chief complaint 48 year old man with suspicious looking mole on his backhistory max burnell a si

Name: chief complaint 48 year old man with suspicious looking mole on his backhistory max burnell a single 48 year old avid long distance runner previously in good health presented to his primary 61577
Uploaded: 2023-04-25T19:02:32-08:00
Duration: 2 min 58 s
Channel: Madhur L
Description: chief complaint 48 year old man with suspicious looking mole on his backhistory max burnell a single 48 year old avid long distance runner previously in good health presented to his primary 61577

Question

Chief Complaint: 48-year-old man with a suspicious-looking mole on his back. History: Max Burnell, a single, 48-year-old avid long-distance runner previously in good health, presented to his primary physician for a yearly physical examination, during which a suspicious-looking mole was noticed on the back of his left arm, just proximal to the elbow. He reported that he has had that mole for several years but thinks that it may have gotten larger over the past two years. Max reported that he has noticed itchiness in the area of this mole over the past few weeks. He had multiple other moles on his back, arms, and legs, none of which looked suspicious. Upon further questioning, Max reported that his aunt died in her late forties of skin cancer, but he knew no other details about her illness. Max is a computer programmer who spends most of the workweek indoors. On weekends, however, he typically goes for a 5-mile run and spends much of his afternoons gardening. He has a light complexion, blonde hair, and reports that he sunburns easily but uses protective sunscreen only sporadically. Physical Examination: Head, neck, thorax, and abdominal exams were normal, with the exception of a hard, enlarged, non-tender mass felt in the left axillary region. In addition, a 1.6 x 2.8 cm mole was noted on the dorsal upper left arm. The lesion had an appearance suggestive of a melanoma. It was surgically excised with 3 mm margins using a local anesthetic and sent to the pathology laboratory for histologic analysis. Questions: 1. How does the appearance of a malignant melanoma differ from that of a normal mole, or nevus, on gross inspection (i.e., the macroscopic appearance)? 2. Why was it important to surgically excise and examine this mole? 3. Why is it useful to determine the level of invasion of this lesion? 4. Max is told that he has a malignant melanoma and that it may have already metastasized. Why does Max's physician think that his cancer has already metastasized? 5. How do malignant melanomas normally spread to other areas of the body? 6. What are two treatments available for Max's malignant melanoma? How effective might each be? 7. The incidence of malignant melanoma has increased over the past few decades. What do you think is the reason for this trend?

Chief Complaint: 48-year-old man with a suspicious-looking mole on his back.

History: Max Burnell, a single, 48-year-old avid long-distance runner previously in good health, presented to his primary physician for a yearly physical examination, during which a suspicious-looking mole was noticed on the back of his left arm, just proximal to the elbow. He reported that he has had that mole for several years but thinks that it may have gotten larger over the past two years. Max reported that he has noticed itchiness in the area of this mole over the past few weeks. He had multiple other moles on his back, arms, and legs, none of which looked suspicious. Upon further questioning, Max reported that his aunt died in her late forties of skin cancer, but he knew no other details about her illness. Max is a computer programmer who spends most of the workweek indoors. On weekends, however, he typically goes for a 5-mile run and spends much of his afternoons gardening. He has a light complexion, blonde hair, and reports that he sunburns easily but uses protective sunscreen only sporadically.

Physical Examination: Head, neck, thorax, and abdominal exams were normal, with the exception of a hard, enlarged, non-tender mass felt in the left axillary region. In addition, a 1.6 x 2.8 cm mole was noted on the dorsal upper left arm. The lesion had an appearance suggestive of a melanoma. It was surgically excised with 3 mm margins using a local anesthetic and sent to the pathology laboratory for histologic analysis.

Questions:
1. How does the appearance of a malignant melanoma differ from that of a normal mole, or nevus, on gross inspection (i.e., the macroscopic appearance)?
2. Why was it important to surgically excise and examine this mole?
3. Why is it useful to determine the level of invasion of this lesion?
4. Max is told that he has a malignant melanoma and that it may have already metastasized. Why does Max's physician think that his cancer has already metastasized?
5. How do malignant melanomas normally spread to other areas of the body?
6. What are two treatments available for Max's malignant melanoma? How effective might each be?
7. The incidence of malignant melanoma has increased over the past few decades. What do you think is the reason for this trend?

Added by Isabel S.

Biology for AP Courses

Julianne Zedalis, John Eggebrecht

Instant Answer

Solved by Expert Madhur L

04/25/2023

Step 1

The appearance of a malignant melanoma differs from that of a normal mole, or nevus, on gross inspection in several ways. Malignant melanomas are often larger, have irregular borders, and may have varying colors within the lesion. A normal mole is usually smaller, Show more…

Show all steps

Thanks for your feedback!

Chief Complaint: 48-year-old man with a suspicious-looking mole on his back. History: Max Burnell, a single, 48-year-old avid long-distance runner previously in good health, presented to his primary physician for a yearly physical examination, during which a suspicious-looking mole was noticed on the back of his left arm, just proximal to the elbow. He reported that he has had that mole for several years but thinks that it may have gotten larger over the past two years. Max reported that he has noticed itchiness in the area of this mole over the past few weeks. He had multiple other moles on his back, arms, and legs, none of which looked suspicious. Upon further questioning, Max reported that his aunt died in her late forties of skin cancer, but he knew no other details about her illness. Max is a computer programmer who spends most of the workweek indoors. On weekends, however, he typically goes for a 5-mile run and spends much of his afternoons gardening. He has a light complexion, blonde hair, and reports that he sunburns easily but uses protective sunscreen only sporadically. Physical Examination: Head, neck, thorax, and abdominal exams were normal, with the exception of a hard, enlarged, non-tender mass felt in the left axillary region. In addition, a 1.6 x 2.8 cm mole was noted on the dorsal upper left arm. The lesion had an appearance suggestive of a melanoma. It was surgically excised with 3 mm margins using a local anesthetic and sent to the pathology laboratory for histologic analysis. Questions: 1. How does the appearance of a malignant melanoma differ from that of a normal mole, or nevus, on gross inspection (i.e., the macroscopic appearance)? 2. Why was it important to surgically excise and examine this mole? 3. Why is it useful to determine the level of invasion of this lesion? 4. Max is told that he has a malignant melanoma and that it may have already metastasized. Why does Max's physician think that his cancer has already metastasized? 5. How do malignant melanomas normally spread to other areas of the body? 6. What are two treatments available for Max's malignant melanoma? How effective might each be? 7. The incidence of malignant melanoma has increased over the past few decades. What do you think is the reason for this trend?