Survival among patients with clinical Stage I cutaneous malignant melanoma diagnosed in Western Australia in 1975/1976 and 1980/1981

Article Abstract:

The rate of malignant melanoma is increasing in most developed countries, which is believed to reflect lifestyle changes which result in greater exposure to sunlight. However, the survival rates of patients with this highly malignant form of skin cancer are also increasing, which probably reflects greater awareness of melanoma and consequently earlier diagnosis. Australia is one of the countries experiencing an increase in the incidence of melanoma, and a study was conducted to determine which factors most strongly influence survival. Patients who were diagnosed in the years 1975 and 1976 with melanoma that had not yet spread from the superficial layers of the skin were compared with similar patients diagnosed in 1980 and 1981. The five-year survival rate for the earlier group was 88 percent for men and 91 percent for women. For the later group, the survival rates were 89 percent for men and 95 percent for women. The 10-year survival rates for the earlier group were 82 percent for men and 87 percent for women. This decrease when compared with the five-year survival rates indicates that recurrence and death may occur significantly later than the initial diagnosis, and that even patients who have survived for five years after the diagnosis of melanoma are still at higher risk for recurrence and death. A melanoma has many characteristics, which may include ulceration and level of cell-dividing activity. However, an analysis revealed that the most important prognostic factor for melanoma is the thickness of the tumor itself at the time of diagnosis. It was also found that the melanomas diagnosed in the 1980 to 1981 interval were significantly thinner than those diagnosed in 1975-1976; this difference is most likely responsible for the slight improvement in survival for the later group. This observation suggests that only very minor improvements in the survival of patients with melanoma may be expected in the future unless ways can be found to sharply reduce the number of thicker tumors that are diagnosed. (Consumer Summary produced by Reliance Medical Information, Inc.)

Australia, Patient outcomes, Mortality, Diagnosis, Melanoma, Skin cancer

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Superior vena cava syndrome caused by an intrathoracic plasmacytoma

Article Abstract:

Historically, the development of aneurysms caused by the syphilis organism were one of the most common causes of obstruction of the superior vena cava. Today, the most likely cause of obstruction of this major vein is the growth of a lung cancer. The authors report an unusual case in which symptoms of superior vena cava obstruction were observed in a 61-year-old heavy smoker with a visible mass in the chest on X-ray. Lung cancer was expected as the most likely cause of these symptoms in this male patient; he was ultimately found to have a plasmacytoma. The patient had developed difficulty breathing and produced brown sputum on coughing. Chest X-ray revealed a hilar mass. (The hilum is where the blood vessels and windpipe enter the lungs.) Laboratory evaluation revealed a high level of immunoglobulin G, an indicator that an antibody-secreting tumor rather than a lung cancer might be involved. To conclusively rule out lung cancer, a biopsy was performed. The findings confirmed a plasmacytoma. Plasmacytomas are tumors with mature lymphocytes or plasmacytes. Although similar tumors developing within the bone marrow (myelomas) are common, the extramedullary plasmacytoma is uncommon. It is even less common for a plasmacytoma to develop within the chest, and in no previous case has a plasmacytoma been reported to press against the superior vena cava and cause symptoms of superior vena cava obstruction. Radiation therapy would be the treatment of choice, but the patient in the present case refused radiation. Fortunately, the plasmacytoma responded to chemotherapy. The patient's X-ray findings have improved, as have the levels of immunoglobulin G. (Consumer Summary produced by Reliance Medical Information, Inc.)

Abnormalities, Complications and side effects, Vena cava, Venae cavae, Plasmacytoma

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