WordNet

relating to or characterized by or having nodules; "Nodular vaginitis"
having nodules or occurring in the form of nodules; "nodular ores" (同)nodulated, noduled
any of several malignant neoplasms (usually of the skin) consisting of melanocytes (同)malignant_melanoma

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2016/07/21 18:12:08」(JST)

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Evolution of a 4 mm nodular melanoma.

Nodular melanoma (NM) is the most aggressive form of melanoma. It tends to grow more rapidly in thickness (penetrate the skin) than in diameter. Instead of arising from a pre-existing mole, it may appear in a spot where a lesion did not previously exist . Since NM tends to grow in depth more quickly than it does in width, and can occur in a place that did not have a previous lesion, the prognosis is often worse because it takes longer for a person to be aware of the changes. NM is most often darkly pigmented; however, some NM lesions can be light brown, multicolored or even colorless (non-pigmented). A light-colored or non-pigmented NM lesion may escape detection because the appearance is not alarming, however an ulcerated and/or bleeding lesion is common. ^[1]^:696 Polypoid melanoma is a virulent variant of nodular melanoma.^[1]^:696

The microscopic hallmarks are:

Dome-shaped at low power
Epidermis thin or normal
Dermal nodule of melanocytes with a 'pushing' growth pattern
No "radial growth phase"

Treatment

Therapies for metastatic melanoma include the biologic immunotherapy agents ipilimumab, pembrolizumab, and nivolumab; BRAF inhibitors, such as vemurafenib and dabrafenib; and a MEK inhibitor trametinib.^[2]

References

^ ^a ^b James, William D.; Berger, Timothy G.; et al. (2006). Andrews' Diseases of the Skin: clinical Dermatology. Saunders Elsevier. ISBN 0-7216-2921-0.
^ Maverakis E, Cornelius LA, Bowen GM, Phan T, Patel FB, Fitzmaurice S, He Y, Burrall B, Duong C, Kloxin AM, Sultani H, Wilken R, Martinez SR, Patel F (2015). "Metastatic melanoma - a review of current and future treatment options". Acta Derm Venereol 95 (5): 516–524. doi:10.2340/00015555-2035. PMID 25520039.

External links

Melanoma Education Foundation
Mole Map
BC Cancer Agency
Victoria (Australia) Nodular Melanoma Slides

UpToDate Contents

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1. 黒色腫の病理学的特徴 pathologic characteristics of melanoma
2. Clinical features and diagnosis of cutaneous melanoma
3. 皮膚黒色腫におけるtumor node metastasis（TNM）病期分類法およびその他の予後因子 tumor node metastasis tnm staging system and other prognostic factors in cutaneous melanoma
4. 黒色腫のスクリーニングおよび早期発見 screening and early detection of melanoma
5. ダーモスコピーによる皮膚癌の治療優先順位決定のアルゴリズム dermoscopic algorithms for skin cancer triage

English Journal

Basal cell carcinoma margin delineation: is curettage useful? A surgical and histological study.

Dika E, Fanti PA, Ismaili A, Misciali C, Vaccari S, Barisani A, Patrizi A.SourceDepartment of Specialised, Experimental and Diagnostic Medicine, Dermatology, Sant'Orsola - Malpighi Hospital, University of Bologna , Bologna , Italy.
The Journal of dermatological treatment.J Dermatolog Treat.2013 Jun;24(3):238-42. doi: 10.3109/09546634.2012.756572. Epub 2013 Feb 24.
Basal cell carcinoma (BCC) is the most common variety of non-melanoma skin cancer. Treatment modalities include cryotherapy, topical imiquimod 5% cream, photodynamic therapy, electrodessication and curettage, classic surgical excision, Mohs surgery, and radiotherapy. Surgical treatments are regarded
PMID 23216407

Socioeconomic status as a predictor of melanoma survival in a series of 1083 cases from Brazil: just a marker of health services accessibility?

Quintella Mendes GL, Koifman S.SourceaBrazilian National Cancer Institute-INCA, Cancer Hospital II bOswaldo Cruz Foundation/National School of Public Health (ENSP/FIOCRUZ), Rio de Janeiro, Brazil.
Melanoma research.Melanoma Res.2013 Jun;23(3):199-205. doi: 10.1097/CMR.0b013e32835e76f8.
Melanoma survival is determined by disease-related and patient-related factors; there is a growing body of evidence that other issues may play a role in this disease. In this study, the role of socioeconomic factors in the evolution of melanoma was evaluated. This was a retrospective study with inci
PMID 23442344

Japanese Journal

今月の症例 Rhabdoid型組織像を呈した結節型悪性黒色腫の1例

藤井瑞恵,村上正基,井川哲子
臨床皮膚科 65(12), 932-935, 2011-11
NAID 40019039078

色素法とRI法併用によるセンチネルリンパ節生検を施行した悪性黒色腫44例の解析

柳澤健二,高田知明,肥田時征,米田明弘,廣崎邦紀,小野一郎,山下利春
Skin cancer : official organ of the Japanese Society for Skin Cancer = 皮膚悪性腫瘍研究会機関誌 26(1), 85-88, 2011-05-20
… 転移陽性例のうち，T4症例が7例，組織型ではnodular melanomaが5例であった。 …
NAID 10030441864

Related Pictures

★リンクテーブル★

リンク元	「悪性黒色腫」「NM」「結節型黒色腫」
関連記事	「nodular」

「悪性黒色腫」

Nodular melanoma
Classification and external resources
Specialty	oncology, dermatology
ICD-10	C43 (ILDS C43.L10)
ICD-O	M8721/3
	[edit on Wikidata]

　　[★]

英: malignant melanoma MM
同: メラノーマ melanoma
ラ: melanoma malignum
関: メラニン尿

概念

メラノサイト(神経堤由来)が癌化した悪性腫瘍
色調は多くが黒褐色。紅色調病変もありうる(無色素性黒色腫 amelanotic melanoma)　←　メラニン合成能の喪失
転移能しやすい。予後不良。　→　リンパ行性が最も頻度が高い・・・だっけ？
原発：皮膚。粘膜(口腔、鼻腔)、脈絡膜、脳軟膜、眼もありうる。

悪性黒色腫のABCDE NDE.421

頭文字	特徴
A	Asymmetry	不規則形
B	Borderline irregularity	境界不鮮明
C	Color variegation	色調多彩
D	Diameter enlargement	拡大傾向(直径6mm以上)
E	Elevation of surface	表面隆起