Nodular melanoma: what it looks like, predictions

Today, various neoplasms affecting the skin are increasingly common. At the same time, about 4-10% of them are malignant tumors. They hit with the same frequency of people of different sexes. In most cases, the tumor is not formed spontaneously. A number of conditions precede its formation, and it is formed gradually, passing through a series of stages. The cancerous process develops evenly, creating an unfavorable background. If there are certain factors, it turns into an independent disease - cancer. These tumors include nodular melanoma. A characteristic feature of this tumor is the ability for unlimited growth.

[1], [2], [3], [4], [5], [6], [7]

Epidemiology

Statistics show that about 2-3 times more often, melanoma is found in persons of mature age, which can be explained by the fact that immunity is significantly reduced, and loses the ability to eliminate genetically alien material, which become transformed cells for the body. The risk of genetic mutations is also significantly increased, with the result that the normal functioning of the gene responsible for cell apoptosis may be disrupted. A certain contribution is made by changes in hormonal background, increased viral load, an increase in the number of carcinogenic, potentially oncogenic viruses, which trigger the processes of cell degeneration.

Most often, melanoma affects fair-haired women, as well as people with fair skin and blue eyes. There is no exact explanation for this phenomenon, but perhaps this is due to the genetic predisposition, and the greater susceptibility of light skin to solar radiation, other types of radiation. Light skin is more susceptible to lesions, and the least protected from the effects of external environmental factors.

[8], [9], [10], [11], [12], [13], [14]

Causes of the nodular melanoma

To date, the causes of the formation of nodular melanoma has not yet been established. Presumably, melanoma develops from a normal mole (nevus), which undergoes a malignant transformation. A number of factors can trigger the process of malignancy, including injury, mechanical, chemical damage. Self-medication, cauterization, cuts, rupture of spots can lead to the rebirth of any growths in a malignant neoplasm. Also, this includes excessive insolation, the impact of a number of irritants, hormonal disorders, a decrease in the immune system.

[15], [16], [17]

Risk factors

At risk are people who are exposed to adverse factors such as physical and mechanical effects on the skin, the effects of toxic fumes, working with chemicals reagents, vapors deposited on the skin. Risk factors include prolonged exposure to sunlight, exposure to various types of radiation (X-ray, ultraviolet, infrared radiation). Some chemicals, and even substandard cosmetics, can cause malignancy (malignant cell transformation). It also includes people with reduced immunity, with various hormonal disorders, with hidden pathologies, chronic diseases. An important factor is the genetic predisposition.

[18], [19], [20], [21]

Pathogenesis

The basis of pathogenesis is malignant cell degeneration. They undergo malignancy - transformation. As shown by the results of recent studies, cell death is determined by the genes that program apoptosis - cell death. With malignant tumors, the cell loses its ability to die, and, in fact, is a cell that has reached immortality. Thus, a characteristic feature of a malignant tumor is unlimited growth.

[22], [23], [24], [25], [26], [27], [28], [29], [30], [31]

Symptoms of the nodular melanoma

The main symptom - skin tumors of various sizes, which begin to grow rapidly. In the initial stages, the value ranges from a pinhead to the size of a large coin. Mostly they are localized on the upper layer of the skin - the epidermis. But some are found in other layers - the dermis, the subcutaneous tissue (keratome, dermatoepithelioma). They may be flat or sublime. But a characteristic feature and an unfavorable prognostic sign is the moment when they begin to grow quite quickly, to multiply. Often growths are the only form of manifestation of this disease. As the state progresses, regional lymph nodes are affected, then internal organs (metastases are formed).

The first sign of melanoma is the formation of moles (nevi), their sharp increase in size, as well as the multiplicity of manifestations. Also of concern is the fact that the tumor spreads and affects other areas. In particular, pain and swelling of the lymph nodes, is an unfavorable prognostic factor that may indicate the development of a malignant process.

Nodular non-pigmented melanoma in the eyelid

The appearance of nodular non-pigmented melanoma on the eyelid of the eye is most often associated with dissemination of the primary focus. It is usually fairly easy to recognize visually, but to confirm the diagnosis, it may be necessary to use a radiometric method that accurately recognizes the malignancy of the process.

Nodular melanoma of the skin

For recognition of the pathological process and setting a differential diagnosis, cytological studies are taken. But there is one caveat - cytology can be performed only if there is ulceration on the surface of the skin, or the affected surface, from which a smear is taken. Further, the features of the structure and growth of cells are investigated.

How fast does melanoma grow?

It is impossible to unequivocally answer the question of how fast the melanoma will grow. This process is individual for everyone, since it depends on a number of factors, including genetic characteristics, the immunological status of a person, viral, bacterial load, hormones, the age of a person. Histological studies will help answer this question, in which they take a piece of tissue (melanoma), produce a culture on nutrient media. By the nature and rate of growth of cells, and then the tissues on the medium, you can predict the growth rate.

Stages

There are three stages of melanoma growth. At the initial stage, skin malignancy occurs, that is, the cells are reborn, transformed and give rise to malignant growth. At this stage, the treatment will be as effective as possible. This manifests itself as the initial stage of growth, when the mole acquires an enlarged size, begins to grow and multiply.

In the second stage, progressive rapid tumor growth occurs. It increases dramatically in size. At these stages, the condition may deteriorate sharply. The size of the tumor increases, an increase in the lymph nodes is also observed, their pain is manifested. It is worth noting that at this stage treatment can be effective, but you need to act.

The third stage is the hardest, neglected stage.

At this stage, the person usually experiences pain, and the condition worsens markedly. Cancer affects the biochemical parameters of blood. The forecast is serious. Death is not excluded.

At the initial stage of development of melanoma, it is a standard mole (nevus), which gradually increases in size. But in it pathological processes already proceed. In particular, cells undergo malignancy and undergo malignant transformations.

The most famous scale, which determine the severity of the condition, is the Clarke scale, in accordance with which there are 3 degrees of severity of the pathological process.

[32], [33], [34], [35]

Forms

There are several types of melanoma, depending on the characteristics of the classification. So, nodular melanoma is pigmented and non-pigmented. Separately distinguish the horizontal form of melanoma, as well as epithelial cell form.

• Nodular non-pigmented melanoma

It occurs in about 30% of patients with malignant tumors of the skin. Quite often occurs in patients with AIDS, other immunodeficiency states. It is worth noting that the decrease in immunity and hormonal imbalance are the main predisposing factors contributing to the development of the malignant process.

• Nodular pigmented melanoma

By nodular pigmented melanoma is meant a malignant process in which malignant degeneration of cells occurs. The pathological process involves melanocytes that synthesize pigment. If the function of melanocytes is not impaired, and they do not stop the synthesis of pigments, the melanoma retains pigmentation.

• Horizontal nodular melanoma

With the horizontal form of nodular melanoma, the distinguishing feature is that it spreads quite quickly, tends to expand.

• Nodular nonpigmental melanoma epitheliocellular

First of all, melanocytes are involved in the pathological process - cells that normally produce melanin pigment. When the function of melanocytes is impaired, they cease to synthesize pigment, which contributes to the development of nodular pigmentless melanoma.

[36], [37], [38]

Complications and consequences

First of all, it is worth noting such complications as metastasis, relapse, and death.

• Relapse

With surgical removal of nodular melanoma, a relapse may develop over time.

• Ulcerations

Melanoma has the ability to spread (dissemination): first, in the neighboring areas in the form of satellite nodules, then in the regional lymph nodes, in later periods it gives metastases to the internal organs. Early ulceration of nodular melanoma is considered as an unfavorable prognostic factor. The malignancy of the process increases dramatically with the trauma of the tumor.

[39], [40], [41], [42]

Diagnostics of the nodular melanoma

Differential diagnosis is important, which allows to distinguish one type of wart from another, as well as to identify the exact species and generic name of the virus that caused the development of pathology.

[43], [44], [45], [46],

Analyzes

The main method of confirming a diagnosis is to confirm the presence of malignant degeneration (malignancy), which can only be achieved after passing the appropriate tests. The only accurate method is histological examination, the essence of which is to take a piece of tissue for analysis (biopsy). Then, it is sown on special nutrient media, and the growth pattern determines whether the tumor is benign or malignant. Also, the analysis for tumor markers is a direct confirmation of the presence or absence of a malignant neoplasm. There are a number of factors in a person’s blood that appear only if a cancer develops in the body and that are not normally diagnosed. By the nature and number of these markers judged on the location, severity of the tumor, stage, and so on. A definite clarity in the diagnosis can make and biochemical analysis of blood.

Standard clinical methods are not informative, however, and they are used because they can show a general picture of the pathology. Based on the results, one can indirectly judge the nature of the neoplasm (the malignant process is reflected in blood counts).

If a viral infection is suspected, serological and virological methods are used. Also often used methods such as DNA probing, hybridization, genome sequencing, PCR analysis. These methods allow you to identify not only the virus itself in the blood, but the products of its vital activity and even DNA, or its individual fragments.

Additional methods can serve as a microscopic examination, scraping. Microscopy will help identify the virus itself, or its metabolic products in a smear. When a tumor is ulcerated (melanoma), a smear is taken from its surface. It is important cytology, which allows to investigate cells and identify transformed cells characteristic of a malignant tumor.

[47], [48], [49], [50]

Instrumental diagnostics

The essence of instrumental diagnostics is that the study is carried out with the help of special equipment, tools and instruments. They allow you to visualize the picture of pathology, identify structural and functional changes, predict their effects, the rate of progression.

Differential diagnosis

Differential diagnosis is one of the main stages of the final diagnosis. Allows you to differentiate the symptoms of several pathologies that have similar external manifestations. Most often, it is necessary to differentiate between malignant and benign tumors, since they are very similar in appearance, but differ in many parameters found during the study. In particular, such methods of setting a differential diagnosis include histological examination. During this analysis, the characteristics of the tumor are determined by the nature of growth. Often it is necessary to differentiate various types and forms of warts, nevi, melanomas, keratomas, for example, from papillomas, fibroids, tumors, traumatic scars and other pathologies. It is also important to determine what exactly is the cause of malignant degeneration. This will prevent recurrence in the future, as well as prevent metastasis. For example, if the cause was a virus, then you need to accurately determine the species and generic name of the virus, and carry out appropriate treatment against this virus.

Lentiginous melanoma

Arise several years after the start of chemotherapy for patients with psoriasis. First, lentigious patches appear, then their malignant degeneration occurs, melanomas form. Considered as a complication of chemotherapy, it develops against the background of reduced immunity.

Acralinoplatinous melanoma

It is a tumor that is formed as a result of the malignant transformation of lentigious spots. There can be many reasons for such a transformation, but above all, it is injury to an existing skin growth. In second place is a viral infection (carcinogenic viruses), in third place is a decrease in immunity. Often, these reasons work together.

There are many viruses that can trigger the development of melanoma. In general, HPV (16, 33, 58 type), herpes, varicella-zoster, cytomegalovirus, retroviruses act as triggers (triggering mechanisms). HIV infection has a special role. Malignant degeneration of skin tumors is observed in 56% of AIDS patients. This happens against the background of a sharp immunodeficiency and the inability of the body to resist foreign agents. There are forms that promote the transition of a flat wart or nevus from a passive, flat state to a hanging position and trigger further growth. With age, growths, papillomas and hanging warts may appear on the skin, with a tendency to grow.

Often the cause is a decrease in immunity. Normally, immunity suppresses the activity of viruses, and also destroys all foreign agents, including their own cells, which have undergone malignant degeneration. With reduced immunity, this does not occur. It is also associated with the persistence of viruses that are activated against the background of reduced immunity. Immunity decreases sharply after an illness, in the postoperative period, during pregnancy, during menopause, during adolescence, after a course of antibiotic therapy, and with AIDS. Often, growth is boosted and changes in the shape of growths occur during pregnancy, or some time after birth, which is also associated with a decrease in immunity. A similar phenomenon is observed in the period of menopause, against the background of certain diseases of the immune and endocrine systems, in violation of metabolic processes, biochemistry.

[51]

Basalioma

It is a tumor of the basal layer of the epidermis. It develops in the presence of certain conditions (predisposing factors): reduced immunity, increased reactivity and sensitization, weakness of the body, violation of the biochemical and menstrual cycle, hormonal background.

[52], [53], [54], [55], [56]

Warts

Warts can be located anywhere on the body. Presented by connective tissue. Top covered with stratified epithelium. As a rule, at first they are flat, but over time they can grow, become pendant, multiple. Formed everywhere. In fact, there is no such area where a wart could not form. They are formed even on the mucous membranes.

The axillary region is a zone that is rather prone to the formation of hanging warts (the skin is thin, a rather large number of sweat glands are formed in its surface layer, almost always high humidity due to copious sweat).

Another place where warts are often formed is the groin area. Often, penile warts associated with a sexually transmitted viral infection are formed in the groin. They are transmitted during sexual intercourse. These warts are potentially oncogenic, that is, they provoke the development of malignant neoplasms under certain conditions.

At first glance it may seem that warts are not dangerous, but simply not attractive in appearance, spoil the aesthetic appearance. But this is only part of the consequences, so to speak "the tip of the iceberg." One of the most dangerous consequences is the possibility of malignant degeneration of the wart and the risk of developing a tumor. Special danger is caused by tumors that are located on the internal organs: they can be damaged and cause bleeding. Also a great danger develops during pregnancy, since warts can lead to pregnancy pathologies. There is an increased risk of infection of the child during childbirth.

Various methods are used to remove hanging warts. It can be both traditional medical and radical methods. From radical methods, excision of the wart using surgical methods. Such methods are most effective.

Dysplastic nevus

Under the nevus imply the usual birthmark (pigment) spot. May be congenital or acquired. By dysplastic nevus, an expanding, malignantly transformed spot is meant. This is facilitated by a decrease in immunity, as well as hormonal changes, viral infections, and dysbacteriosis.

[57], [58], [59], [60], [61], [62], [63]

Keratoma

This is a malignant tumor, localized in the deeper layers of the skin. Most often develops in people with reduced immunity, with senile, age-related changes in the body. Frequently ill people, those who are in contact with people with warts and pigment spots, are at risk. More at risk are people exposed to frequent stress, chronic illness, malnutrition, with impaired work and rest.

Angiokeratoma

They are vascular tumors localized in epithelial tissue. Formed mainly on the neck. Can quite rise above the surface (on the leg).

[64], [65], [66], [67], [68], [69], [70]

Dermatofibroma

It is a benign skin tumor with a high risk of malignant degeneration. People with this diagnosis should constantly monitor the condition, be observed by an oncologist (to prevent malignant degeneration of the tumor). At risk are people who are carriers of carcinogenic viruses. This is, first of all, the herpes virus, papillomas, retroviruses, and others. This also includes people with reduced immunity, with impaired or altered hormonal levels, often ill people, patients with chronic pathologies, immunodeficiencies, and AIDS. There are certain life stages in which the risk of malignant degeneration increases dramatically - adolescence, adolescence, pregnancy, lactation, menopause, old age. People of old age are especially at risk, because in their bodies metabolic processes and hormones are often disturbed.

[71], [72], [73], [74], [75]

Lentigo

It is a malignant reborn pigment spot. Requires removal. Rarely used drug treatment. But it is often ineffective. High immunity will help improve the condition and prevent malignant degeneration. To do this, it is recommended to take immunostimulating agents, vitamins. You should regularly consult with an immunologist, oncologist. You can also try some alternative means that have immunostimulating, antiviral properties.

Recipe number 1.

In a common alcohol (500 ml) add a tablespoon of dandelion roots, tubers, orchid grass, greater celandine grass, comfrey roots, and parsnip herb. Drink a tablespoon twice a day.

Recipe number 2.

To prepare, take a tablespoon of peony roots evading, buds and pine needles of Siberian fir, grass moss claviform, blueberry leaves, flowers and fruits cherry. All this insist at least 3-4 days, drink a tablespoon 2-3 times a day.

Recipe number 3.

The plantain leaves are taken in equal shares, the leaves of wormwood, the male rhizome of the fern, the grass are threefold, horseradish roots, pour 500 ml of alcohol. Drink a third cup per day.

Recipe number 4.

As a basis take vodka or pure alcohol. Then add approximately one tablespoon of the following components: motherwort grass, fragrant chamomile baskets, forest pine needles, bog creeper grass, creeping thyme herb. Stir, then set aside and provide an opportunity to insist. Drink a tablespoon 3-4 times a day.

Recipe number 5.

In a common alcohol (500 ml) add a tablespoon of violet tricolor, horsetail. Drink a tablespoon twice a day.

Treatment of the nodular melanoma

Independently you should not attempt to remove melanoma, it is fraught with dissemination and the development of a malignant process (metastasis). In addition, special equipment and tools are required, it is necessary to create sterile conditions, it is important to know the removal technique accurately. Improper removal, damage can result in multiple metastases, including internal organs. It is worth noting that not less dangerous and incomplete excision of the tissue, since then new tumors develop from it, metastasis occurs.

From drug therapy, drugs are mainly used for internal administration (antibiotics, anticancer, antivirals, immunomodulators). Various antineoplastic ointments for topical administration have proven themselves quite well, but they have serious side effects.

From radical methods, excision using surgical methods, laser removal, and burning in various ways are used.

Surgery

Surgical treatment is resorted to if the tumor begins to grow, and the analysis confirms the malignant process. It is necessary that the operation was done by an experienced oncologist, since the tumor can in no way be damaged, and even a small piece of tissue should not be left. Otherwise, metastasis will begin, relapses will begin. First, metastases affect the nearest lymph nodes, and then they can go to the internal organs. Be sure to remove if a tumor reaches a sufficiently large size, or if it is in the lumen of the internal organs, and there is a risk of blockage. The main method is mechanical excision. Also used laser removal, cryosurgery.

Prevention

The basis of prevention lies primarily in improving immunity, the elimination of viral load, the normalization of microflora. It is important to monitor the state of all neoplasms on the skin - nevi, rhodium, warts, papillomas. It should be periodically consulted by an immunologist, oncologist. If necessary, should be tested for viruses, latent infection, oncomer. At the slightest suspicion of malignant degeneration of the neoplasm, it is necessary to conduct a histological examination of the sample, which will help to determine the nature of the tumor. Make a prediction, choose an adequate treatment. A prerequisite is proper nutrition, fortification of the body, a healthy lifestyle. It is necessary to observe the day regimen, do not overcool, avoid stress. Do not allow injury, damage to skin growths, spots. It is necessary to avoid exposure to ultraviolet radiation, chemical reagents, radiation.

[76], [77], [78], [79]

Forecast

In most cases, with proper and timely treatment, the prognosis will be favorable. Nodular melanoma is  successfully removed by surgical methods. If everything is done correctly, in a timely manner, and in the future to follow all the recommendations of the doctor, to be observed by the oncologist, everything will end well. Otherwise, relapses, metastases may occur, and all will end in death.

[80], [81], [82]