Book contents
- Frontmatter
- Contents
- List of Contributors
- Foreword by Daniel R. Salomon
- Foreword by Robin Marks
- Foreword by Kathy Schwab
- Preface
- Acknowledgments
- SECTION ONE TRANSPLANT DERMATOLOGY: AN EVOLVING DYNAMIC FIELD
- Section Two Transplant Medicine and Dermatology
- Section Three Pathogenic Factors in Transplant Dermatology
- Section Four Cutaneous Effects of Immunosuppressive Medications
- Section Five Infectious Diseases of the Skin in Transplant Dermatology
- Section Six Benign and Inflammatory Skin Diseases in Transplant Dermatology
- Section Seven Cutaneous Oncology in Transplant Dermatology
- 20 The Pathogenesis of Skin Cancer in Organ Transplant Recipients
- 21 The Epidemiology of Skin Cancer in Organ Transplant Recipients
- 22 The Clinical Presentation and Diagnosis of Skin Cancer in Organ Transplant Recipients
- 23 Actinic Keratosis in Organ Transplant Recipients
- 24 Basal Cell Carcinoma in Organ Transplant Recipients
- 25 Squamous Cell Carcinoma in Organ Transplant Recipients
- 26 Malignant Melanoma in Organ Transplant Recipients
- 27 Merkel Cell Carcinoma in Organ Transplant Recipients
- 28 Kaposi's Sarcoma in Organ Transplant Recipients
- 29 Posttransplant Lymphoproliferative Disorder/Lymphoma in Organ Transplant Recipients
- 30 Rare Cutaneous Neoplasms in Organ Transplant Recipients
- 31 Histopathologic Features of Skin Cancer in Organ Transplant Recipients
- Section Eight Special Scenarios in Transplant Cutaneous Oncology
- Section Nine Educational, Organizational, and Research Efforts in Transplant Dermatology
- Index
26 - Malignant Melanoma in Organ Transplant Recipients
from Section Seven - Cutaneous Oncology in Transplant Dermatology
Published online by Cambridge University Press: 18 January 2010
- Frontmatter
- Contents
- List of Contributors
- Foreword by Daniel R. Salomon
- Foreword by Robin Marks
- Foreword by Kathy Schwab
- Preface
- Acknowledgments
- SECTION ONE TRANSPLANT DERMATOLOGY: AN EVOLVING DYNAMIC FIELD
- Section Two Transplant Medicine and Dermatology
- Section Three Pathogenic Factors in Transplant Dermatology
- Section Four Cutaneous Effects of Immunosuppressive Medications
- Section Five Infectious Diseases of the Skin in Transplant Dermatology
- Section Six Benign and Inflammatory Skin Diseases in Transplant Dermatology
- Section Seven Cutaneous Oncology in Transplant Dermatology
- 20 The Pathogenesis of Skin Cancer in Organ Transplant Recipients
- 21 The Epidemiology of Skin Cancer in Organ Transplant Recipients
- 22 The Clinical Presentation and Diagnosis of Skin Cancer in Organ Transplant Recipients
- 23 Actinic Keratosis in Organ Transplant Recipients
- 24 Basal Cell Carcinoma in Organ Transplant Recipients
- 25 Squamous Cell Carcinoma in Organ Transplant Recipients
- 26 Malignant Melanoma in Organ Transplant Recipients
- 27 Merkel Cell Carcinoma in Organ Transplant Recipients
- 28 Kaposi's Sarcoma in Organ Transplant Recipients
- 29 Posttransplant Lymphoproliferative Disorder/Lymphoma in Organ Transplant Recipients
- 30 Rare Cutaneous Neoplasms in Organ Transplant Recipients
- 31 Histopathologic Features of Skin Cancer in Organ Transplant Recipients
- Section Eight Special Scenarios in Transplant Cutaneous Oncology
- Section Nine Educational, Organizational, and Research Efforts in Transplant Dermatology
- Index
Summary
INTRODUCTION
Malignant melanoma (MM) is the most life-threatening form of skin cancer. It is considered an immunologic tumor and, therefore, raises concerns regarding its behavior and outcomes in the population of immunosuppressed solid organ transplant recipients. Three clinical scenarios are of concern for transplant patients with MM: (1) a history of MM before transplant, (2) development of MM as a result of transmission from the organ donor, and (3) de novo development of MM after transplantation. In making clinical decisions for patients within each scenario, a basic understanding of the pathogenesis of MM, prognostic variables, treatment outcomes, and survival in the general population and transplant population is required.
PATHOGENESIS
Cutaneous melanoma develops from melanocytes that reside in the bottom layer of the epidermis or in nevi extending down into the dermis. Sun exposure, genetic susceptibility with known familial susceptibility genes CDKN2A and CDK4, BRAF gene mutations, and immune response all can have a role in the development of melanoma.
In one early study of MM in renal transplant recipients, a precursor nevus was detected at the margin of the majority of tumor. Additionally, a decreased tumor lymphocytic infiltrate response was present in 10 of 14 tumors. The authors concluded that “MM in renal transplant recipients appears to evolve from precursor nevi in a host unable to mount a tumor-specific cellular immune response.” Although simplistic, the mechanism of pathogenesis proposed on the basis of this study's findings seemed to confirm intuitive ideas.
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- Chapter
- Information
- Skin Disease in Organ Transplantation , pp. 182 - 189Publisher: Cambridge University PressPrint publication year: 2008