Familial atypical multiple mole-melanoma syndrome in Adult
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Synopsis

Features associated with FAMMM syndrome include multiple cases of melanoma within a family, young age at diagnosis of melanoma, family members with pancreatic cancer, and family members with multiple primary melanomas.
The CDKN2A gene encodes two proteins, p16 and p14ARF, but mutations seen in melanoma families are associated more often with an impaired activity of p16. Not all mutation carriers will develop melanoma. Risk differences have been seen from one geographic area of residence to another, suggesting that sun exposure, or other co-inherited factors, also contribute to the incidence of the disease.
Melanoma in a patient with mutated CDKN2A occurs at a significantly earlier age (median 40 versus 50 years), and multiple primary melanomas are more common in individual patients (40% versus 15% in one study) compared with families harboring wild-type CDKN2A. The risk of pancreatic cancer is estimated to be 13-22 times higher for FAMMM syndrome patients than the general population. This risk increases to 38-fold in CDKN2A-mutant FAMMM syndrome patients. Nevi in patients with FAMMM syndrome are phenotypically diverse.
Melanoma-astrocytoma syndrome is a rare syndrome thought to be a variant of FAMMM syndrome secondary to loss of p14ARF function.
Related topic: amelanotic melanoma
Codes
ICD10CM:D23.9 – Other benign neoplasm of skin, unspecified
SNOMEDCT:
254819008 – Atypical mole syndrome
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Differential Diagnosis & Pitfalls
FAMMM syndrome is unique because the numbers of nevi in concert with a family history are needed for diagnosis. Other melanoma tumor syndromes include:- BAP1 tumor syndrome
- MITF tumor syndrome
- TERT/Shelterin mutations
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Last Reviewed:08/15/2021
Last Updated:01/16/2022
Last Updated:01/16/2022