{"id":63,"date":"2014-03-10T13:27:15","date_gmt":"2014-03-10T18:27:15","guid":{"rendered":"https:\/\/deltadermpath.com\/?page_id=63"},"modified":"2014-05-06T10:11:50","modified_gmt":"2014-05-06T15:11:50","slug":"a-pigmented-nodule-with-bleeding","status":"publish","type":"page","link":"https:\/\/deltadermpath.com\/?page_id=63","title":{"rendered":"A Pigmented Nodule with Bleeding"},"content":{"rendered":"<p><a title=\"Case Reports\" href=\"https:\/\/deltadermpath.com\/index.php\/case-reports\/\"><span style=\"color: #3366ff;\">&lt;&lt; Back<\/span><\/a><\/p>\n<p>The patient is a 47 year old woman who complains of a nodule on the buttock growing for the last year and bleeding for the last 2 weeks.\u00a0 Examination shows a 1.8 cm lesion with variable pigmentation, an irregular border, and a raised ulcerated nodular component measuring approximately 1.0 cm.\u00a0 An excisional biopsy was performed.<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" alt=\"\" src=\"https:\/\/deltadermpath.com\/wp-content\/uploads\/2014\/03\/S0948005-Low-Power.jpg\" width=\"500\" height=\"375\" \/><\/p>\n<p><img loading=\"lazy\" decoding=\"async\" alt=\"\" src=\"https:\/\/deltadermpath.com\/wp-content\/uploads\/2014\/03\/S0948005-Shotgunning.jpg\" width=\"500\" height=\"375\" \/><\/p>\n<p><img loading=\"lazy\" decoding=\"async\" alt=\"\" src=\"https:\/\/deltadermpath.com\/wp-content\/uploads\/2014\/03\/S0948005-Mitoses.jpg\" width=\"500\" height=\"375\" \/><\/p>\n<p><strong>Diagnosis:\u00a0\u00a0<\/strong>Malignant melanoma.<\/p>\n<p><strong>Microscopic Description:\u00a0\u00a0<\/strong>Sections stained with the H&amp;E stain show nests of atypical melanocytes present along the junction and in the dermis.\u00a0 Pagetoid spread of individual melanocytes is present in the epidermis.\u00a0 Numerous mitotic figures are visible in the dermal component of the lesion.<\/p>\n<p><strong>Discussion:\u00a0\u00a0<\/strong>The lifetime incidence of melanoma has increased in the USA over the last 50 years from approximately 1 in 600 to &gt;1 in 50 individuals.\u00a0 Over 123,000 new cases were diagnosesd in 2011 in the USA, the number increasing yearly.\u00a0 Over 8,790 deaths from melanoma were recorded\u00a0in the USA in 2011.\u00a0 Malignant melanoma is the most common form of cancer in\u00a0patients 25-29 years old and the second most common cancer in patients 15-29 years old.<\/p>\n<p>At the time of diagnosis, the presence of lymph node metastases is the most important clinical piece of prognostic information.\u00a0 Five year survival is 98% if treated before spreading to lymph nodes but drops to 16% if distant nodes or other metastases are present.\u00a0 The most important histologic prognostic factor is the thickness of the tumor at the time of diagnosis (Breslow thickness).<\/p>\n<p><strong>References:<\/strong>\u00a0\u00a0\u00a0Breslow A.\u00a0 Thickness, cross-sectional areas and depth of invasion in the prognosis of cutaneous melanoma.\u00a0 Ann Surg1970; 172:902-908.<\/p>\n<p>Balch CM, et al.\u00a0 Prognostic factors analysis of 17,600 melanoma patients: validation of the American Joint Committee on Cancer melanoma staging system. J ClinOncol, 2001; 19:3622-3634.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>&lt;&lt; Back The patient is a 47 year old woman who complains of a nodule on the buttock growing for the last year and bleeding for the last 2 weeks.\u00a0 Examination shows a 1.8 cm lesion with variable pigmentation, an irregular border, and a raised ulcerated nodular component measuring approximately 1.0 cm.\u00a0 An excisional biopsy [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":33,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-63","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/deltadermpath.com\/index.php?rest_route=\/wp\/v2\/pages\/63","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/deltadermpath.com\/index.php?rest_route=\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/deltadermpath.com\/index.php?rest_route=\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/deltadermpath.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/deltadermpath.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=63"}],"version-history":[{"count":3,"href":"https:\/\/deltadermpath.com\/index.php?rest_route=\/wp\/v2\/pages\/63\/revisions"}],"predecessor-version":[{"id":135,"href":"https:\/\/deltadermpath.com\/index.php?rest_route=\/wp\/v2\/pages\/63\/revisions\/135"}],"up":[{"embeddable":true,"href":"https:\/\/deltadermpath.com\/index.php?rest_route=\/wp\/v2\/pages\/33"}],"wp:attachment":[{"href":"https:\/\/deltadermpath.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=63"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}