Cardiac Involvement in melanoma - Essay Example

Malignant Melanoma Malignant Melanoma is the malignant tumor that occurs in melanocytes, the pigment producing cells, which are found predominantly in skin as well as in eyes, ears, bowels. When these melanocytes are damaged in one way or other, the cells display an uncontrolled proliferation, changing the shape and color of the existing moles. When the moles or the lesions begin to itch and ulcerate, it can be termed as Melanoma. Melanoma will become life-threatening, when the outer skin lesions starts to grow deeper into the skin and beyond, reaching the blood as well as the lymphatic vessels, thereby affecting the whole body.

As it mainly affects the skin, it causes majority of skin cancer related deaths worldwide. At present, it is the sixth most common cancer in the United States, with the current lifetime risk for developing invasive melanoma is 1 case per 60 Americans, a 2000% increase since 1930. (Swetter, 2010). Cause of the disorder Melanoma is caused when the melanocytes are constantly exposed to sunlight, paving the way for Ultra-violet photons to strike the chromophore, a part of melanocyte. So, exposure to UV radiation clearly plays a role in melanoma.

As people with history of sunburns, especially blistering sunburns during childhood or in teenage, are likely to show an augmented risk of developing melanoma. (aad.org). Another widely accepted caustic factor is genetics, with familial melanoma occurring mainly due to the chromosomes 1p, 9p and 12q. Having two or more close relatives who have had this disease is a risk factor. (medicinenet.com). Symptoms The symptoms of Melanoma, as mentioned above, are any changes in the shape and color of the existing moles and also any new lump or lesions on the skin.

The early symptoms of melanoma can be summarized by the mnemonic, “ABCD”. ‘A’ stands for Asymmetry and it means one half difference between the abnormal area and the other half. When the mole or lesion or growth has irregular edges, it constitutes Border. Another important symptom is, there will be color changes from one area to another, with shades of tan, brown, or black. (nlm.nih.gov). Finally, D stands for Diameter, with the affected area usually (but not always) larger than 6 mm in diameter. (nlm.nih.gov) Diagnosis Diagnosis will be mainly done by the dermatologist, starting with visual examination.

If this visual examination raises doubts, the dermatologist will go for biopsy. This is the only way to know with certainty if the lesion is melanoma or another type of skin cancer. (aad.org). During biopsy, the entire or a portion of the lesion is removed, and then it is examined under a microscope. If the melanoma cells are seen through the microscope, then the diagnosis is melanoma. In certain cases, Sentinel Lymph Node (SLN) biopsy will also be performed to find whether melanoma has affected the Lymphatic vessels, and has chances of spreading. (aad.org).

Treatment There are number of treatment options available to treat melanoma, including surgery, chemotherapy, biological and radiation therapy. Surgery is the common form of treatment, with the melanoma cells as well as some normal tissues that surrounds the affected area are removed surgically. If it spreads to the nearby lymph nodes as well, then these nodes may also be removed. (nlm.nih.gov). After the surgery or as part of chemotherapy, cycles of drugs are given. Only if melanoma spreads beyond skin and lymph nodes, the treatment will become more difficult leading to fatalities.

Another treatment options are also practiced like Biological therapy, in which substances called cytokines are given to boost the immune system to fight the cancer cells and radiation therapy, in which high-energy rays are used to kill the cancer cells. Cardiac Involvement in Melanoma It is reported that 64% of the metastatic melanoma cases display cardiac metastases (Glancy, 1968). Although cardiac metastases are infrequent, but they are reported in cases of malignant melanoma. Advances in medical research illustrates that metastatic tumors in pericardium are further widespread than primary tumors.

The occurrence has enhanced in the last decades due to extended endurance of patients with cancer and the increased incidence of the disease in general population. Studies suggest cardiac involvement namely pericarditis, pericardial effusion, congestive heart failure, arrhythmias, embolic events and the rare syncope are associated with the cardiac metastasis (Chrissos, 2008). Advances in technology paves the way for its early diagnosis, these encompass echocardiography, transesophageal approach, CT scan or MRI imaging techniques aid in the early detection of cardiac metastases (Chrissos, 2008).

In one of the cases reported, an individual was operated for malignant skin melanoma, four years later he was diagnosed for cardiac involvement by means of echocardiography. The case was in advanced stage, so chemotherapy could not work for him and he died in 4 months. The incidence suggests that it is essential to suspect a patient for cardiac involvement when he is reported for malignant skin melanoma. Early diagnosis is of much significance so as to procure benefit from recent advances in cancer therapy (Chrissos, 2008).

Echocardiography aids in identifying multiple metastases in the heart concerning the pericardium, the myocardium and the atrium, tumor in the above mentioned case was movable generating tricuspid valve stenosis (Chrissos, 2008). It is difficult to diagnose cardiac melanoma, but early detection has imperative therapeutic and prognostic insinuation. By means of Echocardiography, diagnosis could be made at an early stage to carry out timely treatment care and prevention. References aad.org. Malignant Melanoma.

American Academy of Dermatology. Retrieved on October 30, 2010 from http://www.aad.org/public/publications/pamphlets/sun_malignant.html Chrissos, D.M., Stougiannos, P.N., Mytas, D. Z., Katsaros, A. A., Andrikopoulos, G. k., Kallikazaros, I. E. (2008). Multiple cardiac metastases from a malignant melanoma. Eur J Echocardiogr. 9(3): 391-392. Glancy, D. L., Roberts, W. C. (1968). The heart in malignant melanoma: A study or 70 autopsy cases. Am J Cardiol. 21(4):555-571. medicinenet.com. Melanoma.

Retrieved on October 30, 2010 from http://www.medicinenet.com/melanoma/page3.htm#2whatare nlm.nih.gov. Melanoma. Retrieved on October 30, 2010 from http://www.nlm.nih.gov/medlineplus/ency/article/000850.htm Swetter, S. M. (2010). Malignant Melanoma. Retrieved on October 30, 2010 from http://emedicine.medscape.com/article/1100753-overview