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Melanoma in pregnancy: certainties unborn
Enrico Zelin1, Claudio Conforti1, Roberta Giuffrida2
1Dermatology & Venereology Department, Dermatology Clinic, Maggiore Hospital, University of Trieste, Trieste, Italy.
Melanoma Management
|September 14, 2020
Summary
Pregnancy-associated melanoma (PAM) may have a worse prognosis, but research is ongoing. Prompt biopsy is recommended, while staging and systemic therapy during pregnancy require careful consideration.
Area of Science:
- Oncology
- Dermatology
- Obstetrics & Gynecology
Background:
- Pregnancy-associated melanoma (PAM) is defined as melanoma diagnosed during childbearing years or within one year postpartum.
- Existing evidence suggests PAM may have a poorer prognosis compared to melanoma in non-pregnant individuals, though this remains inconclusive.
- Potential contributing factors include hormonal and immune changes, increased lymphangiogenesis, and diagnostic/therapeutic delays.
Purpose of the Study:
- To review the current understanding and management of pregnancy-associated melanoma.
- To highlight the diagnostic and therapeutic challenges of PAM during pregnancy.
Main Methods:
- Literature review of studies investigating pregnancy-associated melanoma.
- Analysis of factors influencing PAM prognosis and management.
Main Results:
- Excisional biopsy for suspected PAM is feasible regardless of gestational stage.
- Staging procedures like sentinel lymph node biopsy and systemic therapies during pregnancy are subjects of ongoing debate.
- Multidisciplinary care and comprehensive maternal counseling are crucial.
Conclusions:
- Management of PAM requires a tailored, multidisciplinary approach.
- Further research is needed to clarify the prognosis and optimize treatment strategies for PAM, especially concerning pregnancy.
- Balancing maternal health and fetal well-being is paramount in PAM management.
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