Clinical and histological features of head and neck melanoma: a population-based study in France.

BACKGROUND: Head and neck melanomas (HNMs) account for an increasing proportion of melanomas and have a poor prognosis. OBJECTIVES: To compare the clinical and histological characteristics of HNMs with those of melanomas at other sites (MOS), and to identify pertinent clinicopathological subgroups of HNM. METHODS: A retrospective population-based study of incident in situ and invasive melanomas in the period 2004-2011 was performed. RESULTS: HNMs represented 26·7% of 1548 melanomas, corresponding to a density ratio of 3·7 between HNMs and MOS. HNMs occurred later than MOS (71·2 vs. 58·4 years; P < 0·01), included a higher proportion of in situ cases (49·6% vs. 13·5%; P < 0·01) and were mainly lentigo malignant melanomas (73·0% vs. 2·6%; P < 0·01). Invasive HNMs included a higher proportion of thick (> 2 mm) tumours [33·7% vs. 24·1% (P = 0·01); mean Breslow thickness: 2·18 vs. 1·77 mm (P = 0·03)] and nodular melanomas (20·1% vs. 12%; P < 0·01). HNMs in the peripheral area of the head and neck differed from those of central location by a younger age of onset (65·2 vs. 72·4 years; P < 0·01), male predominance (64·4% vs. 33·8%; P < 0·01), and higher proportions of invasive (67·2% vs. 42%; P < 0·01) and nodular (15·1% vs. 7·5%; P = 0·01) melanomas. CONCLUSIONS: HNMs highly differ from MOS, and are clinically and histologically heterogeneous, possibly as a consequence of different patterns of sun exposure. These data could help to improve primary and secondary prevention messages for patients and doctors.

Comparison of anatomical locations of cutaneous melanoma in men and women: a population-based study in France.

BACKGROUND: Identification of differences in melanoma location between the sexes could lead to sex-specific preventive measures. OBJECTIVES: To compare precise melanoma location and side in men and women. METHODS: The location of 1542 incident melanomas diagnosed during the period 2004-2011 in the French Champagne-Ardenne region (1·3 million inhabitants) was recorded using a regional registry and questionnaires sent to physicians. Men and women were compared for frequency of tumours on the head and neck; trunk; upper limb; lower limb; hand and foot. For each location, more precise sublocations were recorded. The laterality (right vs. left) was studied for head/neck and limb tumours. RESULTS: Melanomas predominated on the lower limb in women (32·2% vs. 9·3% in men; P < 0·01) and on the trunk in men (41·8% vs. 14·9%; P < 0·01), while the proportion of upper limb and head/neck tumours was similar in both sexes. Hand and foot melanomas predominated in women (10·3% vs. 6·3%; P < 0·01), with a sex-related distribution between sublocations. Within the head and neck location, 75·1% of tumours in women were located in the central area vs. 53·7% in the peripheral area in men (P < 0·01). Head and neck melanomas were more frequently right-sided in women and left-sided in men (P = 0·04), with the left/right ratio reaching 1·58 in men vs. 0·61 in women for peripheral tumours (P < 0·01). No difference in laterality was observed for other locations. CONCLUSIONS: Sex differences in occupational and leisure time ultraviolet exposure, clothing (including shoes), hairstyle, and side and photo exposure in cars could explain these results. General preventive messages could be completed by sex-specific advice for melanoma prevention.

Clinical and pathological characteristics of melanoma: a population-based study in a French regional population.

BACKGROUND: Although incidence and mortality data are numerous, population-based studies including clinical and pathological characteristics of melanoma are rare. OBJECTIVES: To describe the characteristics of melanoma in a rural French region during 2004-2008 and to identify differences according to age, gender and geographical areas. METHODS: Pathology reports of cutaneous melanomas diagnosed in residents from the Champagne-Ardenne region during 2004-2008 were anonymously collected from pathology laboratories. Demographic, clinical and pathological data were extracted and analysed by experts, including dermatologists, pathologists and epidemiologists. RESULTS: One hundred and seventy-seven in situ melanomas were diagnosed in 177 patients (female/male ratio : 1.72). Patients with head and neck in situ melanomas were older than patients with melanomas in other locations (72 vs. 54 years; P < 0.0001). Six hundred and sixty-one invasive melanomas were diagnosed (female/male ratio : 1.26), corresponding to an annual incidence rate of 6.3/100,000. Male patients had thicker and more frequently ulcerated tumours. The location widely varied between genders, involving the trunk in 47% of male patients and the lower limb in 48% of female patients. Older patients had thicker and more advanced melanomas, with a more frequent head and neck location. Nodular, acral lentiginous and unclassified melanomas were much thicker than superficial spreading and lentigo maligna melanomas (4.37 vs. 1.33 mm, P < 0.0001). Primary melanomas of advanced stages were more frequent in one of the four districts of the study area. Overall, the mean Breslow thickness (2.02 mm) was much higher than that previously observed in other regions of north-eastern France (1.59 mm). CONCLUSIONS: Information and screening campaigns should particularly target rural areas, males, older people and focus on nodular, acrolentiginous and unclassified subtypes.

[Biliary hamartoma. Reflexions on a new personal case]. / Les hamartomes biliaires. Réflexions à propos d'un nouveau cas personnel.

In this study of a personal case of biliary hamartoma showing complete aplasia of the hepatic parenchyma as well as a cystic ectasy of the corresponding bile ducts, particular emphasis has been laid on the clinical, paraclinical and anatomo-pathological aspects of these dysgeneses. There seems to be an analogy between the radiographic, anatomical and anatomo-pathological studies made in this case and those that could have been made in pulmonary sequestration. As regards the pathogenesis of these complaints, the authors therefore put forward the same hypothesis for biliary hamartoma as for pulmonary sequestration and highlight the advantages of pre-operative angiography.

[Visceral Kaposi sarcoma associated with a thyroid medullary carcinoma in a child in prolonged remission of lymphoblastic leukaemia (author's transl)]. / Sarcome de Kaposi viscéral associé à un carcinome médullaire thyroïdien chez une enfant en très longue rémission de leucémie lymphoblastique.

This report concerns a 12-years-old child, in remission for 8 years from lymphoblastic leukaemia. The course was rapidly fatal. The authors compare this case with those published in the literature of Kaposi sarcoma occuring in transplant patients and discuss the possible mechanisms, in particular the role of immunodepression.