Malignant Melanomas of the Skin Arising on the Feet

Česká verzia

Authors: Bartoš Vladimír ¹; Kullová Milada ²
Authors place of work: Oddelenie patologickej anatómie FNsP Žilina ¹; Dermatovenerologický stacionár FNsP Žilina ²
Published in the journal: Klin Onkol 2018; 31(4): 289-292
Category: Case Report
doi: https://doi.org/10.14735/amko2018289

Summary

Background:

Cutaneous melanoma frequently develops on the lower limbs, but rarely on the feet, in people with light skin. By contrast, the feet are one of the most frequently affected sites in people with dark skin. This study assessed the prevalence and clinico-pathological findings of biopsy-proven skin melanomas that were diagnosed over 11 years.

Materials and methods:

The study group comprised 217 primary melanomas from 210 patients.

Results:

Eight (3.7%) melanomas were located on the feet. These were all invasive and obtained from 8 patients (5 females and 3 males) aged 56–85 years (mean age 72 years). In general, the lesions were large (mean diameter 3.5 cm) and had a high Breslow index (mean thickness 5.6 mm). They were all ulcerated, and some invaded deep into the subcutaneous tissue. Histologic analyses demonstrated that three tumors exhibited features of acral lentiginous melanoma, two were nodular melanomas, and one was a superficial spreading melanoma. Two cases could not be histologically classified.

Conclusion:

Although skin melanomas arising on the feet are relatively rare in our ethnicity, they are usually bioptically diagnosed at an advanced stage. Such melanomas may initially imitate other pathologic entities. Therefore, this location should not be overlooked during the medical workup, and melanoma should be suspected when patients present with non-healing defects or local pigmented changes on the soles of the feet or toes.

Key words:

malignant melanoma – anatomic distribution – foot

The authors declare they have no potential confl icts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers.

Submitted: 9. 2. 2018

Accepted: 16. 5. 2018

Zdroje

1. Ryška A, Horký O, Berkovcová J et al. Maligní melanom – od klasické histologie k molekulárně genetickému testování. Klin Onkol 2017; 30 (3): 182–189. doi: 10.14735/amko2017182.

2. Jurga Ľ, Dienerová M, Haruštiaková M et al. Atypická primárna lokalizácia a priebeh malígneho melanómu. Klin Onkol 2000; 13 (3): 96–97.

3. Bulliar JL, De Weck D, Fisch T et al. Detailed site distribution of melanoma and sunlight exposure: aetiological patterns from a Swiss series. Ann Oncol 2007; 18 (4): 789–794. doi: 10.1093/annonc/mdl490.

4. Elwood JM, Gallagher RP. Body site distribution of cutaneous malignant melanoma in relationship to patterns of sun exposure. Int J Cancer 1998; 78 (3): 276–280. doi: 10.1002/ (SICI) 1097-0215 (19981029) 78: 3<76:: AID-IJC2>3.0.CO; 2-S.

5. Cubitt JJ, Khan AA, Royston E et al. Melanoma in Buckinghamshire: data from the inception of the skin cancer multidisciplinary team. J Skin Cancer 2013; 2013: 843282. doi: 10.1155/2013/843282.

6. Mufti ST. Pattern of cutaneous melanoma at King Abdulaziz University Hospital, Jeddah, Saudi Arabia. Pak J Med Sci 2012; 28 (1): 154–157.

7. Nam KW, Bae YC, Nam SB et al. Characteristics and treatment of cutaneous melanoma of the foot. Arch Plast Surg 2016; 43 (1): 59–65. doi: 10.5999/aps.2016.43.1.59.

8. Kukita A, Ishihara K. Clinical features and distribution of malignant melanoma and pigmented nevi on the soles of the feet in Japan. J Invest Dermatol 1989; 92 (Suppl 5): 210S–213S.

9. Samaila MO, Rafindadi AH. Pattern of cutaneous malignant melanoma in Zaria, Nigeria. Ann African Med 2006; 5 (1): 16–19.

10. Green A, MacLennan R, Youl P et al. Site distribution of cutaneous melanoma in Queensland. Int J Cancer 1993; 53 (2): 232–236.

11. Liburd CG, Gibson TN, Hanchard B et al. Cutaneous malignant melanoma in Jamaika, 1958 to 2007. West Indian Med J 2014; 63 (7): 717–720. doi: 10.7727/wimj.2013.265.

12. Zemelman V, Roa J, Tagle SR et al. Malignant melanoma in Chile: an unusual distribution of primary sites in men from low socioeconomic strata. Clin Exp Dermatol 2006; 31 (3): 335–338. doi: 10.1111/j.1365-2230.2005.02038.x.

13. Juzeniene A, Baturaite Z, Moan J. Sun exposure and melanomas on sun-shielded and sun-exposed body areas. In: Reichrath J (eds). Sunlight, vitamin D and skin cancer. Second ed. USA: Landes Bioscience and Springer Science+Business Media 2014: 375–389.

14. Sanlorenzo M, Osella-Abate S, Ribero S et al. Melanoma of the lower extremities: foot site is an independent risk factor for clinical outcome. Int J Dermatol 2015; 54 (9): 1023–1029. doi: 10.1111/ijd.12730.

15. Walsh SM, Fisher SG, Sage RA. Survival of patients with primary pedal melanoma. J Foot Ankle Surg 2003; 42 (4): 193–198. doi: 10.1053/jfas.2003.50044.

16. Sondermann W, Zimmer L, Schadendorf D et al. Initial misdiagnosis of melanoma located on the foot is associated with poorer prognosis. Medicine (Baltimore) 2016; 95 (29): e4332. doi: 10.1097/MD.0000000000004332.

17. Bristow I, Bower C. Melanoma of the foot. Clin Podiatr Med Surg 2016; 33 (3): 409–422. doi: 10.1016/j.cpm.2016.02.008.