Cutaneous Melanoma : Histological and Clinical Characteristics in a Lebanese Series of 146 Cases of Cutaneous Melanoma.
Introduction: Cutaneous melanoma is one of the rarer skin cancer types, but the one with the highest mortality rate. Objectives: To try to determine the characteristics of cutaneous melanoma in Lebanon (site of predilection, histological types, affected age group…) since no recent available study in Lebanon has addressed these questions. Methods: A case series of all cutaneous melanoma cases diagnosed between January 1st 2000 and December 31st 2008 at the National Institute of Pathology and the Pathology Department at the Notre Dame Des Secours University Hospital. A questionnaire was used and histological information from pathology reports was gathered along with clinical characteristics when available. The size of the sample was 146 patients. Results: The mean age at diagnosis was 53.2 years. 79.4% had white complexion and 63.6% had reported sun exposure. The predominant site lesion was the head and neck region and the predominant histological type was Superficial Spreading Melanoma. Most lesions were discovered at an advanced stage with high mean Breslow score of 3.1mm, ulceration present in 69.4% and predominantly a Clark’s Level IV (41%). Only 45 (30.8%) patients had documented follow up with a mean of 3.1 years. 75% developed metastases after a mean of 1.6 year from diagnosis and 45% died from their disease after a mean of 2 years from diagnosis. The mortality was higher in patients younger than 50 years, Breslow score >1mm, with head and neck lesions (p=0.03) and those with metastases at diagnosis (p=0.013). Sentinel lymph node resection was performed in 5 patients only. Conclusion: The small size of the sample along with the difficulty to obtain all required data on patients prevented us from establishing significant associations. Most lesions however are discovered at an advanced local stage mostly, and less commonly at a metastatic stage. Awareness campaigns are a must in our country that has high levels of natural sunlight, thus increased risk for cutaneous melanoma.
Abi Hatem, Nathalie
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