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العنوان
Head & Neck Melanomas /
المؤلف
Yousseif, Houssein El-Said Soliman.
هيئة الاعداد
باحث / Houssein El-Said Soliman Yousseif
مشرف / Osama Mahmoud Ibrahim Saad
مشرف / Ahmed Gamal Mahdy Khafagy
مناقش / Ahmed Gamal Mahdy Khafagy
تاريخ النشر
2015.
عدد الصفحات
166 P. :
اللغة
الإنجليزية
الدرجة
ماجستير
التخصص
الحنجرة
تاريخ الإجازة
1/1/2015
مكان الإجازة
جامعة عين شمس - كلية الطب - قسم الانف والاذن والحنجرة
الفهرس
Only 14 pages are availabe for public view

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from 166

Abstract

 Cutaneous melanoma of the head and neck, traditionally, was a disease of the elderly, but now melanomas are found in all age groups.
 Melanomas tend to have specific mutations in their DNA (BRAF, NRAS and KIT), depending on where they originated.
 The greatest hope for controlling this disease lies in careful surveillance and early detection of atypical pigmented lesions.
 The primary treatment of melanoma is wide surgical excision.
 Sentinel lymph node biopsy which now plays a major role in detecting micrometastasis and providing information about the necessity of therapeutic neck dissection.
 Primary radiation therapy and chemotherapy are usually reserved for palliative treatment in far-advanced lesions.
 IFN alfa-2b & pegylated interferon alfa-2b have shown promise as adjuvant therapy of melanoma.
 FDA approved dacarbazine, ipilimumab, vemurafenib, trametinib/dabrafenib combo, pembrolizumab and finally nivolumab for treating advanced melanoma.
 Tumor thickness, the presence of ulceration, nodal status, and distant metastasis are the most important prognostic factors.
 HNMM presents at the 6th decade of life.
 Majority of patients present with localized diseases.
 Ballantyne’s staging is easily applicable and useful for comparison to other studies in the literature. However, substaging of stage I disease is necessary for providing more useful prognostic information.
 Sinonasal cavity is the commonest site for HNMM accounting for more than half of the cases.
 Oral cavity melanomas are more likely to have nodal metastasis at presentation when compared to sinonasal melanoma.
 Lymphatic drainage pattern of some cases of sinonasal MM appears to be different from the expected lymphatic drainage pattern.
 Surgery with clear resection margins remains the treatment of choice. In more recent series, in which surgical treatment has been aggressive and prompt due to early detection, salvage rates have been acceptable.
 Adjuvant radiotherapy does not improve overall survival. Its role in local control is undefined.
 Local control is not associated with overall survival.
 The prognosis remains grave, with a 5-year survival in the range of 20- 30%.