of the melanoma the histology will be done, which is the final word on what stage the tumor was in. There is no room for mistakes, so physicians have built in safeguards to verify the extent of the tumor.
1. Cancer: Principles &Practice of Oncology, 4th edition, by V.T. De Vita,Jr.,et. al J.B. LippincottCo.,Philadelphia, 1993.Vol.2: Chapter on Cutaneous melanoma.
2. The Merck Manual, 7th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999. Chapter 126, p. 843-845.
3. Cancer: Principles&Practice of Oncology. 5th edition, volume 2. Edited by Vincent T. DeVita, Jr. et al. Lippincott-Raven Publ., Philadelphia,PA, 1997. Chapter on Cutaneous melanoma.
4. SA Rosenberg et al. Ann Surg 1998 Sep 228(3): 307-319.
5. SA Rosenberg Nature 2001 May 17;411(6835):380-384.
6. T Todo et al. Proc Natl Acad Sci U S A 2001 May 15 ( page not available yet).
7. GJ Tsioulias et al. Ann Surg Oncol 2001 Apr;8(3):198-203.
8. Conn’s Current Therapy 2004, 56th ed., Copyright © 2004 Elsevier
9. Ferri: Ferri’s Clinical Advisor: Instant Diagnosis and Treatment, 2004 ed., Copyright © 2004 Mosby, Inc