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Brănișteanu DE, Porumb-Andrese E, Stărică A, Munteanu AC, Toader MP, Zemba M, Porumb V, Cozmin M, Moraru AD, Nicolescu AC, Brănișteanu DC. Differences and Similarities in Epidemiology and Risk Factors for Cutaneous and Uveal Melanoma. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59050943. [PMID: 37241175 DOI: 10.3390/medicina59050943] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 04/17/2023] [Accepted: 05/12/2023] [Indexed: 05/28/2023]
Abstract
Both cutaneous melanoma (CM) and uveal melanoma (UM) represent important causes of morbidity and mortality. In this review, we evaluate the available knowledge on the differences and similarities between cutaneous melanoma and uveal melanoma, focusing on the epidemiological aspects and risk factors. Uveal melanoma is a rare condition but is the most prevalent primary intra-ocular malignant tumor in adults. Cutaneous melanoma, on the other hand, is significantly more common. While the frequency of cutaneous melanoma has increased in the last decades worldwide, the incidence of uveal melanoma has remained stable. Although both tumors arise from melanocytes, they are very distinct entities biologically, with complex and varied etiologies. Both conditions are encountered more frequently by individuals with a fair phenotype. ultraviolet-radiation is an important, well-documented risk factor for the development of CM, but has shown not to be of specific risk in UM. Although cutaneous and ocular melanomas seem to be inherited independently, there are reported cases of concomitant primary tumors in the same patient.
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Affiliation(s)
- Daciana Elena Brănișteanu
- Dermatology Department, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iasi, Romania
- Railway Clinical Hospital, 700506 Iasi, Romania
| | - Elena Porumb-Andrese
- Dermatology Department, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iasi, Romania
- Railway Clinical Hospital, 700506 Iasi, Romania
| | - Alexandra Stărică
- Dermatology Department, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iasi, Romania
- Railway Clinical Hospital, 700506 Iasi, Romania
| | - Anca Catalina Munteanu
- Dermatology Department, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iasi, Romania
- Railway Clinical Hospital, 700506 Iasi, Romania
| | | | - Mihail Zemba
- Ophthalmology Department, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Vlad Porumb
- Department Surgery, 'Grigore T. Popa' University of Medicine and Pharmacy, 700111 Iasi, Romania
| | - Mihai Cozmin
- Clinical Department, Apollonia University of Iasi, 700511 Iasi, Romania
| | - Andreea Dana Moraru
- Ophthalmology Department, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Alin Codruț Nicolescu
- Roma Medical Center for Diagnosis and Treatment, 011773 Bucharest, Romania
- "Agrippa Ionescu" Emergency Clinical Hospital, 011773 Bucharest, Romania
| | - Daniel Constantin Brănișteanu
- Railway Clinical Hospital, 700506 Iasi, Romania
- Ophthalmology Department, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iasi, Romania
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Ellis NT. Carcinogenicity of Solar and Tanning Booth Radiation: School and Community Health Interventions. ACTA ACUST UNITED AC 2013. [DOI: 10.1080/10556699.1992.10610028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Nancy T. Ellis
- a Department of Applied Health Science , Indiana University , Bloomington , IN , 47405 , USA
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Pane AR, Hirst LW. Ultraviolet light exposure as a risk factor for ocular melanoma in Queensland, Australia. Ophthalmic Epidemiol 2009. [DOI: 10.1076/0928-6586(200009)731-vft159] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Harbour JW, Brantley MA, Hollingsworth H, Gordon M. Association between posterior uveal melanoma and iris freckles, iris naevi, and choroidal naevi. Br J Ophthalmol 2004; 88:36-8. [PMID: 14693769 PMCID: PMC1771959 DOI: 10.1136/bjo.88.1.36] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
AIM To investigate the association between posterior uveal melanoma and iris freckles, iris naevi, and choroidal naevi. METHODS Cross sectional study of 65 patients with posterior uveal melanoma and 218 controls. Iris colour, iris freckles, iris naevi, and choroidal naevi were recorded for each eye of each patient. RESULTS Iris freckles were present in 40 (61.5%) patients with melanoma and 135 (61.9%) controls (p = 0.494). Iris naevi were present in four (6.2%) patients with melanoma and nine (4.1%) controls (p = 0.955). Choroidal naevi were present in 12 (18.5%) patients with melanoma and 38 (17.4%) controls (p = 0.815). CONCLUSION This study did not detect an association between posterior uveal melanoma and iris freckles, iris naevi, or choroidal naevi.
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Affiliation(s)
- J W Harbour
- Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, Box 8069, 660 S. Euclid Avenue, St Louis, MO 63110, USA.
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Vajdic CM, Kricker A, Giblin M, McKenzie J, Aitken J, Giles GG, Armstrong BK. Eye color and cutaneous nevi predict risk of ocular melanoma in Australia. Int J Cancer 2001; 92:906-12. [PMID: 11351315 DOI: 10.1002/ijc.1281] [Citation(s) in RCA: 60] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Ethnicity, cutaneous nevi and eye color are generally accepted risk factors for melanoma of the eye, although case-control studies have produced conflicting results. We sought to determine the constitutional risk factors for melanomas of the choroid, ciliary body, iris and conjunctiva in Australia. A population-based case-control study was conducted, with case ascertainment from a prospective national incidence survey and randomly selected community controls. Two hundred and ninety cases aged 18-79 years and diagnosed between 1st January 1996 and 31st July 1998 were enrolled with 916 controls frequency matched by age, sex and State or Territory of residence. Risk of choroidal and ciliary body melanoma (n = 246) was increased in people with grey (OR 2.9, 95% CI 1.5-5.5), hazel (OR 2.2, 95% CI 1.4-3.7) and blue eyes (OR 1.7, 95% CI 1.0-2.7) compared with brown eyes. Risk was also increased in those with 4 or more nevi on their back, those unable to tan, and those who squinted when outdoors as a child. Risk was reduced in people born other than in Australia and New Zealand (OR 0.7, 95% CI 0.5-1.0). Non-brown eye color was a risk factor for iris melanoma (n = 25). No risk factors were identified for conjunctival melanoma (n = 19). Eye color is the strongest constitutional predictor of choroidal and ciliary body melanoma, and may indicate a protective effect of melanin density at these sites. An independent association with cutaneous nevi suggests a role for other genetic factors.
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Affiliation(s)
- C M Vajdic
- Cancer Research and Registers Division, New South Wales Cancer Council, Sydney, Australia
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Lutz JM, Cree IA, Foss AJ. Risk factors for intraocular melanoma and occupational exposure. Br J Ophthalmol 1999; 83:1190-3. [PMID: 10502585 PMCID: PMC1722835 DOI: 10.1136/bjo.83.10.1190] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- J M Lutz
- Registre Genevois des Tumeurs, 55 Bvd de la Cluse, CH-1205 Genève, Switzerland
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Abstract
Uveal melanoma is the most common primary intraocular malignancy, with an annual incidence of 6 per million. The environmental factors known to increase the risk of cutaneous melanoma appear to be less important in ocular melanoma and it is conceivable that host factors have a greater impact. The coexistence of ocular and cutaneous melanoma in some patients suggests a predisposition to both types and implicates mutations in the CDKN2A gene in a proportion of these cases. An association between ocular melanoma and breast and/or ovarian cancer has also been reported and recent studies of breast cancer families strongly implicate BRCA2 as a predisposition gene. Other more common genes predisposing to ocular melanoma may be of low penetrance. An example of a gene in this class is MC1R, which affects host response to ultraviolet radiation. Identification of genes conferring an increased risk of ocular melanoma should provide insights into the pathogenesis of this tumour. Furthermore, it offers an opportunity to identify individuals at a high risk who may benefit from targeted surveillance. At present the identification of such individuals is restricted to the small number belonging to BRCA2 families and those with the atypical mole syndrome.
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Affiliation(s)
- R S Houlston
- Section of Cancer Genetics, Institute of Cancer Research, Sutton, Surrey, UK.
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Routaboul C, Marguery MC, Garigue J, Bazex J. Influence of UVA pre-exposure on UVB-induced erythema. A chromometric study. PHOTODERMATOLOGY, PHOTOIMMUNOLOGY & PHOTOMEDICINE 1999; 15:52-8. [PMID: 10321516 DOI: 10.1111/j.1600-0781.1999.tb00057.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
We examined the influence of ultraviolet A (UVA) pre-exposure on UVB minimal erythemal dose in 9 Caucasian subjects. Three zones were tested. One zone received only UVB, the second zone received a low UVA dose+UVB, and the third zone received a high UVA dose+UVB. Each zone was divided into 9 circles receiving increasing doses of UVB in order to obtain 3 different UVA-exposed series of 9 circles. Visual and chromometric readings were performed 24 h later. Pre-exposure to UVA caused variations in the slope of the dose-response curve (colorimetric index as a function of the UVB dose). In relation to UVB erythema, these variations indicated a protective effect for 6/9 subjects and an aggressive effect for 3/9 subjects. No predictive criteria were found for inclusion within a group.
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Affiliation(s)
- C Routaboul
- Service de dermatologie, Hopital Purpan, Toulouse, France
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Affiliation(s)
- J M Spencer
- Department of Dermatology and Cutaneous Surgery, University of Miami, School of Medicine, Florida, USA
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Abstract
The indoor tanning industry is a $1 billion-a-year business in the United States, and use of these high-intensity UVA tanning devices continues to grow. Many members of the medical community are concerned about the safety of these largely unregulated devices, but tanning salon operators state such concerns are unfounded and unproved. A comprehensive review of current knowledge of the operation and effects of indoor tanning is presented. The effects of UV radiation (especially UVA) on experimental animals and human beings are examined. Both acute and chronic effects are delineated from experimental sources as well as from epidemiologic studies and clinical observations. Existing safety regulations are described. Information on operator knowledge and compliance with existing safety regulations is reviewed.
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Affiliation(s)
- J M Spencer
- Division of Dermatology, University of Tennessee, USA
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Bataille V, Sasieni P, Cuzick J, Hungerford JL, Swerdlow A, Bishop JA. Risk of ocular melanoma in relation to cutaneous and iris naevi. Int J Cancer 1995; 60:622-6. [PMID: 7860135 DOI: 10.1002/ijc.2910600509] [Citation(s) in RCA: 46] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
A case-control study was set up to assess the risk of eye melanoma in relation to the number and type of cutaneous melanocytic naevi and pigmented lesions of the iris. Cases comprised 211 unselected ocular melanoma patients attending the Ocular Oncology Clinic at Moorfields Eye Hospital, London, during November 1990 to October 1991 and diagnosed after August 1986. Hospital and general practice controls (416) were recruited in the North East Thames Region of the UK. Cutaneous naevi greater than or equal to 2 mm in diameter were counted on the skin. Clinically atypical and congenital naevi were recorded separately. Pigmented lesions of the iris were counted. The relative risk for ocular melanoma increased with numbers of atypical naevi and numbers of common naevi. Ten percent of cases but 3% of controls had at least 100 naevi of 2 mm or greater diameter. Seven percent of cases and 0.4% of controls had 4 or more atypical naevi. Pigmented lesions of the iris were significantly more common in cases than controls. Nine percent of cases had the Atypical Mole syndrome (AMS) phenotype compared with 1% of controls. Six cases had concurrent cutaneous melanoma primaries. We conclude that atypical and iris naevi are important risk factors for eye melanoma and that patients with eye melanoma are at increased risk of cutaneous melanoma. Dermatological examination for the AMS phenotype and cutaneous melanoma should be recommended in eye melanoma patients with large numbers of pigmented lesions of the skin or family history of melanoma.
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Affiliation(s)
- V Bataille
- ICRF Skin Tumour Laboratory, Royal London Hospital, Whitechapel, UK
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Tilley EA, Adam EJ, Joseph AE. Case of the month. Blindingly obvious. Br J Radiol 1988; 61:87-8. [PMID: 3280063 DOI: 10.1259/0007-1285-61-721-87] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Affiliation(s)
- E A Tilley
- Department of Radiology, St George's Hospital, London
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