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Abstract
Aim: This study was carried out to present our surgical experience with malignant melanoma (MM) in the University Hospital Centre of Yaoundé Cameroon.
Patients and methods: In this study, the file of patients with strong suspicion for MM and subsequently admitted for surgery between December 1996 and January 2010 were reviewed. We recorded the country of origin; the age; and the sex of the patients, the site, the duration, and after excision, the type, the depth, and stage of the tumour as well as the definitive surgery offered.
Results: 29 patients had confirmed MM of the lower limb in 14years. Their main age was 56.53years with extremes of 26years to 82years. There were 11males and 18females. The patients were all black Cameroonians except one Lebanese. The tumours were located on the plantar surface of the foot in 28cases and on the ankle in one case. The duration varied from 7months to 5years before reporting to the hospital. Twelve patients presented with advanced disease at diagnosis with inguinal metastases in three cases and abdominal metastases in two cases . Histology showed increased tumour thickness in most cases (Clark C). 15 cases had excision and skin grafting with relapses in four of them within 6months while seven had excision and primary closure with local flaps. Eight patients were offered amputation but refused. Two year survival rate was 35%.
Conclusion: Malignant melanoma of the lower limb is a disease seen more in the female black Cameroonian above 50yers of age. The tumour is located mostly, on the plantar surface of the foot. It is seen late due to late reporting. Public sensitization for its early diagnosis when the tumour is small and superficial could improve its prognosis since wide excision and primary closure will be curative.
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References
- George AO, Ogunbiyi Ao, Daramola OOM, Campbell OB. Albinism among Nigerians with Malignant melanoma. Trop Doct 2005;35 (1): 55-56.
- Berwick M, Armstrong DK, Benporat L Fine 5,Kricker A Eberle C, Barnhill R. Sun exposure and mortality from melanoma. J. Nath Cancer Inst. 2005; 97 (3): 197 – 7
- Giraud Rm, Rippey e, Rippey JJ. Malignant melanoma of the skin in Black Africans. S. Afr. MJJJed. J. 1975; 49 (16): 665.8.
- Jahnson S, Yamane S, Monta S, Yonelhara C, Wong J H. malignant melanoma in non courcanians: experience from Hawai.
- Kopf A W et al: Familial malignant melanoma. JAMA 1986 ; 256 : 1915.
- Arnt KA Precursors to melanoma : Congenital and dysplastic naevi. JAMA 1984; 251: 1992.
- Out AA thorn injury preceding malignant melanoma of the foot in Nigeria. Lancet 1985; 1: 220 – 221.
- Mbuagbaw J, Pisoh C, Bengomdo CM, Kegoum B, Takongmo S. Malignant melanoma in Cameroon. The Internet Journal of surgery 2007 Volume 9 Number 1.
- Balch CM et al Management of cutaneous melanoma in the United States Surg Gynaecol Obstet 1984; 158: 311.
- Onuigbo WI Malignant melanomas in the Igbos of Nigeria. Br. J. Plast surg. 1975; 28 (2): 114 – 7.
- Elder DE et al The role of lymph node dissection for clinical stage I malignant melanoma of intermediate thickness (1.5 – 3.99mm). Cancer 1985; 56: 413.
- 8yrd Km, Wilson DC; Hopler SS, Peck GL advanced presentation of malignant melanoma in Africa Americans. J. Am Acad Sermatol 2004; 51(6): 1031 – 2.
References
George AO, Ogunbiyi Ao, Daramola OOM, Campbell OB. Albinism among Nigerians with Malignant melanoma. Trop Doct 2005;35 (1): 55-56.
Berwick M, Armstrong DK, Benporat L Fine 5,Kricker A Eberle C, Barnhill R. Sun exposure and mortality from melanoma. J. Nath Cancer Inst. 2005; 97 (3): 197 – 7
Giraud Rm, Rippey e, Rippey JJ. Malignant melanoma of the skin in Black Africans. S. Afr. MJJJed. J. 1975; 49 (16): 665.8.
Jahnson S, Yamane S, Monta S, Yonelhara C, Wong J H. malignant melanoma in non courcanians: experience from Hawai.
Kopf A W et al: Familial malignant melanoma. JAMA 1986 ; 256 : 1915.
Arnt KA Precursors to melanoma : Congenital and dysplastic naevi. JAMA 1984; 251: 1992.
Out AA thorn injury preceding malignant melanoma of the foot in Nigeria. Lancet 1985; 1: 220 – 221.
Mbuagbaw J, Pisoh C, Bengomdo CM, Kegoum B, Takongmo S. Malignant melanoma in Cameroon. The Internet Journal of surgery 2007 Volume 9 Number 1.
Balch CM et al Management of cutaneous melanoma in the United States Surg Gynaecol Obstet 1984; 158: 311.
Onuigbo WI Malignant melanomas in the Igbos of Nigeria. Br. J. Plast surg. 1975; 28 (2): 114 – 7.
Elder DE et al The role of lymph node dissection for clinical stage I malignant melanoma of intermediate thickness (1.5 – 3.99mm). Cancer 1985; 56: 413.
8yrd Km, Wilson DC; Hopler SS, Peck GL advanced presentation of malignant melanoma in Africa Americans. J. Am Acad Sermatol 2004; 51(6): 1031 – 2.