克氏外科学19版Chapter 32.pdfVIP

CHAPTER 32 MELANOMA AND CUTANEOUS MALIGNANCIES Kelly M. McMasters and Marshall M. Urist and xeroderma pigmentosum. The average annual age-adjusted cutaneous melanoma melanoma incidence/100,000 persons is 18.4 for whites com- cutaneous malignancies: nonmelanoma skin cancer pared with 2.3 for Hispanics, 1.6 for Asians, 1.0 for Native Americans, and 0.8 for African Americans. Melanoma is slightly more common in males than in females.5,6 Melanoma affects patients at all stages of life. Although the CUTANEOUS MELANOMA median age of melanoma patients is about 50 years, it occurs in In 1787, Hunter published one of the first accounts of a patient a wide age distribution. The incidence is greatest in older with melanoma. Laennec, who found metastatic melanoma patients, but it is one of the most common cancers in young deposits in distant viscera, described melanoma as cancer noire, adults and adolescents. Because of the relatively young median or the black cancer, in 1806. He subsequently named the disease age of melanoma patients, melanoma ranks among the worst melanosis in 1812.1 cancers in terms of years of life lost per malignancy. The causes of melanoma are not completely defined, but it Epidemiology and Causes