Saturday, December 1, 2012

Yet Another Reason to See the Dermatologist

I am trying to highlight more of the CLL literature in the lead up to ASH and even more so in the weeks that follow, but my blog will always continue to tell my personal story and add my commentary.

Stay tuned here for some more video interviews from ASH here starting a few weeks after the meeting next weekend.

Below is an interesting recent abstract from a surgical journal (not our usual source for CLL research) dealing with the association of melanoma with CLL.

What it is saying, among other things is that sometimes the CLL is an unexpected incidental finding when doing a lymph node biopsy for melanoma. Believe me, it is way better to find CLL in the node than melanoma. Having melanoma in a node is not good news.

It also says that those with melanoma have a much higher (10 fold) incidence of CLL compared to other cancers. Thanks for returning the favor, as we already know that those of us with CLL have a higher incidence of melanoma.

What goes around comes around.

We also already know from older research that those of us who develop a melanoma along with our CLL tend to have a more aggressive form of the skin cancer with a worse prognosis.

 Isn't this fun?

While this abstract doesn't address the risk of melanoma with CLL (it address the reverse), we still need to see our dermatologists regularly and avoid excessive sun.

No point in beating the CLL and then succumbing to a metastatic melanoma. There is no watch and wait for melanoma. Treatment is usually a full on wide ranging immediate assault. Early diagnosis can be life saving for us.

Ann Surg Oncol 2012 Nov 20. [Epub ahead of print]

A Collision of Diseases: Chronic Lymphocytic Leukemia Discovered During Lymph Node Biopsy for Melanoma.


Department of Surgical Oncology, Fox Chase Cancer Center, Philadelphia, PA, USA,



In the United States in 2012, there were 16,060 new cases of chronic lymphocytic leukemia (CLL). Often CLL is clinically occult and first detected during pathologic evaluation of the sentinel lymph node biopsy (SLNB). We reviewed our experience of patients with the coexisting diagnosis of melanoma and CLL.


An institutional review board-approved review was performed on patients with CLL and melanoma treated from 1995 to 2009 at Moffitt Cancer Center and compared with the incidence of melanoma and CLL in our tumor registry patients with breast, prostate, lung, and colon cancer.


Fifty-two patients (44 males; median age, 71 years [range, 46-88]) were identified with concurrent diagnoses of melanoma and CLL. Twenty-two patients (42 %) had CLL on SLNB for their melanoma. Thirty-two patients (62 %) were diagnosed with melanoma before CLL. Concomitant or prior cancer diagnoses included nonmelanoma skin cancers (N = 29), prostate (N = 6), colorectal (N = 2), and Merkel cell carcinoma (N = 2). Five of 20 patients (25 %) had metastatic melanoma found at the time of SLNB. Patients with melanoma had a tenfold increase of CLL diagnosis compared with colorectal cancer patients, an eightfold increase compared to prostate cancer patients, and a fourfold increase compared with breast cancer patients.


We have confirmed an increased association of CLL and melanoma. This may be related to an underlying immunologic defect; however, there has been scant investigation into this phenomenon. Surgeons and pathologists should understand this occurrence and recognize that not all grossly enlarged or abnormal sentinel lymph nodes in melanoma patients represent melanoma.
[PubMed - as supplied by publisher]

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