Multiple primary melanomas versus single melanoma of head and neck: A comparison of genetic, diagnostic and therapeutic implications.

Single primary and multiple primary melanomas of the head and neck region may be confused at first glance because of the common clinical and dermoscopic patterns. An inaccurate diagnosis may lead the clinician to a wrong diagnostic and therapeutic pathway because multiple primary melanomas occurring in familial or sporadic settings are often involved in individual cancer susceptibility. We investigated clinical, demographic, histological and survival differences between multiple primary melanomas and single melanoma occurring in head and neck region. A retrospective analysis of medical and histologic records from 217 melanomas of head and neck region was performed.Malignant neoplasms affecting MPMs patients were also reported. Mutational analysis of specific genes was performed when clinical data and family history were suggestive for familial/hereditary setting. Two hundred five out of 217 patients (94.5%) were affected by single primary melanoma (SPM) and 12 (5.5%) by multiple primary melanomas (MPMs) of the head and neck region. Individuals affected by MPMs were distinguished by a significantly higher mutation frequency and a higher prevalence of malignant neoplasms such as renal cancer. Genetic testing revealed germline mutations affectingMITF E318K, CDKN2A genes. Our data highlight the importance of strict cancer surveillance in individuals with MPMs and the role of appropriate genetic counseling and testing in selected patients. Finally, personalized clinical and inst...
Source: Head and Neck Oncology - Category: Cancer & Oncology Source Type: research