Fast growing melanomas have distinct traits


skin cancerMelanoma skin cancers that are growing rapidly exhibit a number of identifying characteristics. According to Australian researchers, rapidly growing melanomas are thicker, symmetrical, or elevated, have regular borders, and often itch or bleed. They do not fit the ABCD rule for melanoma, which stands for asymmetry, border irregularity, color irregularity, large diameter, the team notes.

"Because of their rapid growth," lead investigator Dr. Wendy Liu told Reuters Health, "there is only a small window of opportunity to capture these melanomas in their early stage of development."

"Rapidly growing melanomas can occur in anyone," she added, "not necessarily those with large numbers of moles and freckles. In fact, they more often occur in those without large numbers of moles and freckles, and elderly men. Morphologically, they are more often red -- rather than brown and black -- symmetrical, elevated and symptomatic."

Liu of the Alfred Hospital in Melbourne and colleagues describe their observations in 404 melanoma skin cancer patients in the medical journal Archives of Dermatology.

One third of the melanomas grew 0.5 mm per month or more. These fast growing tumors tended to be thicker with a faster mitotic rate (the rate at which the cancer cells multiple). As well as being more likely to be symmetrical, symptomatic, and elevated, these lesions were also likely to have regular borders and lack the pigment melanin.

"The current early detection program has done a good job promoting features of the common and less aggressive type of melanomas," continued Liu. "I think now it's time to direct our focus onto the more rapidly growing, biologically aggressive melanomas, which can kill rapidly."

"So any rapidly growing skin lesion," she concluded, "regardless of its morphology and perceived host risk factors for melanoma, deserves prompt medical assessment."

In an accompanying editorial, Dr. Dan Lipsker of Clinique Dermatologique, Strasbourg, France, agrees that much has been done in recognition of slow-growing melanomas, the "challenge in the coming years," he adds, "will be to do the same work for fast-growing tumors."

SOURCE: Archives of Dermatology December 2006.

Copyright © 2007 Reuters Limited


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