This points up the importance of recognizing the early signs of melanoma and bringing them to the attention of a physician so that an experienced dermatologist, surgeon or oncologist can become involved. In addition, several advances in biological treatment have prolonged useful survival, even at advanced stages of the disease.
Once the melanoma has penetrated deeply into the skin and has reached the lymphatic and blood vessels in the second level of the skin (the dermis), it is more difficult to cure, but a long period of quiescence may still be achieved by surgery.
Types There is only one type of malignant cell composing all melanomas—the malignant pigment-producing cell called a melanocyte—but there are a few variants distinguished by their shapes, such as cuboidal or spindle-shaped. The behavior of each is generally similar in skin melanomas, although in eye melanomas the shape determines the behavior to a significant degree.
All melanocytes have pigment granules in them even when the cells are not black or dark brown. In all cases, they have the enzymes necessary to produce melanin, the black pigment. When melanomas spread, they often do not produce pigment and are said to be amelanotic, but the degree of malignancy of both amelanotic or melanotic melanomas seems to be the same.
Melanomas are most commonly found on the skin, but 10 percent arise in the eye. The most common variants in the skin are called the superficial spreading melanoma and the nodular melanoma, terms that describe the pattern of enlargement.
