Melanoma and pregnancy C43

The last decades were marked by a worldwide increasing incidence of melanoma diseases. Melanocytic nevi change during pregnancy (growth tendency; increase in size) and therefore require careful control.

The incidence is 0.2-2.8 per 1000 births / year, about 1% of melanoma patients are pregnant at diagnosis. Almost 35% of women diagnosed with melanoma are of childbearing age (Morton SK et al. 2017). Malignant melanoma is the most common malignant tumour during pregnancy (Driscoll MS et al. 2016).

In the case of surgical interventions, it is recommended that local anaesthetic measures be applied whenever possible. Epinephrine/lidocaine has proven to be a safe local anaesthetic during pregnancy. (Li JN et al. 2019).

The influence of pregnancy on the prognosis of women with melanoma was clearly negated in numerous case-control studies. In several large studies, no difference could be demonstrated with regard to overall survival or disease-free survival with adequate therapy.

There is no need to refuse pregnancy in women with previous melanoma. A melanoma is not a reason for an abruptio.

If the child is carried, it is recommended to examine the placenta histologically for metastases, since melanoma is one of the most frequently metastasizing tumors in the placenta (Salvini C et al. 2017).

Women in a later stage of melanoma disease should be informed about the increased risk that their child may grow up without a mother.

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5. Morton SK et al (2017) Melanoma and pregnancy. Australas J Dermatol 58:259-267.
6. Salvini C et al. (2017) Melanoma and pregnancy. G Ital Dermatol Venereol152:274-285.