TSEI - Associated Malignant Melanoma in Mycosis Fungoides Lutsyk M, Kuten A, Cohen Y, Barchana

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Division of Oncology, Radiotherapy Unit, Rambam Health Care Campus, Haifa, Israel

Introduction

According to the Annual Report of the Israel National Cancer Registry for 2007, the Age Standardized Rate of Malignant Melanoma (MM) for Jewish Males is 13.5 per 100.000 and for Jewish Females - 10.3 per 100,000.

Increased risk of secondary cancers in patients with Primary Cutaneous T cell Lymphoma (CTCL) has already been reported. The following is a report of 7 cases of MM in cohort of 196 patients with Mycosis Fungoides (MF) treated at Rambam Health Care Campus.

Results

Seven cases of MM in MF patients were identified. Five patients were treated with Total Skin Electron Irradiation (TSEI), one patient was treated with involved field skin electron irradiation (SubTSEI), and one had no radiotherapy. Two patients were treated with PUVA or Mustard Nitrogen (MN) topically and one received total body photon irradiation in addition to TSEI. Most of the patients had early stage (IA-IB) MF.

Fig. 1 ASR of Skin Melanoma in Israel, 1980 - 2007 Table 1. Demographic and treatment data of the 7 MF pts with MM Objective

To present the Rambam Health Care Campus experience of patients with MF and malignant melanoma.

Methods

The database of the Rambam Radiotherapy Unit comprised the management of 250 MF patients treated in the years 1960-2010. Data of 196 patients were available for this analysis. The Israel National Cancer Registry was queried for second primary tumors in these patients.

Conclusion

The prevalence of second primary MM in MF patients was much higher than expected – 3,6%. The mechanism of the phenomenon may be related to a host immunomodulation that results in CTCL pathogenesis and/or in sun exposure influence in combination with electron beam radiotherapy.

Contact information:

Dr.Lutsyk Myroslav, MD, Division of Oncology, Rambam Health Care Campus, Haifa 31096, Israel. e-mail: [email protected]