Cutaneous Malignant Melanoma After Hodgkin's Disease

doi:10.1059/0003-4819-102-1-37

Cutaneous Malignant Melanoma After Hodgkin's Disease

Bethesda, Maryland; Palo Alto and Stanford, California; and Philadelphia, Pennsylvania

Abstract

Eight cutaneous malignant melanomas occurred in 6 of 1405 patients with Hodgkin's disease, although the expected incidence rate was 0.77 (relative risk, 8; 95% confidence interval, 3 to 17). One melanoma was a thin, level II lesion less than 0.76 mm thick; the rest were mostly bulky, deeply invasive lesions despite close clinical surveillance. The melanomas spread aggressively; 3 of 6 patients died within 1 to 3 years. Two of the six patients developed a second primary malignant melanoma 1 year after the first. Two of six patients had biopsy-proven dysplastic nevus syndrome, a known precursor to cutaneous malignant melanoma, and an additional 3 patients had clinical evidence of dysplastic nevus syndrome. Histologically, the malignant melanomas showed a sparse inflammatory infiltrate, an abnormal host response seen previously in cutaneous melanomas developing in immunosuppressed patients. Dysplastic nevi may identify patients at highest risk who require modified medical management.

Article and Author Information

▸From the Family Studies Section, Environmental Epidemiology Branch, Division of Cancer Etiology, National Cancer Institute, National Institutes of Health, Bethesda, Maryland; the Division of Oncology, Department of Medicine, Stanford University Medical School, Palo Alto Veterans Administration Medical Center, Palo Alto, California; the Division of Oncology, Department of Medicine, and the Division of Radiation Therapy, Department of Radiology, Stanford University Medical Center, Stanford, California; and the Pigmented Lesion Study Group, Departments of Dermatology and Pathology, and the Cancer Center, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania.
Grant support: in part by research grants CA 05838 and CA 34233 from the National Institutes of Health.
▸Requests for reprints should be addressed to Margaret A. Tucker, M.D.; Environmental Epidemiology Branch, National Cancer Institute, Landow Building, Room 3C-19, 7910 Woodmont Avenue; Bethesda, MD 20205.