GIST, melanoma and sarcoma 500PD NEW DIAGNOSTIC TECHNIQUES IN EARLY DIAGNOSIS OF MELANOMA IN SITU

The incidence of malignant melanoma is increasing every year. Revealing melanoma in situ on time is increasing good prognosis of these patients. To evaluate the role of digital epiluminescence microscopy (DELM) in the differential diagnosis of cutaneous pigmented lesions and to improve the early diagnosis of melanoma in situ, 8384 pigmented lesions from 3927 consecutive patients were evaluated using digital epiluminescence microscope, in the period of three years (2002–2005), in a prospective study at the Dept. of Surgical Oncology of the Belgrade UMC ‘‘Bezanijska Kosa’’. After clinical examination and skin-surface microscopy of the pigmented skin lesions, suspicious skin lesions, undergone to further surgical procedures of removing skin lesions, with ‘ex tempore’ biopsy. From the total number of 3927 patients, we were suspicious about the malignancy of the pigmented skin lesion in about 147 patients. 147 patients underwent to the surgical treatment, from which all of 144 patients (97.6%) had pigmented skin lesion diagnosed by ‘ex tempore’ biopsy during surgical management as a malignant pigmented skin tumor (malignant melanoma). From the total number of patients with suspicious pigmented skin tumors (147 patients) on 97.6% patients diagnosis made by DELM was the same as diagnosis got from ‘ex tempore’ biopsy, which means that this procedure is highly accurate, especially if we know that all 15 patients with melanoma in situ verified with ‘ex tempore’ biopsy, was diagnosed prior with DELM, what is 100% accuracy. Surgical procedure-excision of the tumor was the only treatment of the patients with melanoma in situ. Digital epiluminescence microscopy is helpful device to the surgeon oncologist in deciding which pigmented lesions need surgical excision, as well as in diagnosing of early cutaneous malignant melanoma which use will increase, with adequate surgical procedure, a 5 year survival period of these patients.