Full Text Available ... com oc180205 Last reviewed: 07/07/2011 2 Changes in chromosomes may also occur as a result of exposure to infections, drugs, tobacco, chemicals, or other factors. In the case of skin cancer, sunlight causes damage to the chromosomes, leading to cancer. Melanoma Melanoma occurs when the pigment ...
Full Text Available ... 2) Some patients with advanced melanoma may receive drug treatments that may improve the body’s natural defense (immune ... swelling. You may feel very tired and these drugs can cause a headache, muscle aches, a fever, or weakness. Radiation Therapy uses high-energy rays to kill cancer cells. ...
Full Text Available ... for your specific condition. ©1995-2011, The Patient Education Institute, Inc. www.X-Plain.com oc180205 Last reviewed: 07/07/2011 9 Regular examinations of the skin for abnormal growths are essential for early detection. Thanks to advances in medicine, melanoma can ...
Choroidal melanoma is the most common primary intra-ocular malignant tumor and second most common site of ten malignant melanoma sites in the body. Current diagnosis of choroidal melanoma is based on both the clinical experience of the specialist and modern diagnostic techniques such as indirect ophthalmoscopy, A- and B-ultrasonography scans, fundus fluorescein angiography, and transillumination. Invasive studies such as fine needle aspiration cytology can have significant morbidity and shoul...
Singh, Parul; Singh, Abhishek
Ocular melanomas comprise uveal and conjunctival sub-types, which are very different from each other. A large majority of uveal melanomas involve the choroid, with less than 10% being confined to the ciliary body and iris. They tend to metastasize haematogenously, almost always involving the liver. Therapeutic methods include various forms of radiotherapy, surgical resection and phototherapy, which are often used in combination. Conjunctival melanomas show many similarities to their cutaneous...
Tullo, A. B.; Dodd, C. L.; Noble, J. L.; Owens, S.; Rao, H.
Full Text Available Melanoma is a malignant tumor that originates from melanocyte cells. Its oral type is rare. The goal of this investigation was to determine the prevalence of oral malignant melanoma in Iran, as determined by age, sex and location. This research reviewed 623 cases of oral and non-oral malignant melanoma in Immam-Khomeini hospital, Mearaj cancer institute and department of oral pathology of dental faculty, Tehran University of Medical Sciences in a period of 19 years from 1981-1999. The results showed that 54 cases of biopsy lesions were melanoma of oral cavity that included 7.8% of these lesions. The mean age incidence of oral melanoma was 55.5(between 26-86 years. The most prevalent sites were palate (37.1% and alveolar mucosa (20.4% and less common sites included floor of mouth. buccal mucosa and tongue.
Uveal melanoma is the most common primary intraocular malignancy and the leading primary intraocular disease which can be fatal in adults. In this paper epidemiologic, pathogenetic, and clinical aspects of uveal melanoma are discussed. Despite the advance in local ocular treatments, there has been no change in patient survival for three decades. Development of metastases affects prognosis significantly. Current survival rates, factors predictive of metastatic potential and metastatic screenin...
Papastefanou, Vasilios P.; Cohen, Victoria M. L.
Full Text Available Melanomas are a major cause of premature death from cancer. The gradual decrease in rates of morbidity and mortality has occurred as a result of public health campaigns and improved rates of early diagnosis. Survival of melanoma has increased to over 90%. Management of melanoma involves a number of components: excision, tumor staging, re-excision with negative margins, adjuvant therapies (chemo, radiation or surgery, treatment of stage IV disease, follow-up examination for metastasis, lifestyle modification and counseling. Sentinel lymph node status is an important prognostic factor for survival in patients with a melanoma >1 mm. However, sentinel lymph node biopsies have received partial support due to the limited data regarding the survival advantage of complete lymph node dissection when a micrometastasis is detected in the lymph nodes. Functional mutations in the mitogen-activated pathways are commonly detected in melanomas and these influence the growth control. Therapies that target these pathways are rapidly emerging, and are being shown to increase survival rates in patients. Access to these newer agents can be gained by participation in clinical trials after referral to a multidisciplinary team for staging and re-excision of the scar.
We conclude that malignant melanoma in Iraqi patients is a disease of younger females, which presented mainly as acral lentiginous melanoma, nodular melanoma and lentigo maligna melanoma and superficial spreading melanoma.
Khalifa E. Sharquie
Sinclair(S-1) miniature swine spontaneously develop melanomas which have many biologic and histologic features in common with human superficial spreading melanoma. Host control of this neoplasm was indicated by the high incidence of spontaneous regression, a decrease in tumor development with age and a decrease in progressive growth of the tumor as age of tumor development increases. Immunologic mechanisms were implicated in host control by histologic observation of a mononuclear inflammatory infiltration of tumors which lead to depigmentation and fibrosis. In vitro immunologic studies revealed that leukocytes from melanoma swine were sensitized specifically to a tumor associated antigen like substance present in extracts of cutaneous melanomas and cultured swine melanoma cells and that melanoma swine leukocytes were cytotoxic for swine melanoma cells. Furthermore, these studies suggested the existence of a common cross reactive, melanoma associated antigen shared by human and swine melanomas. Antigenic analyses of swine melanomas with mouse monoclonal antibodies developed to a single swine melanoma cell culture and with rabbit antisera developed to pooled extracts of cutaneous melanomas demonstrated the presence of tumor associated antigens in swine melanoma cell culture and cutaneous melanomas. The failure of mouse monoclonal antibodies to detect antigens in cutaneous melanoma extracts and the failure of rabbit antisera to detect antigens in melanoma cell culture extracts suggested a differential in antigen expression between swine melanoma cells grown in vitro and in vivo
Choroidal melanoma is the most frequent intraocular tumor in adults. Due to its anatomic location the diagnosis often should be made on the basis of clinical examination and ancillary diagnostic procedures. The choroid melanoma may appear as a visual disturbance, retinal detachment and decrease of visual acuity. The diagnostic methods of choice are: Ultrasonography, Doppler, Ophthalmoscopy and Fluorescein Angiography, Computed Tomography and Magnetic Resonance Imaging (MRI) and are very useful in evaluating extra ocular extension of the tumor, post treatment local recurrence and differential diagnosis. Ultrasound is the primary method of diagnosis and follow up when a conservative treatment has been used, showing changes in vascularity and echogenicity. Magnetic resonance imaging is very useful in melanotic melanomas because the paramagnetic properties of melanine. They appear as areas of moderately high T1 signal and proton weighted MRI greater than vitreous and hypointensity in T2. The proper interpretation of its clinical presentation and the early use of imaging diagnostic methods allow a correct therapeutic approach and avoid local and distant metastasis which decrease survival time in these patients. (author)
A useful and practical guide is developed to better track to the uveal melanoma, due to its highly malignant character. Melanoma of the uveal tract (choroid, iris, ciliary body) has been the intraocular tumor most frequent in adults. The biopsy has been inaccessible, due to its location; therefore, the diagnostic should be based on clinical examination and the correct utilization of the diagnostic procedures (ultrasound, fluorescent angiography, computed axial tomography and magnetic resonance). The cases are diagnosed in the histological examination of the operatory piece post-enucleation for other causes. Epidemiological research has been key to determine the associated factors and better to understand the mechanisms of onset of the disease. Anatomopathological studies of choroidal melanoma have permitted to know the natural history of the disease. The decrease of the visual acuity, pain or inflammation are presented as a defect in the visual field. Different techniques to diagnose the disease are explained. Ultrasound in mode A and B, computed axial tomography and magnetic resonance are the diagnostic method of election. Ultrasound has been the primary method of diagnostic, giving the size and vascularisation, useful in tracking, when they are treated in shape conservatively, showing changes in echogenicity and less vascularisation as good response to treatment. The treatments of choroidal melanoma are specified. The correct interpretation of the clinical symptoms and early utilization of diagnostic imaging methods, have permitted to establish the adequate therapeutic and to avoid local and distant metastasis. The uveal melanoma, depending on their size and location, traditionally has been treated by enucleation. Data from the literature and authors, have promoted the conservation of the ocular globe, depending on the size of the tumor. Transpupillary thermotherapy has been an available alternative for small tumors in Costa Rica and level of social security. Patients have had the option to keep the ocular globe and even maintain good visual acuity with this therapy. Brachytherapy has been another alternative treatment in tumors of medium size, and can be performed in countries like Colombia and the United States
Full Text Available Background. Primary ovarian malignant melanoma is extremely rare. It usually appears in the wall of a dermoid cyst or is associated with another teratomatous component. Metastatic primary malignant melanoma to ovary from a primary melanoma elsewhere is well known and has been often reported especially in autopsy studies. Case report. We presented a case of primary ovarian malignant melanoma in a 45- year old woman, with no evidence of extraovarian primary melanoma nor teratomatous component. The tumor was unilateral, macroscopically on section presented as solid mass, dark brown to black color. Microscopically, tumor cells showed positive immunohistochemical reaction for HMB-45, melan-A and S-100 protein, and negative immunoreactivity for estrogen and progesteron receptors. Conclusion. Differentiate metastatic melanoma from rare primary ovarian malignant melanoma, in some of cases may be a histopathological diagnostic problem. Histopathological diagnosis of primary ovarian malignant melanoma should be confirmed by immunohistochemical analyses and detailed clinical search for an occult primary tumor.
Ciliary Body and Choroid Melanoma, Medium/Large Size; Ciliary Body and Choroid Melanoma, Small Size; Extraocular Extension Melanoma; Iris Melanoma; Metastatic Intraocular Melanoma; Mucosal Melanoma; Recurrent Intraocular Melanoma; Recurrent Melanoma; Stage IIC Melanoma; Stage IIIA Intraocular Melanoma; Stage IIIA Melanoma; Stage IIIB Intraocular Melanoma; Stage IIIB Melanoma; Stage IIIC Intraocular Melanoma; Stage IIIC Melanoma; Stage IV Intraocular Melanoma; Stage IV Melanoma
Full Text Available Pedunculated malignant melanoma is a rare occurrence. A 29 year old woman presented with a pedunculated malignant melanoma on a congenital melanocytic naevus with halo. Pedunculated malignant melanoma is known to have a high incidence of metastasis. The absence of metastasis and the presence of halo, in the case presented, suggests, that the body?s immunological process may have arrested the spread of the melanoma.
An appropriate biopsy is the pivotal procedure that facilitates accurate histopathologic diagnosis of a pigmented skin lesion. Excisional skin biopsy is the method of choice for removing a suspected malignant melanoma. More than 95% of malignant melanomas that involve the skin belong to one of the four most common clinicopathologic categories: superficial spreading, nodular, lentigo maligna, and acral lentiginous melanoma. A small but important group of cutaneous melanomas can be classified as unusual variants. Many of these unusual variants have a distinct histopathologic appearance; they include desmoplastic melanoma, neurotropic melanoma, pedunculated melanoma, metastatic melanoma, amelanotic melanoma, melanoma arising within a benign nevus, regressing ("invisible") melanoma, and balloon cell melanoma. Other lesions may simulate malignant melanoma histopathologically. Immunohistochemical stains, such as S-100 protein, vimentin, keratin, and HMB-45, are useful for distinguishing these lesions from true melanoma. PMID:9070205
Malignant melanomas of the mucosal regions of the head and neck are extremely rare neoplasms accounting for less than 1% of all melanomas. Approximately half of all head and neck melanomas occur in the oral cavity. Less than 2% of all melanomas lack pigmentation, in the oral mucosa however, up to 75% of cases are amelanotic. No etiologic factors or risk factors have been recognized for oral melanomas. Some authors have suggested that oral habits and selfmedication may be of etiological significance. Oral melanoma is rare but it is relatively frequent in countries like Japan, Uganda, and India. It is rarely identified under the age of 20 years. In Australia where cutaneous melanomas are relatively common primary melanoma of the oral mucosa is rare. The surface architecture of oral melanomas ranges from macular to ulcerated and nodular. The lesion is said to be asymptomatic in the early stages but may become ulcerated and painful in advanced lesions. The diagnosis of amelanotic melanoma is more difficult than that of pigmented lesions. The neoplasm consists of spindle-shaped cells with many mitotic figures and no cytoplasmic melanin pigmentation. Immunohistochemistry using S-100, HMB-45, Melan-A and MART-1 will help in establishing the correct diagnosis. Radical surgery with ample margins and adjuvant chemotherapy are appropriate management protocol for malignant melanoma. Oral melanoma is associated with poor prognosis but its amelanotic variant has even worse prognosis because it exhibits a more aggressive biology and because of difficulty in diagnosis which leads to delayed treatment. PMID:25161399
Adisa, A O; Olawole, W O; Sigbeku, O F
Full Text Available El melanoma es un tumor maligno originado en los melanocitos, cuya incidencia y mortalidad han aumentado en las últimas décadas. Sus factores de riesgo más importantes son la susceptibilidad genética relacionada con sensibilidad al sol (capacidad para broncearse y tendencia a las quemaduras y con ciertos genes especíLcos; factores ambientales tales como la exposición a la radiación UV, latitud y una combinación de ambos, como la cantidad de nevos. Sus formas clínicas son: melanoma extensivo superLcial (70%, nodular (15-30%, lentigo maligno (10-15% y acrolentiginoso (5%. De todas las características histológicas, el espesor de Brelow (medido en mm desde la granulosa hasta el punto más profundo de penetración tumoral es el predictor de sobrevida más importante. El tratamiento quirúrgico adecuado con 1 cm de margen en aquellos pacientes de bajo riesgo (Breslow Melanoma is a malignant tumor that originates in melanocytes and whose incidence and mortality have increased in the last decades. The most important risk factors are a genetic susceptibility related to sun sensitivity (having tanning capacity and being prone to sunburn and with certain speci1c genes; environmental factors such as exposure to UV radiation, latitude and a combination of both such as the number of nevis. Its clinical forms are: super1cial spreading melanoma (70%, nodular melanoma (15-30%, lentigo maligna melanoma (10-15% and acral lentiginous melanoma (5%. Among all the histological characteristics, Breslow's depth (measured in mm from the granular layer of the epidermis to the deepest point of tumor invasion is the most important predictor for progression free survival. An appropriate surgical treatment with 1-cm margin melanomas in low-risk patients (Breslow < 1 mm cures over 90% of the patients. Thus, early detection of melanoma is an important goal in melanoma treatment.
O melanoma é um tumor que se desenvolve como resultado da transformação maligna dos melanócitos, estimando-se a sua incidência global em 132.000 casos/ano. Este relato de caso reporta-se a um doente do sexo masculino com 70 anos, história de Diabetes Mellitus tipo 2 há dez anos e psoríase vulgar extensa há seis anos. Em aproximadamente um ano, este desenvolveu lesão ulcerada da região plantar do pé direito, que ao exame histológico revelou melanoma maligno...
Elias Ribeiro; Ana Luísa Silva; Cláudia Sofia Rego
Acral Lentiginous Malignant Melanoma; Lentigo Maligna Malignant Melanoma; Nodular Malignant Melanoma; Recurrent Melanoma; Solar Radiation-related Skin Melanoma; Stage IV Melanoma; Superficial Spreading Malignant Melanoma
Full Text Available Varias estrategias terapéuticas como la cirugía, radioterapia y quimioterapia están siendo utilizadas para tratar el cáncer. Sin embargo, en el caso del melanoma solamente la cirugía en las etapas tempranas de la enfermedad (estadíos I-II puede ser curativa en una alta proporción de pacientes. El tratamiento quimioterápico con dacarbacina (DTIC así como combinaciones con cisplatino, vinblastina y carmustina resulta ineficaz para eliminar las células de melanoma, ya que sólo se alcanza una respuesta en alrededor del 10% de los pacientes sin prolongar la sobrevida. La quimiorresistencia puede deberse tanto a una falta de respuesta primaria del melanoma como al desarrollo de mecanismos de resistencia adquiridos por el tumor, comúnmente definidos como multi-resistencia a drogas (MDR. En este artículo se analizan los principales mecanismos responsables de dicha resistencia y cómo el conocimiento de los mismos es aplicado al desarrollo de nuevos agentes terapéuticos. Por último, se discuten las recientes estrategias que combinan la quimioterapia con la inmunoterapia (Bioquimioterapia para optimizar el tratamiento del melanoma metastásico.Several therapeutic strategies such as surgery, radiotherapy and chemotherapy are being used to treat cancer. However, in the case of melanomas, only surgery during the early stages (stages I-II of the disease can be curative in a high proportion of patients. Chemotherapy treatment with dacarbazine (DTIC as well as combinations with cisplatin, vinblastine and carmustine proves to be ineffective to eliminate melanoma cells, since only 10% of patients responded positively without prolonging survival. Chemoresistance can be caused by both a lack of primary response of the melanoma and the development of resistance mechanisms acquired by the tumor usually defined as multi-drug resistance (MDR.The most important mechanisms responsible for such resistance and how the knowledge of those mechanisms is applied to the development of new therapeutic agents are analyzed in this article. Finally, the latest strategies that combine chemotherapy and immunotherapy (Biochemotherapy to optimize the treatment of metastatic melanoma will be further discussed.
María Marcela Barrio
The American Joint Committee on Cancer (AJCC) staging of cutaneous melanoma is a continuously evolving system. The identification of increasingly more accurate prognostic factors has led to major changes in melanoma staging over the years, and the current system described in this review will likely be modified in the near future. Likewise, application of new imaging techniques has also changed the staging work-up of patients with cutaneous melanoma. Chest and abdominal computed tomography (CT...
Mohr, P.; Eggermont, A. M. M.; Hauschild, A.; Buzaid, A.
Abstract The characterization of the molecular mechanisms involved in development and progression of melanoma could be helpful to identify the molecular profiles underlying aggressiveness, clinical behavior, and response to therapy as well as to better classify the subsets of melanoma patients with different prognosis and/or clinical outcome. Actually, some aspects regarding the main molecular changes responsible for the onset as well as the progression of melanoma toward a more agg...
Sini Maria; Casula Milena; Stroncek David F; Gentilcore Giusy; Ascierto Maria; Capone Mariaelena; Palmieri Giuseppe; Palla Marco; Mozzillo Nicola; Ascierto Paolo A
Se ha postulado que el melanoma tiene la capacidad de producir una excelente respuesta inmunitaria, ya que hay reportes de casos en los que se ha observado regresión total del melanoma y de la metástasis. Sin embargo, las diferentes inmunoterapias utilizadas contra el melanoma han fallado continuamente, lo cual sugiere la existencia de un mecanismo supresor inmunitario. Las células Tregs son una población de linfocitos T inmunosupresores que expresan altas concentraciones de CD25+ y Foxp3...
Lez, Norma Estela Herrera Gonz U. E.; Mez Pantoja, Gabriel G. U. F.
Full Text Available Subungual melanoma is a rare, but one of the diagnostically most difficult variants of melanoma. Unfortunately, due to its late detection, lack of an early reaction from the patient and diagnosis in advanced stages, subungual melanoma is deemed as a prognostically unfavorable variant of this malignancy. Diagnosis of subungual melanoma is very difficult to establish merely on the basis of clinical examination due to the resemblance of subungual hematoma to melanocytic nevus, fungal or bacterial infections. Dermoscopy seems to be the ideal diagnostic tool in the differential diagnosis of this life-threatening disease. Aims. To describe the basic aspects of dermoscopy of subungual melanoma and other conditions involving the nails. Methods. Review of medical database PubMed for the literature of the last 10 years on the dermoscopic patterns of subungual melanoma and other subungual diseases. Results. We collate the fundamental rules of performing dermoscopy in subungual melanoma, as well as basic dermoscopic features and diagnostic algorithms of selected subungual lesions requiring differentiation from melanoma. Conclusions. Dermoscopy is a safe, easily repeatable diagnostic method, and the knowledge of basic dermoscopic patterns of developing melanoma in subungual localization, along with the differential diagnosis of other diseases within the nail plate, will help not only dermatologists, but also the professionals of other specialties, such as surgeons, oncologists, orthopedists, and also general practitioners.
Full Text Available Primary melanoma of testis is extremely rare and even the existence of such an entity is questioned. We present the case of a 60-year-old man with primary malignant melanoma in the testis. We report this case to emphasize the need for awareness of the possibility of the testis being the primary site in the patient with a melanoma and to underline the necessity of meticulous investigation of suspicious lesions of the testis in patients with or without a past history of malignant melanoma.
A potential diagnostic pitfall in the histologic assessment of melanoma is the inability to recognize unusual melanoma variants. Of these, the more treacherous examples include the desmoplastic melanoma, the nevoid melanoma, the so-called 'minimal-deviation melanoma,' melanoma with prominent pigment synthesis or 'animal-type melanoma,' and the malignant blue nevus. Also problematic are the unusual phenotypic profiles seen in vertical growth phase melanomas; these include those tumors whose morphological peculiarities mimic cancers of nonmelanocytic lineage and those melanomas that express aberrant antigenic profiles not commonly associated with a melanocytic histogenesis. Metaplastic change in melanoma, balloon cell melanoma, signet-ring cell melanoma, myxoid melanoma, small cell melanoma and rhabdoid melanoma all have the potential to mimic metastatic and primary neoplasms of different lineage derivations. Abnormal immunohistochemical expression of CD 34, cytokeratins, epithelial membrane antigen, and smooth muscle markers as well as the deficient expression of S100 protein and melanocyte lineage-specific markers such as GP100 protein (ie HMB-45 antibody) and A103 (ie Melan-A) also present confusing diagnostic challenges. In this review, we will discuss in some detail certain of these novel clinicopathologic types of melanoma, as well as the abnormal phenotypic expressions seen in vertical growth phase melanoma. PMID:16446716
Magro, Cynthia M; Crowson, A Neil; Mihm, Martin C
A rare case of subungual malignant melanoma in a 43-year-old male, with black dystrophic left middle finger nail plate with positive Hutchison sign is presented. Patient underwent disarticulation at the proximal interpholangeal joint. Histopathology confirmed malignant melanoma, and resection free of tumour cells.
De, Krishna K; Sharma P
There are 8100 new cases of malignant melanoma and 1800 deaths a year in the UK, largely as a result of metastatic disease. The median survival of people with metastatic melanoma is 6 to 9 months after diagnosis, with 10% of people alive at 5 years.Chemotherapy is given with palliative rather than curative intent for metastatic disease.
Larkin, James; Gore, Martin
... of the Foot Text Size Print Bookmark Malignant Melanoma of the Foot What is Malignant Melanoma? Melanoma is a cancer that begins in the cells ... produce pigmentation (coloration). It is also called malignant melanoma because it spreads to other areas of the ...
Primary genitourinary melanoma accounts for less than one per cent of all cases of melanoma. Most cases attributed to the prostate actually originate from the prostatic urethra. Due to its infrequency, primary malignant melanoma of the genitourinary tract presents a difficult diagnostic and management challenge. We report a case of primary malignant melanoma of the prostate found during transurethral resection of the prostate.
Doublali M; Chouaib A; Khallouk A; Tazi M; El Fassi M; Farih My; Elfatmi H; Bendahou M; Benlemlih A; Lamarti O
Full Text Available O melanoma do aparelho ungueal é apresentação relativamente rara dessa neoplasia, muitas vezes diagnosticada como nevo juncional, hematoma subungueal ou mesmo onicomicose. Esse fato leva a um atraso no diagnóstico e, conseqüentemente, na instituição da terapêutica específica, contribuindo para agravar o prognóstico de uma doença que por si só já é muito agressiva. Os autores relatam um caso de melanoma no primeiro quirodáctilo esquerdo de uma paciente negra com evolução de um ano, ressaltando a importância de avaliar certos critérios clínicos para obter o diagnóstico em fases mais precoces da doença.Nail apparatus melanoma is a rare presentation of melanoma and may be misdiagnosed as junctional nevus, subungual hematoma or onychomycosis. This fact often leads initially to inappropriate treatment and significant delays in appropriately managing such an aggressive disease. The authors report a case of melanoma on the left thumb of a black patient evolving for a year. Emphasis was placed on the importance of assessing certain clinical characteristics in order to reach an early diagnosis.
Ignez Regina dos Santos Muri Mendonça
Recent evidence suggests that the biology of noncutaneous melanoma differs significantly from cutaneous melanoma and may provide therapeutic opportunity. The most frequent sites of origin of noncutaneous melanoma are the eye and mucosal surfaces. Although noncutaneous melanomas are an uncommon group of cancers (representing less than 10% of all melanomas) a greater understanding of their genetic and molecular abnormalites is being translated into novel treatment strategies. These developments...
Wilkins, D. K.; Nathan, P. D.
Ophthalmic melanomas can be divided in extra-ocular (conjunctiva, caruncle) and intraocular uveal melanomas (iris, ciliary body and choroid). Uveal melanomas account for 95% of ocular melanomas, while only 5% are conjunctival in origin. The extra-ocular and intra-ocular melanomas differ in biological behavior. Melanocytes originate from the neural crest and are normally present in the uveal stroma, similar to dermal melanocytes. Intraepithelial precursor lesions of invasive mel...
Mooij, C. M.
The anorectum is a rare anatomic location for primary melanoma. Mucosal melanoma is a distinct biological and clinical entity from the more common cutaneous melanoma. It portrays worse prognosis than cutaneous melanoma, with distant metastases being the overwhelming cause of morbidity and mortality. Surgery is the treatment of choice, but significant controversy exists over the extent of surgical resection. We present an update on the state of the art of anorectal mucosal melanoma. To illu...
P Carcoforo, M. T. Raiji
The efficiency of radiotherapy of malignant melanoma is discussed according to observations by other clinicians and ourselves. There is no proof that the melanoma is radiotherapy-resistant. The clinical radiosensitivity of human melanoma can be compared with the experimental hamster or mice melanoma or with the sensitivity of cultured melanoma cells. The possibility of increasing the efficiency of radiotherapy in the future by electroaffine sensitizers, fast electrons, or neutrons with a high LET and a small OER is mentioned. (orig.)
Primary central nervous system (CNS) melanoma is a rare condition that accounts for only 1% of all melanomas. A 34-year-old Korean female presented with a two-month history of progressive weakness in both legs. Spinal magnetic resonance image (MRI) revealed a spinal cord tumor at the level of T4, which was hyperintense on T1-weighted imaging and hypointense on T2-weighted imaging. The intradural and extramedullary tumor was completely resected and diagnosed as melanoma. There were no metastat...
Kim, Min Soo; Yoon, Do Heum; Shin, Dong Ah
Uveal melanoma is the most common primary intraocular malignancy in adults, with an incidence of 5-7 per million per year. It is associated with the development of metastasis in about 50% of cases, and 40% of patients with uveal melanoma die of metastatic disease despite successful treatment of the primary tumour. The survival rates at 5, 10 and 15 years are 65%, 50% and 45% respectively. Unlike progress made in many other areas of cancer, uveal melanoma is still poorly understood and survival rates have remained similar over the past 25 years. Recently, advances made in molecular genetics have improved our understanding of this disease and stratification of patients into low risk and high risk for developing metastasis. However, only a limited number of studies have been performed using proteomic methods. This review will give an overview of various proteomic technologies currently employed in life sciences research, and discuss proteomic studies of uveal melanoma.
A case of primary leptomeningeal melanoma is presented in which the diagnosis was made by ultrastructural demonstration of melanoma cells from the cerebrospinal fluid (CSF) at a time when cranial computed tomography (CT) still gave negative results. Later CT examinations documented the emergence of a tumor mass of the left temporoparietal lobe. This case clearly illustrates the complementary role of these investigational procedures for the diagnosis of cerebrospinal melanoma: leptomeningeal involvement, characterized by two-dimensional diffuse spread of melanoma tissue (''leptomeningeal melanomatosis''), is invisible with CT, but easily recognisable by CSF cytology; in contrast, nodular parenchymal tumor deposits can be readily detected by CT. Identification of pigmented cells recovered from the CSF requires ultrastructural confirmation.
Aichner, F.; Schuler, G.
Full Text Available The anorectum is a rare anatomic location for primary melanoma. Mucosal melanoma is a distinct biological and clinical entity from the more common cutaneous melanoma. It portrays worse prognosis than cutaneous melanoma, with distant metastases being the overwhelming cause of morbidity and mortality. Surgery is the treatment of choice, but significant controversy exists over the extent of surgical resection. We present an update on the state of the art of anorectal mucosal melanoma. To illustrate the multimodality approach to anorectal melanoma, we present a typical patient.
P Carcoforo, M.T Raiji, G.M Palini, M Pedriali, U Maestroni, G Soliani, A Detroia, M.V Zanzi, A.L Manna, J.G Crompton, R.C Langan, A Stojadinovic, I Avital
Melanoma is the deadliest form of skin cancer and is increasing in incidence. Recent treatment advances have been made, but there remains a need for continued development of effective therapy options, as treatment rarely leads to cure. Many melanomas contain somatic mutations involved tumor pathogenesis. Accurate identification of these mutations is necessary in order to stratify patients for the purpose of treatment and potential for clinical trials, given the absence or presence of a specif...
Wilson, Melissa Ann; Nathanson, Katherine L.
BACKGROUND/AIM—There has been no consistent pattern reported on how mortality for uveal melanoma varies with age. This information can be useful to model the complexity of the disease. The authors have examined ocular cancer trends, as an indirect measure for uveal melanoma mortality, to see how rates vary with age and to compare the results with their other studies on predicting metastatic disease.?METHODS—Age specific mortality was examined for England and Wales, the USA, and Canada. ...
Foss, A.; Cree, I.; Dolin, P.; Hungerford, J.
Primary intracranial melanoma is an extremely rare lesion of the brain. A 28 years old lady, without any co-morbid conditions, presented with headache and left side facial numbness. MRI of brain showed a mass lesion in left middle cranial fossa extending into posterior fossa, with signals characteristics of melanoma. Histology and immunohistochemistry confirmed the diagnosis after surgical excision of that lesion. Patient remained symptom-free till the last follow-up that was four years postoperatively. (author)
Wide local excision is the mainstay in the treatment of the primary lesion with consideration given to specific anatomic constraints in head and neck melanoma. Sentinel lymph node biopsy is considered in all lesions with ulceration, mitoses greater than or equal to 1/mm(2), stage1B or higher, and in all high-risk nonmetastatic melanoma. Reconstructive strategy must be considered in multidisciplinary teams with reconstructive surgeons for large head and neck defects. PMID:25245970
Cheriyan, Jerry; Wernberg, Jessica; Urquhart, Andrew
Full Text Available We describe a case of metastatic malignant melanoma on the thigh with comedo-like appearance, which histologically showed elimination of tumor cells. A 70 year-old man was diagnosed with a nodular type malignant melanoma involving the lower back with satellite lesions (stage IIIB, T4b N2c M0, Breslow’s tumor thickness; 10.3 mm, Clark’s level; IV.
Full Text Available A 25-year-old man had multiple asymptomatic, nodular lesions on the trunk, extremities and the face for 3 months. He also had left facial palsy with severe headache and vomiting. There were no other systemic or constitutional symptoms. Skin biopsy from a nodular lesion showed features of malignant melanoma, confirmed by Fontana Masson and S-100 protein staining. A diagnosis of disseminated malignant melanoma was made and the patient was treated symptomatically. The patient died in 4 months.
A 25-year-old man had multiple asymptomatic, nodular lesions on the trunk, extremities and the face for 3 months. He also had left facial palsy with severe headache and vomiting. There were no other systemic or constitutional symptoms. Skin biopsy from a nodular lesion showed features of malignant melanoma, confirmed by Fontana Masson and S-100 protein staining. A diagnosis of disseminated malignant melanoma was made and the patient was treated symptomatically. The patient died in 4 months.
Verma Kaushal; Souza Paschal, D. X.; Sirka C; Raman R; Rathi Sanjay
Background/Aim. The lack of effective therapy for advanced stages of melanoma emphasizes the importance of preventive measures and screenings of population at risk. Identifying individuals at high risk should allow targeted screenings and follow-up involving those who would benefit most. The aim of this study was to identify most significant factors for melanoma prediction in our population and to create prognostic models for identification and differentiat...
Nikoli? Jelena; Lon?ar-Turukalo Tatjana; Sladojevi? Sr?an; Marinkovi? Marija; Janji? Zlata
Full text: Malignant choroidal melanoma is one of the most common primary intraocular neoplasms. Despite significant advances in indirect ophthalmology, ultrasound, computed tomography (CT), magnetic resonance imaging (MRI) and fluoroescein angiography, choroidal melanomas may be difficult to distinguish from other malignant and non-malignant eye lesions. Radioimmunoscintigraphy (RIS) with 99Tcm-labelled monoclonal antibody F(ab')2 fragments was performed on three patients (2 females, 1 male) who were suspected of having a choroidal melanoma. Patients were injected with 240-420 MBq Technemab-K-1 and scanned 6 and 22 h post-injection. Both planar and single photon emission tomographic (SPET) imaging were performed. RIS was faintly positive in one patient in whom the diagnosis of choroidal melanoma was confirmed by enucleation of the left eye. In the other two patients, immunoscintigraphy was negative. One patient had a benign choroidal haemangioma and the other an amelanotic melanoma. This was confirmed on clinical follow-up. These preliminary results indicate that this procedure may have utility for choroidal melanoma
A blind painful eye may harbour an unsuspected malignant melanoma. We report a case of ocular melanoma that presented with confusion owing to direct extension via the optic nerve into the anterior cranial fossa.
Jones, D. R.; Scobie, I. N.; Sarkies, N. J.
The diagnosis of melanocytic tumors is one of the most problematic areas in dermatology and diagnostic pathology. Melanoma is a malignant melanocytic tumor and the risk for metastasis and associated mortality is mainly dependent on tumor thickness and depth of invasion. Early recognition and correct diagnosis is therefore important for successful and effective treatment. The correct diagnosis of melanoma is, however, challenging due to the wide morphological spectrum. Historically, the disease was subdivided into superficial spreading, nodular, lentigo maligna and acral lentiginous melanoma but many more subtypes have subsequently been added. Some of these melanoma variants also show differences relating to the genetic background, clinical presentation, prognosis and treatment and may be associated with a specific differential diagnosis. In this article four of these melanoma variants, desmoplastic melanoma, nevoid melanoma, malignant blue nevus and pigment synthesizing melanoma will be discussed in more detail. PMID:25589353
Full Text Available Primary genitourinary melanoma accounts for less than one per cent of all cases of melanoma. Most cases attributed to the prostate actually originate from the prostatic urethra. Due to its infrequency, primary malignant melanoma of the genitourinary tract presents a difficult diagnostic and management challenge. We report a case of primary malignant melanoma of the prostate found during transurethral resection of the prostate.
Metastatic melanoma has a propensity for multiple intra cranial deposits. Rarely, metastatic melanoma to the pituitary gland has been reported, usually in conjunction with widespread systemic metastases. We describe a patient with metastatic melanoma to the pituitary gland as the first clinical presentation of widespread metastatic disease and review the relevant literature. PMID:20965730
Wang, Y Y; Norris, Andrea; du Plessis, D; Gnanalingham, K K
Melanoma is a tumor that develops as a result of the malignant transformation of the melanocytes. There is a worldwide estimate of 132,000 new cases per year. This case study presents a 70-year-old male person with history of Diabetes Mellitus type 2 for 10 years and extensive psoriasis vulgaris for 6 years. The patient developed an ulcerated lesion in the plantar region of the right foot in one-year time period. The histol...
Cláudia Sofia Rego; Ana Luísa Silva; Elias Ribeiro
Iris Melanoma; Medium/Large Size Posterior Uveal Melanoma; Ocular Melanoma With Extraocular Extension; Recurrent Uveal Melanoma; Small Size Posterior Uveal Melanoma; Stage IIIA Uveal Melanoma; Stage IIIB Uveal Melanoma; Stage IIIC Uveal Melanoma; Stage IV Uveal Melanoma
Surgical excision is the treatment of choice for primary melanomas and radiation therapy is the accepted alternative for the subset of lesions not amenable to surgery. With the recent rise in melanoma incidence, especially in the elderly, there are a growing number of cases that are neither amenable to surgery nor radiation therapy. In this article, we review pharmacotherapeutic approaches to microinvasive melanoma (invasive radial growth phase melanoma) that might be considered in such circumstances. There are no approved drugs for the treatment of primary melanoma and randomized controlled trials with 5 or more years of follow-up have not been performed. The limited studies and numerous case series in the literature on pharmacologic treatment of primary melanoma have focused on topical therapies. Accordingly, we provide a review of the potential pharmacotherapeutic agents in the treatment of microinvasive melanoma by extrapolating from the available limited literature on the use of fluorouracil, azelaic acid, retinoic acid derivatives, interferon (IFN)-?, imiquimod, and other agents for melanoma in situ, invasive melanoma, and epidermotropic melanoma metastases. Our review indicates that topical fluorouracil and tretinoin are not effective as single agents. The efficacy of azelaic acid, tazarotene, cidofovir, and intralesional IFN-?, interleukin-2, and IFN-? is undefined. Imiquimod is the most studied and promising agent; however, optimal dosage, therapeutic regimen, and survival rates are unknown. In the face of a growing demand for non-surgical treatments, formal clinical trials are needed to ascertain the role of pharmacotherapeutic agents in the treatment of microinvasive melanoma. PMID:23479385
Quigley, Elizabeth A; Halpern, Allan C
Immunoscintigraphy (IS) of malignant tumors has become an encouraging tool in nuclear medicine. Early diagnosis of small lesions is mandatory for successful cancer therapy generally. The scintigraphic detectability of small lesions (2 fragments of the anti-melanoma monoclonal antibody 225.28S; this antibody recognizes the high-molecular-weight melanoma-associated antigen. No adverse effects were observed. In terms of true positive results, Single Photon Emission CT proved to be superior compared to planar scans (81 versus 46 percent true positive results). (author). 30 refs
Full Text Available SciELO Peru | Language: Spanish Abstract in spanish El melanoma esofágico primario (MEP) es una neoplasia extremadamente rara, con menos de 270 casos descritos. Aunque la presentación clínica es similar a cualquier otra neoplasia esofágica, su comportamiento es más agresivo y fatal en la mayoría de los casos. Presentamos dos nuevos casos de MEP diagn [...] osticados mediante endoscopia y estudio anatomopatológico de las biopsias obtenidas, siendo en ambos casos las muestras positivas para HMB-45 y S100, descartando así mismo la presencia de melanoma primario en otra localización. En el primer caso merece destacar la forma de presentación como miosis izquierda sin ptosis palpebral ni enoftalmos, siendo el primer caso descrito con esta manifestación inicial, lamentablemente al momento del diagnóstico fue irresecable, demostrando así mismo por ecoendoscopia afectación de la aorta torácica. El segundo caso a pesar de ser una neoplasia sin extensión locorregional y sometido a esofaguectomía transhiatal presentó múltiples complicaciones postoperatorias falleciendo al decimo noveno día de la intervención. Así mismo se hace una revisión bibliográfica sobre diagnóstico, opciones de tratamiento y pronóstico de esta excepcional neoplasia. Abstract in english Primary Esophageal Melanoma (PEM) is an extremely rare neoplasm, with less than 270 cases described. Although clinical presentation is similar to any other esophageal neoplasm, MEP's behavior is more aggressive and fatal in most cases. We report two new cases of MEP diagnosed through endoscopy and a [...] natomical-pathological analysis of collected biopsies. Both samples were positive for HMB-45 and S100, so the presence of primary melanoma in other location was ruled out. The form of presentation as left miosis with no eyelid ptosis or enophthalmos should be highlighted in the first case, which was described by this early manifestation. Unfortunately, the neoplasm could not be excised when diagnosed because the thoracic artery was found to be affected through echoendoscopy. In the second case, in spite of the fact that the neoplastic extension was only local, and neoplasm was subject to transhiatal esophagectomy, the patient had multiple post-surgical complications and died nineteen days after the surgical procedure. Furthermore, bibliographic review is applied to diagnosis, treatment options, and prognosis of this exceptional neoplasm.
Robin, Rivera Irigoín; Víctor, Aguilar Urbano; Juana, Gonzalo Marín; Cristobal, Albandea Moreno; Francisco, Fernández Pérez; Andrés, Sánchez Cantos.
Full Text Available La teoría de la inmunovigilancia postula que el sistema inmune es capaz de detectar células cancerosas reconociendo sus características particulares y eliminarlas previniendo la progresión del cáncer. Sin embargo, dicho proceso no es absolutamente eficaz, identificándose tres etapas propuestas para explicar la aparición de los tumores: en la primera (Eliminación el sistema inmune es capaz de destruir células neoplásicas básicamente mediante efectores de la inmunidad innata; en la fase de Equilibrio, se inducen efectores específicos que reconocen y destruyen al tumor pero también se genera una presión de selección sobre las células tumorales generando variantes neoplásicas mutadas. Por último, en la etapa de Escape, las variantes del tumor que sobreviven se vuelven resistentes al reconocimiento y/o eliminación por los efectores inmunes y el tumor crece. En este artículo se presentan los principales antígenos (Ags asociados al melanoma, las diversas estrategias terapéuticas que utilizan a estos Ags como blanco para inducir inmunidad, así como la existencia de los mecanismos de escape tumoral en el melanoma. Se analizan las evidencias más recientes acerca de cómo el microambiente tumoral condiciona la efectividad de la inmunidad celular específica evidenciando la necesidad actual de explorar terapias que combinen la acción de efectores de la inmunidad innata y la específica antitumoral, a la vez que modulen el microambiente tumoral para favorecer su acción.The immunosurveillance theory states that the immune system is capable of detecting cancer cells recognizing their particular characteristics and of eliminating them to prevent cancer progression. However, such process is not completely effective. Three stages proposed to explain the emergence of tumors can be identified in the process: in the first stage (Elimination the immune system is capable of destroying neoplasic cells basically by means of innate immunity effectors; in the second (Equilibrium stage, specific effectors that recognize and destroy the tumor are induced, but on the other hand, selection pressure is generated on tumor cells, originating mutated neoplasic variants. Finally, in the Escape stage, the tumor variants that survive become more resistant to identification and /or elimination by the immune effectors and consequently the tumor grows. The main melanoma-associated Ags, the various therapeutical strategies using these Ags as targets to induce immunity, as well as the existence of tumor escape mechanisms in the melanoma will be introduced in this chapter. Furthermore, the latest evidence on how tumor microenvironment determines the effectiveness of specific cell immunity will be analyzed, proving the present need of exploring therapies that both combine the action of innate immunity effectors and the anti-tumor specific effectors, and modulate the tumor microenvironment to favour its actions.
María Marcela Barrio
Full Text Available SciELO Argentina | Language: Spanish Abstract in spanish La teoría de la inmunovigilancia postula que el sistema inmune es capaz de detectar células cancerosas reconociendo sus características particulares y eliminarlas previniendo la progresión del cáncer. Sin embargo, dicho proceso no es absolutamente eficaz, identificándose tres etapas propuestas para [...] explicar la aparición de los tumores: en la primera (Eliminación) el sistema inmune es capaz de destruir células neoplásicas básicamente mediante efectores de la inmunidad innata; en la fase de Equilibrio, se inducen efectores específicos que reconocen y destruyen al tumor pero también se genera una presión de selección sobre las células tumorales generando variantes neoplásicas mutadas. Por último, en la etapa de Escape, las variantes del tumor que sobreviven se vuelven resistentes al reconocimiento y/o eliminación por los efectores inmunes y el tumor crece. En este artículo se presentan los principales antígenos (Ags) asociados al melanoma, las diversas estrategias terapéuticas que utilizan a estos Ags como blanco para inducir inmunidad, así como la existencia de los mecanismos de escape tumoral en el melanoma. Se analizan las evidencias más recientes acerca de cómo el microambiente tumoral condiciona la efectividad de la inmunidad celular específica evidenciando la necesidad actual de explorar terapias que combinen la acción de efectores de la inmunidad innata y la específica antitumoral, a la vez que modulen el microambiente tumoral para favorecer su acción. Abstract in english The immunosurveillance theory states that the immune system is capable of detecting cancer cells recognizing their particular characteristics and of eliminating them to prevent cancer progression. However, such process is not completely effective. Three stages proposed to explain the emergence of tu [...] mors can be identified in the process: in the first stage (Elimination) the immune system is capable of destroying neoplasic cells basically by means of innate immunity effectors; in the second (Equilibrium) stage, specific effectors that recognize and destroy the tumor are induced, but on the other hand, selection pressure is generated on tumor cells, originating mutated neoplasic variants. Finally, in the Escape stage, the tumor variants that survive become more resistant to identification and /or elimination by the immune effectors and consequently the tumor grows. The main melanoma-associated Ags, the various therapeutical strategies using these Ags as targets to induce immunity, as well as the existence of tumor escape mechanisms in the melanoma will be introduced in this chapter. Furthermore, the latest evidence on how tumor microenvironment determines the effectiveness of specific cell immunity will be analyzed, proving the present need of exploring therapies that both combine the action of innate immunity effectors and the anti-tumor specific effectors, and modulate the tumor microenvironment to favour its actions.
María Marcela, Barrio.
Full Text Available SciELO Peru | Language: Spanish Abstract in spanish Paciente varón de 73 años que acude a emergencia con anemia severa (Hb 4.9 g/dL), refiriendo un mes con deposiciones oscuras, astenia y pérdida significativa de peso. La evaluación endoscópica alta no encontró lesiones potencialmente sangrantes. Posteriormente se constató la presencia de heces sangu [...] inolentas rojizas tipo enterorragia y se realizó una colonoscopía, en la cual se encontraron dos lesiones elevadas en el ciego: una pedunculada (con sangrado activo rezumante) y otra sésil, ambas fueron extirpadas; el estudio de anatomía patológica demostró que correspondían a melanoma amelanótico de ciego. El examen físico no reveló lesiones neoplásicas dérmicas. El sangrado digestivo recurrente obligó a realizar una nueva colonoscopia que demostró una nueva lesión sangrante de ciego. Fue intervenido quirúrgicamente con una cecostomía y extirpación de la lesión cecal. La tomografía demostró metástasis en mediastino y en la cirugía se encontraron implantes metastásicos en hígado e intestino delgado. El paciente continuó tratamiento en oncología médica. Nosotros reportamos el presente caso, por ser la hemorragia digestiva una forma inusual de presentación clínica del melanoma maligno metastásico. Abstract in english A 73 year old male patient who presented to emergency with severe anemia (Hb 4.9 g / dL), referring to a month with dark stools, fatigue and significant weight loss. The high endoscopic evaluation found no potentially bleeding lesions. Subsequently, we confirmed the presence of red blood in stools, [...] like enterorrhagia and underwent a colonoscopy, in which two elevated lesions were found in the cecum: a pedunculated (with active bleeding, oozing) and other sessile; both were removed. the pathology showed that corresponded to amelanotic melanoma in cecal region. Physical examination revealed no malignant skin lesions. Recurrent gastrointestinal bleeding forced to make another colonoscopy that showed new bleeding lesion of the cecum. He was operated with a cecostomy and cecal excision of the lesion.. The tomography scan showed metastases in mediastinum and surgical implants were found in liver metastases and small intestine. The patient continued treatment in medical oncology. We report this case, because gastrointestinal bleeding is an unusual clinical presentation of malignant melanoma.
Ofelia, Castillo; Oscar, Frisancho; Americo, Palomino.
Full Text Available SciELO Colombia | Language: Spanish Abstract in spanish El melanoma acral lentiginoso es el tipo de melanoma de localización distal más frecuente, suele diagnosticarse en los estadios más avanzados y tiene un comportamiento biológico más agresivo que otros tipos de melanoma, por lo cual son de peor pronóstico. Representa entre el 5 % y el 10 % de los mel [...] anomas malignos y es más frecuente en asiáticos, en la raza negra y en latinoamericanos. El objetivo de este artículo fue hacer una revisión bibliográfica actualizada con el fin de conocer las tasas de incidencia del tumor, los nuevos avances con respecto a los factores de riesgo, biología molecular, diagnóstico y tratamiento, y el desarrollo de nuevos tratamientos en el manejo del melanoma avanzado y metastásico. Abstract in english Acral lentiginous melanomas, the melanomas most commonly found the distal portions of the limbs, have usually reached more advanced stages than other types of melanoma when diagnosed. Their biologic behavior is more aggressive than in other types of melanoma, so that they have a worse prognosis. It [...] represents 5 to 10% of all malignant melanomas, and is more frequently seen among the Asian, African American and Latin population. The objective of this paper was to complete a review of the current literature, in order to establish the rates of incidence, new findings regarding risk factors, molecular biology, diagnosis and treatment, and the development of new target therapies in the management of advanced and metastatic melanomas.
Carlos, Duarte; Héctor, López.
Background: Malignant melanoma is highly resistant to current treatments. The inhibitor of apoptosis protein (IAP) family member, melanoma IAP (ML-IAP), is overexpressed in some melanoma cell lines, rendering them resistant to apoptotic signals. Targeting ML-IAP is a promising approach to treating melanoma. However, the status of ML-IAP expression in human melanoma tissues and the difference in expression between melanoma and melanocytic naevus are not known.
Gong, J.; Chen, N.; Zhou, Q.; Yang, B.; Wang, Y.; Wang, X.
Primary malignant melanoma of the vagina and esophagus are reported and the literature on the subject is extensively reviewed. The role of large fraction irradiation is appraised. In both cases, no exenterative surgery was imposed but instead, intermittent large fraction irradiation with protracted high doses was elected for local control. (Auth.)
Primary penile melanomas are exceedingly rare (less than 1% of primary penile cancers), 221 cases being reported to date in PubMed indexed medical literature. More than half of the cases occur on the gland, usually in older people than on cutaneous counterpart and have unfavourable prognosis mainly due to the belated diagnosis. We report the case of a 77 years old male diagnosed with a pigmented ulcerated nodular melanoma of the gland with maximal thickness of 4.5 mm, mitotic index 8 mitoses/mm2 and vascular emboli. No lymph node enlargements or distant metastases were identified at presentation. Six months after the diagnosis the patient was well, free of disease. Clinically, penile melanomas may be mistaken for several lesions such as squamous carcinoma, penile nevi, pyogenic granuloma, Kaposi sarcoma. Histopathologic diagnosis is usually straight forward except for highly pleomorphic tumors; discrimination between primary penile tumor and penile metastatic melanoma is the most delicate problem of differential diagnosis. The treatment is not standardized; surgical wide excision or partial/total penectomy completed with sentinel lymph node biopsy are the most frequent methods of treatment; multi-agent chemotherapy and/or high-dose interferon alpha 2b therapy are recommended for patients with locally un-controllable disease and/or metastases. PMID:25338349
Andrei, R; Cioplea, Mirela; Mageriu, V; Chuaibi, A; Cauni, V; Zurac, Sabina; Staniceanu, Florica
autoinmunidad severa. Aunque aún no se conocen los mecanismos por los cuales funcionan estas células, se sabe que secretan citocinas inmunosupresoras y que inhiben la activación y proliferación de células T, con lo cual se pierde respuesta antitumoral. Por tanto, a estas células las hemos llamado "los guardianes del melanoma".
Norma Estela Herrera Gonz\\u00E1lez
Full Text Available Melanomas are malignant neoplasms that originate from melanocytes. The most common are on the skin and mucous membranes. Choroidal melanomas are quite different from cutaneous melanomas with regard to presentation, metastases, and treatment. We report two cases of metastatic gastric malignant melanoma of the eye and skin, with reference to the literature. The first patient was a woman aged 23 years, who underwent gastrectomy 22 months after enucleation of the eye due to malignant choroid melanoma. The second patient was a man, 72 years old, who underwent surgery 28 months before because of malignant melanoma of the skin of the forehead. Paraffin sections, 4 ?m thick were stained using a classic method, as well as immunohistochemical DAKO APAAP method, using a specific S - 100 antibody and Melan A antibodies. The stomach is considered a rare place for the development of metastases. Metastases in the stomach are often limited to the submucosal as well as the serousmuscular layer, as noted in one of our patients. Metastatic melanoma of the gastrointestinal tract should be suspected in any patient with a history of malignant melanoma and new gastrointestinal symptoms. Because of the similarity between certain common histopathological types of malignant melanoma, primarily achromatic, and types of primary cancers of the stomach, the following immunohistochemical studies are needed: Melan A and S - 100 protein ( markers of malignant melanoma , as well as mucins: MUC5AC, MUC2 and CDX2 ( markers of different types of primary gastric carcinoma.
Melanoma is one of the most aggressive cancers known with a high rate of mortality and increasing global incidence. So, the development of radiopharmaceuticals for either diagnostic or therapeutic purposes could make enormous contributions to melanoma patient health care. We have been studying melanoma tumours through several targeting mechanisms including melanin or specific receptor based radiopharmaceuticals Structure activity studies indicate that the substitution patterns on radioiodinated benzamides significantly influence the uptake mechanism from melanin to sigma-receptor binding. Furthermore, the position of the iodine as well as the presence of key functional groups and substituents has resulted in compounds with varying degrees of activity uptake and retention in tumours. From these results, a novel molecule 2-(2-(4-(4-iodo benzyl)piperazin-1-yl)-2-oxo-ethyl)isoindoline- 1,3-dione (M.E.L.037) was synthesized, labelled with iodine-123 and evaluated for application in melanoma tumour scintigraphy and radiotherapy. The tumour imaging potential of 123IM.E.L.037 was studied in vivo in C.57 B.L./ 6 J female mice bearing the B.16 F.0. murine melanoma tumour and in BALB/c nude mice bearing the A.375 human amelanotic melanoma tumour by biodistribution, competition studies and by SPECT imaging. 123I-M.E.L.037 exhibited high and rapid uptake in the B.16 F.0 melanoma tumour at 1 h (13 % I.D./g) increasing with time to reach 25 % I.D./g at 6 h. A swith time to reach 25 % I.D./g at 6 h. A significant uptake was also observed in the eyes (2% I.D., at 3-6 h p.i.) of black mice. No uptake was observed in the tumour or in the eyes of nude mice bearing the A.375 tumour. Due to high uptake and long retention in the tumour and rapid body clearance, standardized uptake values(S.U.V.) of 123I-M.E.L.037 were 30 and 60, at 24 and 48 h p.i.,respectively. SPECT imaging of mice bearing the B.16 melanoma indicated the radioactivity was predominately located in the tumour followed by the eyes, while no specific localisation of the radioactivity was noticed in mice bearing A.375 human amelanotic tumour. In competition experiments,uptake of 123I-M..E.L.037 in brain, lung, heart and kidney, organs known to contain s-receptors, was not significantly different in haloperidol treated animals compared to controls. Therefore,reduction of uptake in tumour and eyes of the pigmented mice bearing the B.16 F.0 tumour suggested that the mechanism of tumour uptake was likely due to an interaction with melanin.These findings suggested that 123I-M.E.L.037, which displays a rapid and very high tumour uptake, appeared to be a promising imaging agent for detection of most melanoma tumours with the potential for development as a therapeutic agent in melanoma tumour proliferation. (authors)
Full Text Available Background/Aim. The lack of effective therapy for advanced stages of melanoma emphasizes the importance of preventive measures and screenings of population at risk. Identifying individuals at high risk should allow targeted screenings and follow-up involving those who would benefit most. The aim of this study was to identify most significant factors for melanoma prediction in our population and to create prognostic models for identification and differentiation of individuals at risk. Methods. This case-control study included 697 participants (341 patients and 356 controls that underwent extensive interview and skin examination in order to check risk factors for melanoma. Pairwise univariate statistical comparison was used for the coarse selection of the most significant risk factors. These factors were fed into logistic regression (LR and alternating decision trees (ADT prognostic models that were assessed for their usefulness in identification of patients at risk to develop melanoma. Validation of the LR model was done by Hosmer and Lemeshow test, whereas the ADT was validated by 10-fold cross-validation. The achieved sensitivity, specificity, accuracy and AUC for both models were calculated. The melanoma risk score (MRS based on the outcome of the LR model was presented. Results. The LR model showed that the following risk factors were associated with melanoma: sunbeds (OR = 4.018; 95% CI 1.724- 9.366 for those that sometimes used sunbeds, solar damage of the skin (OR = 8.274; 95% CI 2.661-25.730 for those with severe solar damage, hair color (OR = 3.222; 95% CI 1.984-5.231 for light brown/blond hair, the number of common naevi (over 100 naevi had OR = 3.57; 95% CI 1.427-8.931, the number of dysplastic naevi (from 1 to 10 dysplastic naevi OR was 2.672; 95% CI 1.572-4.540; for more than 10 naevi OR was 6.487; 95%; CI 1.993-21.119, Fitzpatricks phototype and the presence of congenital naevi. Red hair, phototype I and large congenital naevi were only present in melanoma patients and thus were strongly associated with melanoma. The percentage of correctly classified subjects in the LR model was 74.9%, sensitivity 71%, specificity 78.7% and AUC 0.805. For the ADT percentage of correctly classified instances was 71.9%, sensitivity 71.9%, specificity 79.4% and AUC 0.808. Conclusion. Application of different models for risk assessment and prediction of melanoma should provide efficient and standardized tool in the hands of clinicians. The presented models offer effective discrimination of individuals at high risk, transparent decision making and real-time implementation suitable for clinical practice. A continuous melanoma database growth would provide for further adjustments and enhancements in model accuracy as well as offering a possibility for successful application of more advanced data mining algorithms.
... FDA News Release FDA approves Opdivo for advanced melanoma For Immediate Release December 22, 2014 Release The ... cannot be removed by surgery) or metastatic (advanced) melanoma who no longer respond to other drugs. Melanoma ...
Durante las últimas décadas hubo un aumento de la incidencia del melanoma cutáneo en la población caucásica del mundo, aunque este tumor puede afectar a cualquier grupo étnico. En la actualidad se considera a la exposición solar intermitente como un factor de riesgo cierto, en el desarrollo del melanoma cutáneo. La incidencia del melanoma cutáneo en Auckland, Nueva Zelanda, es la mayor del mundo. En Europa, la incidencia y la mortalidad fue creciente hasta que en la década de los 80...
Leitner, R. M. C.
It can be difficult to distinguish between various forms of pale intraocular tumour, and in particular between an amelanotic malignant melanoma, a choroidal haemangioma, and a solitary metastasis. If a monoclonal antibody specific for melanoma could be identified, it might be radiolabelled to provide a scanning technique which could distinguish between an ocular melanoma and a similar lesion. This pilot, in vitro study was undertaken to determine if monoclonal antibody against cutaneous melan...
Bomanji, J.; Garner, A; Prasad, J.; Albert, D. M.; Hungerford, J. L.; Granowska, M.; Britton, K. E.
Ciliary Body and Choroid Melanoma, Medium/Large Size; Ciliary Body and Choroid Melanoma, Small Size; Extraocular Extension Melanoma; Iris Melanoma; Liver Metastases; Metastatic Intraocular Melanoma; Recurrent Intraocular Melanoma; Stage IV Intraocular Melanoma
The rapidly increasing incidence of melanoma, coupled with its highly aggressive metastatic nature, is of urgent concern. In order to design rational therapies, it is of critical importance to identify the genetic determinants that drive melanoma formation and progression. To date, signaling cascades emanating from the EGF receptor, c-MET and other receptors are known to be altered in melanoma. Important mutations in signaling molecules, such as BRAF and N-RAS, have been identified. In this r...
Ghosh, Papia; Chin, Lynda
Ocular and cutaneous melanomas arose in new inbred lines of transgenic mice having an integrated recombinant gene comprised of the tyrosinase promoter, expressed in pigment cells, and the simian virus 40 early-region transforming sequences. The tumors were hypomelanotic and were histopathologically similar to corresponding human melanomas. Eye melanomas often originated at a young age, chiefly from the retinal pigment epithelium, also from the choroid, and rarely from the ciliary body. The ey...
Bradl, M.; Klein-szanto, A.; Porter, S.; Mintz, B.
AIMS/BACKGROUND: Metastatic disease in patients with ocular melanoma is resistant to chemotherapy. One of the main mechanisms of modulating multidrug resistance is the expression of the multidrug resistance gene 1 (MDR1) product (p-glycoprotein) by tumour cells. The purpose of this study was to evaluate the frequency of expression of the MDR1 gene in ocular melanoma whose primary treatment was surgical excision or enucleation. METHODS: Twelve recent ocular melanomas were received fresh, snap ...
Mcnamara, M.; Clynes, M.; Dunne, B.; Nicamhlaoibh, R.; Lee, W. R.; Barnes, C.; Kennedy, S. M.
Malignant melanoma of the rectum is an extremely rare disease. It typically presents in the fifth or sixth decade of life with nonspecific complaints such as rectal bleeding or anal pain. A timely diagnosis of anal melanoma is made even more difficult by the fact that most of the lesions lack obvious pigmentation and are even histologically amelanotic. Prognosis is very poor. Anorectal malignant melanomas spread along submucosal planes and are often beyond complete resection at the time of di...
Kohli, Supreethi; Narang, Seema; Singhal, Anu; Kumar, Vinod; Kaur, Omkar; Chandoke, Raj
Malignant melanomas are found in a variety of locations, ranging from sun-exposed skin to the nasal cavity and paranasal sinuses. Melanomas arising in the head and neck region comprise some 20% of all melanomas; of these, 7-15% occur in the vicinity of the external ear (most often on the helix). Auricular melanomas, like those arising elsewhere, are rare in childhood and are most often first diagnosed in men in their 50s. Melanomas of the external ear may present as flat pigmented lesions or as raised mass lesions; amelanotic (non-pigmented) variants exist as well. Auricular melanomas are frequently recognized pathologically as either superficial spreading melanomas or nodular melanomas. These tumors are aggressive, with a propensity for spreading to both regional lymph nodes and distant sites. Key pathologic prognostic features of auricular melanomas include the histological subtype, tumor thickness, level of invasion and presence of ulceration. Therapy includes both aggressive surgical attempts at excision in combination with sentinel node sampling in some instances and perhaps, adjuvant therapy as well. This is a tumor which is often overlooked until late in its course, with tragic consequences; vigilance and aggressive attempts at identifying these tumors at earlier stages are strongly advocated. PMID:16353384
Mondin, Vanni; Rinaldo, Alessandra; Shaha, Ashok R; Cureoglu, Sebahattin; Devaney, Kenneth O; Suárez, Carlos; Ferlito, Alfio
RAC1 is a GTPase member of the RAS superfamily, and RAC1(P29S) was recently identified as the third most common recurrent mutation in melanomas, affecting 4-7% of the patients. This is an oncogenic mutation, because the mutant protein remains mostly in its active GTP-bound form, and its ectopic expression increases the rate of normal melanocytes proliferation and migration. There is limited information regarding the functional role of RAC1(P29S) as a "driver" in human melanogenesis and as a cause for drug resistance. This commentary describes the latest data and provides evidence that supports the notion that RAC1 is activated even in melanoma cells that do not carry the mutation rendering it a good target for therapy. On the other hand, its role in conferring resistance to BRAF or MEK inhibitors is still in question. PMID:25465943
The ability to obtain the proper clinical diagnosis in cases of suspected intraocular tumors has greatly advanced during the past 50 years. The clinical characteristics of most intraocular tumors (size, shape, color, and texture) are detectable by skilled ophthalmoscopic examination and, with the use of adjunctive techniques (mainly ultrasonography), the proper diagnosis can be reached without invasive procedures. Notwithstanding, some intraocular tumors need to be biopsied to obtain a reliable diagnosis. In the cytogenetic era, intraocular tumor management is changing, and tumor-sampling procedures are becoming the main prognostic (and theoretically also diagnostic) tools for uveal melanoma. In spite of the widespread use of biopsies in general surgical practice, in ophthalmic oncology, indications and contraindications for biopsy continue to be under debate. The purpose of this paper is to critically evaluate the role of uveal melanoma biopsy in current clinical practice. PMID:22042015
Midena, Edoardo; Parrozzani, Raffaele
The cancer stem cell concept significantly broadens our understanding of melanoma biology. However, this concept should be regarded as an integral part of a holistic cancer model that also includes the genetic evolution of tumor cells and the variability of cell phenotypes within a dynamic tumor microenvironment. The biologic complexity and methodological difficulties in identifying cancer stem cells and their biomarkers are currently impeding the direct translation of experimental findings into clinical practice. Nevertheless, it is these methodological shortcomings that provide a new perspective on the phenotypic heterogeneity and plasticity of melanoma with important consequences for future therapies. The development of new combination treatment strategies, particularly with regard to overcoming treatment resistance, could significantly benefit from targeted elimination of cell subpopulations with cancer stem cell properties. PMID:25631128
Full Text Available We report a case of 65-year-old male patient who presented with multiple erythematous papules coalescing to form a nodular mass over posterior aspect of right thigh of six months duration. His general and systemic examinations were within normal range except for right inguinal lymphadenopathy. Biopsy from the lesion was done, which showed diffuse infiltrate of nests of atypical melanocytes extending upto reticular dermis. Malignant cells were positive for S100 and human melanin black 45(HMB 45. Hence, a diagnosis of amelanotic melanoma (AM - Clarke level IV and TNM stage III was reached. MRI of involved leg showed fungating soft tissue mass in the posterolateral aspect of right thigh and metastatic right inguinal adenopathy. Fine needle aspiration cytology (FNAC from the right inguinal nodes confirmed metastasis of melanoma. The patient was referred to oncosurgery department for further management.
We report a case of 65-year-old male patient who presented with multiple erythematous papules coalescing to form a nodular mass over posterior aspect of right thigh of six months duration. His general and systemic examinations were within normal range except for right inguinal lymphadenopathy. Biopsy from the lesion was done, which showed diffuse infiltrate of nests of atypical melanocytes extending upto reticular dermis. Malignant cells were positive for S100 and human melanin black 45(HMB 45). Hence, a diagnosis of amelanotic melanoma (AM)--Clarke level IV and TNM stage III was reached. MRI of involved leg showed fungating soft tissue mass in the posterolateral aspect of right thigh and metastatic right inguinal adenopathy. Fine needle aspiration cytology (FNAC) from the right inguinal nodes confirmed metastasis of melanoma. The patient was referred to oncosurgery department for further management. PMID:20445300
Nalamwar, Rashmi; Kharkar, Vidya; Mahajan, Sunanda; Chikhalkar, Sidhhi; Khopkar, Uday
Hussein Tawbi, Neelima NimmagaddaUniversity of Pittsburgh Cancer Institute and the University of Pittsburgh School of Medicine, Pittsburg, PA, USAAbstract: Malignant melanoma is a highly lethal disease unless detected early. Single-agent chemotherapy is well tolerated but is associated with very low response rates. Combination chemotherapy and biochemotherapy may improve objective response rates but do not prolong survival and are associated with greater toxicity. Immunotherapeutic approaches...
Hussein Tawbi; Neelima Nimmagadda
Despite advances in drug discovery programs and molecular approaches for identifying the drug targets, incidence and mortality rates due to melanoma continues to rise at an alarming rate. Existing preventive strategies generally involve mole screening followed by surgical removal of the benign nevi and abnormal moles. However, due to lack of effective programs for screening and disease recurrence after surgical resection there is a need for better chemopreventive agents. Although sunscreens h...
Madhunapantula, Subbarao V.; Robertson, Gavin P.
AIMS—The results of 52 endoresections for choroidal melanoma are reported.?METHODS—The current technique involves vitrectomy, retinal incision over or peripheral to the tumour, haemostasis by raising intraocular pressure and by moderate hypotensive anaesthesia, choroidal incision around tumour, endoresection with vitrector, endodiathermy to bleeding points and residual tumour, fluid-air exchange to reattach retina, endolaser to achieve retinal adhesion around the coloboma and destroy r...
Damato, B.; Groenewald, C.; Mcgalliard, J.; Wong, D.
Abstract Human metastatic cutaneous melanoma has gained a well deserved reputation for its immune responsiveness. The reason(s) remain(s) unknown. We attempted previously to characterize several variables that may affect the relationship between tumor and host immune cells but, taken one at the time, none yielded a convincing explanation. With explorative purposes, high-throughput technology was applied here to portray transcriptional characteristics unique to metastatic cutaneous m...
Zanovello Paola; Seliger Barbara; Taylor Phil R; Hu Nan; Mandruzzato Susanna; Zavaglia Katia; Panelli Monica C; Wang Ena; Freedman Ralph S; Marincola Francesco M
Thirty patients with choroidal melanoma in whom tumour thickness was found to increase on serial examination were retrospectively studied. Often when tumours started to increase in thickness, after a period of relative quiescence, the growth rate was relatively rapid. Increased tumour thickness was associated with increased tumour growth. During the phase of active tumour growth the height of the lesion tended to increase more than exponentially. Possible inadvertent biases in the selection o...
Char, D. H.; Heilbron, D. C.; Juster, R. P.; Stone, R. D.
Full Text Available Hussein Tawbi, Neelima NimmagaddaUniversity of Pittsburgh Cancer Institute and the University of Pittsburgh School of Medicine, Pittsburg, PA, USAAbstract: Malignant melanoma is a highly lethal disease unless detected early. Single-agent chemotherapy is well tolerated but is associated with very low response rates. Combination chemotherapy and biochemotherapy may improve objective response rates but do not prolong survival and are associated with greater toxicity. Immunotherapeutic approaches such as high-dose interleukin-2 are associated with durable responses in a small percentage of patients, but are impractical for many patients due to accessibility and toxicity issues. Elucidations of the molecular mechanisms of carcinogenesis in melanoma have expanded the horizon of opportunity to alter the natural history of the disease. Multiple signal transduction pathways seem to be aberrant and drugs that target them have been and continue to be in development. In this review we present data on the most promising targeted agents in development, including B-raf inhibitors and other signal transduction inhibitors, oligonucleotides, proteasome inhibitors, as well as inhibitors of angiogenesis. Most agents are in early phase trials although some have already reached phase III evaluation. As knowledge and experience with targeted therapy advance, new challenges appear to be arising particularly in terms of resistance and appropriate patient selection.Keywords: targeted therapy, metastatic melanoma, sorafenib, oblimersen, bevacizumab
Research highlights: ? Strong ADAM15 expression is found in normal melanocytes. ? ADAM15 expression is significantly downregulated in patients with melanoma metastasis. ? TGF-? can downregulate ADAM15 expression in melanoma cells. ? Overexpression of ADAM15 in melanoma cells inhibits migration, proliferation and invasion of melanoma cells. ? Conclusion: ADAM15 represents an tumor suppressor protein in melanoma. -- Abstract: In a mouse melanoma metastasis model it has been recently shown that ADAM15 overexpression in melanoma cells significantly reduced the number of metastatic nodules on the lung. Unfortunately, the expression of ADAM15 in human melanoma tissue has not been determined so far. In our study, we characterized the expression of ADAM15 in tissue micro-arrays of patients with primary melanoma with melanoma metastasis. ADAM15 was expressed in melanocytes and endothelial cells of benign nevi and melanoma tissue. Importantly, ADAM15 was significantly downregulated in melanoma metastasis compared to primary melanoma. We further demonstrate that IFN-? and TGF-? downregulate ADAM15 protein levels in melanoma cells. To investigate the role of ADAM15 in melanoma progression, we overexpressed ADAM15 in melanoma cells. Importantly, overexpression of ADAM15 in melanoma cells reduced the migration, invasion and the anchorage dependent and independent cell growth of melanoma cells. In summary, the downregulation of ADAM15 plays an important role in melanoma progression and ADAM15 act as a tumorsuppressor in melanoma.
Melanoma is a malignant melanocytic neoplasm with high mortality rate, and steadily and universally increasing incidence rates. Polypoid melanoma is considered an exophytic variant of the nodular subtype. The incidence of polypoid melanoma is extremely variable, most likely because of the different criteria used for its characterization. We presented a rare case of polypoid melanoma and superficial spreading melanoma in the same lesion.
Hikawa, Renato Shintani; Kanehisa, Eliza Sayuri; Enokihara, Mi?lvia Maria Simo?es E. Silva; Enokihara, Mauro Yoshiaki; Hirata, Se?rgio Henrique
Choroidal malignant melanomas are relatively rare tumours and can have a very long natural history. The management of these tumours is controversial. The results of a study of a small group of patients treated by radiotherapy, either as primary treatment or following local excision or enucleation, are presented here. The value of radical radiotherapy in the management of choroidal malignant melanoma is discussed.
Ammar, F.; Robertson, A.G.; Dudgeon, J.
The survival curves for melanoma cells exposed to single radiation doses in vitro and the specific growth delays for melanoma xenografts irradiated with single doses in vivo were found to differ considerably among individual cell lines and tumours. In fact, the differences could be almost as large as the largest differences observed among cell lines and xenografts from tumours of different histology with very different clinical radiocurability. Moreover, radiobiologic parameters that may have significant influence on tumour response to fractionated irradiation, e.g. growth rate, hypoxic fraction, reoxygenation ability, PLD-repair capacity and contact repair capacity, were found to differ greatly in magnitude among individual melanomas. This review therefore concludes that malignant melanoma is a tumour type that is very heterogeneous in radioresponsiveness, i.e. malignant melanomas should no longer be considered to be radiation resistant in general. The values of the ?/? ratio derived from cell survival curves for melanoma cells irradiated in vitro and melanoma xenografts irradiated in vivo were found to cover a wide range relative to those for acutely and late responding normal tissues. Although these ?/? ratios are no more than estimates of the effective ?/? ratios in a clinical situation, they still indicated that hyperfractionation may be beneficial in the treatment of some melanomas, whereas others may be more efficiently treated by use of conventional frac treated by use of conventional fractionation regimes, either based on 2 Gy or higher doses per fraction. Consequently, optimum radiation therapy of malignant melanoma will probably require an individualized treatment strategy. In vitro assays for prediction of radiocurability and choice of treatment strategy for individual melanoma patients seem therefore highly warranted. (orig.)
In a compilation of nine reported series consisting of 2,024 enucleations, the five- and ten-year survivals following surgery were 63% and 43%, respectively. The 25-year survival has been reported to be 40%. In 1974 at Wills Eye Hospital and Hahnemann University, the cobalt-60 plaques technique was introduced. During the following years, other radioactive isotopes were introduced including irridium-192, iodine-125, ruthenium-106/rhodium-106 and more recently palladium-103. At the present time, iodine-125 is the most widely used radionuclide. Until now, 302 patients treated with plaque brachytherapy showed an actuarial survival of 77% and 67.8% at five and eight years, respectively. There was no significant survival difference when compared with a similar group of patients undergoing enucleation. Other retrospective studies show similar excellent results. In spite of these convincing results, the decision making process in management melanoma remains unsettled primarily due to the absence of prospective randomized trials. Because of this, the Collaborative Ocular Melanoma Study was initiated. From the standpoint of toxicity, the data are available on ocular radiation toxicity. In an analysis of 77 patients from the Wills Eye Hospital with pretreatment visual acuities of 20/25 or better, it was noted that 90% of patients who had received less than 500 Gy to the fovea retained visual acuity of 20/200 or better while only 52% of patients receiving more than 5,000 Gy to thatients receiving more than 5,000 Gy to the fovea had vision of 20/200 or better. A serious late effect of radioactivity plaque treatment is scleral necrosis which may require repair or enucleation even in the absence of tumor progression. Enucleation may be necessary in approximately 10% of patients. We conclude that malignant melanoma of the uvea can be safely treated with radioactive plaques. (orig./MG)
In a compilation of nine reported series consisting of 2,024 enucleations, the five- and ten-year survivals following surgery were 63% and 43%, respectively. The 25-year survival has been reported to be 40%. In 1974 at Wills Eye Hospital and Hahnemann University, the cobalt-60 plaques technique was introduced. During the following years, other radioactive isotopes were introduced including irridium-192, iodine-125, ruthenium-106/rhodium-106 and more recently palladium-103. At the present time, iodine-125 is the most widely used radionuclide. Until now, 302 patients treated with plaque brachytherapy showed an actuarial survival of 77% and 67.8% at five and eight years, respectively. There was no significant survival difference when compared with a similar group of patients undergoing enucleation. Other retrospective studies show similar excellent results. In spite of these convincing results, the decision making process in management melanoma remains unsettled primarily due to the absence of prospective randomized trials. Because of this, the Collaborative Ocular Melanoma Study was initiated. From the standpoint of toxicity, the data are available on ocular radiation toxicity. In an analysis of 77 patients from the Wills Eye Hospital with pretreatment visual acuities of 20/25 or better, it was noted that 90% of patients who had received less than 500 Gy to the fovea retained visual acuity of 20/200 or better while only 52% of patients receiving more than 5,000 Gy to the fovea had vision of 20/200 or better. A serious late effect of radioactivity plaque treatment is scleral necrosis which may require repair or enucleation even in the absence of tumor progression. Enucleation may be necessary in approximately 10% of patients. We conclude that malignant melanoma of the uvea can be safely treated with radioactive plaques. (orig./MG).
Brady, L.W.; Hernandez, J.C. (Hylda Cohn/American Cancer Society, Philadelphia, PA (United States) Hahnemann Univ., Philadelphia, PA (United States))
Thirty nine patients suffering from juxtapapillary choroidal melanoma were treated with Ru-106/Rh-106 beta-ray plaques. The tumoricidal dose was 100 Gy at the apex of the tumour within 7-14 days. Additional photocoagulation was performed in 12 eyes. The irradiated eyes of three patients had to be enucleated, seven patients died, five of them (12.8%) from metastases. Thirty two (82%) patients are alive and 29 (74%) have a seeing eye. From the whole series 20 (51%) developed flat scars and 11 (...
Lommatzsch, P. K.; Lommatzsch, R.
Full Text Available Dificuldade potencial no diagnóstico histológico de melanomas é a dificuldade em reconhecer variantes pouco frequentes de melanoma. Entre elas, as mais desafiantes incluem exemplos de melanoma desmoplásico, melanoma nevoide, o chamado "melanoma de desvio mínimo", melanomas com proeminente síntese de pigmento ou "melanoma tipo animal" e o nevo azul maligno. Os autores descrevem dois casos de melanoma tipo animal e discute-se a importância do diagnóstico diferencial clinico-histopatológico nesses casos.A potential diagnostic pitfall in the histological assessment of melanomas is the difficulty in recognizing unusual melanoma variants. Among them, the most challenging examples comprise desmoplastic melanomas, nevoid melanomas, the so-called minimal-deviation melanoma, melanomas with prominent pigment synthesis or animal-type melanoma, and the malignant blue nevus. Two cases of animal type melanoma are reported and the importance of clinical-histopathological differential diagnosis is discussed.
Mariângela Esther Alencar Marques
Radiofrequency ablation (RFA) is a minimally invasive therapy that has, until recently, received limited attention in the management of metastatic melanoma. RFA is well described in the management of primary malignancies of the liver, however limited data are available on its application to metastatic deposits of melanoma occurring in the lung, liver, or adrenal glands. This article explores the basic principles of RFA, its safety, efficacy, and application to metastatic malignancies of the lung, liver and adrenal glands, with particular emphasis on melanoma. Previously published results are reviewed, and we report a small additional series of patients with liver and lung metastases treated in Sydney using RFA. PMID:24375239
Shashank, Arridh; Shehata, Mena; Morris, David L; Thompson, John F
Ultra-violet radiation (UVR) in sunlight is thought to be the main cause of malignant melanoma in lightly-pigmented populations. Individuals with fair skin, fair hair, blue eyes and/or a tendency to burn rather than tan when exposed to the sun are at particularly high risk of melanoma and should be given special attention in primary prevention programmes. Intermittent exposure to the sun, as in recreational exposure, may be a more potent cause of melanoma than more continuous exposure. Primar...
Armstrong, B. K.; Holman, C. D. J.
Subungual melanomas are rare; a delay in the diagnosis is common and is associated with advanced stage. Part of the reason for a delay in presentation to the physician is that patients often attribute the lesion to trauma. Trauma may play a role in the pathogenesis or just draw attention to a skin tumor that may be more susceptible to injury. We report a case of subungual melanoma that was observed in an 86 year old man. The preceding trauma history and misleading clinical appearance delayed the diagnosis slightly. Biopsy of every nodular acral tumor is very important. A direct role of the trauma in the pathogenesis of melanoma remains unclear. PMID:18319030
Ghariani, Najet; Boussofara, Lobna; Kenani, Nesrine; Ghannouchi, Nadia; Mebazaa, Amel; Denguezli, Mohamed; Belajouza, Colandane; Nouira, Rafia
Data from a population-based registry, the Australian Paediatric Cancer Registry, were used to determine the incidence of malignant melanoma in children under 15 years of age in Australia. Over a 17-year period, 217 cases were identified. For the period 1977-89 inclusive, the annual age incidence was 0.34 per 100,000. There was some variation in incidence between the different states with Queensland recording the highest incidence at 0.97 per 100,000, the highest reported incidence in the world for childhood melanoma. Most of the cases occurred in children aged 13 or 14 years old with girls affected slightly more often, the sex ratio being 0.92. There was a statistically significant seasonal variation with fewer cases being diagnosed during the winter months. The commonest site was the trunk. Two of the cases were second neoplasms. This series demonstrates the need for increased education of children living in tropical and subtropical regions about the dangers of sun exposure and of methods of reducing exposure. Children who have undergone chemotherapy appear to be at particular risk. PMID:7638982
McWhirter, W R; Dobson, C
Full Text Available El melanoma lentiginoso acral (MLA es una variante rápidamente progresiva del melanoma maligno (MM. Constituye el 5-10% de todos los tipos de MM y se presenta con mayor frecuencia en pacientes de raza negra, asiáticos y latinoamericanos. En Colombia el MM se encuentra en aumento, con una incidencia de 3.5/100.000, siendo el MLA una de las variantes más comunes. La edad promedio de presentación es de 58 años, con una tasa de sobrevida menor para las personas de raza negra, asociado a un diagnóstico tardío. EL MLA se localiza en plantas, palmas y región subungueal y en su etiopatología se ha descrito la presencia de mutaciones en genes: 9p21 (p16: 67%, 11q13 (CCND1 (47%, 22q11-q13 (40% y 5p15 (20%. El diagnóstico de MLA, se ha fundamentado clásicamente en la histopatología. Herramientas de diagnóstico como la dermatoscopia, la evaluación del ganglio centinela y la determinación de alteraciones en las proteínas del ciclo celular contribuyen a la detección precoz del MLA y el MM en general.
Gloria Andrea Vargas Suaza
Full Text Available We report a case of a metastatic cutaneous melanoma to the orbit. A 60-year-old Caucasian male presented with a 2-day history of left-sided ocular pain, lid swelling and chemosis. Initially, this was treated as conjunctivitis with no signs of improvement. Four days later, the patient developed left proptosis, mechanical ptosis, left esotropia and diplopia. Computed tomography scan of the orbit demonstrated marked thickening of the lateral rectus muscle. The patient was treated as pseudotumor. Subsequent biopsy revealed malignant cutaneous melanoma. The patient had a history of cutaneous melanoma excised 15 years previously. Further imaging showed advanced metastatic disease in the brain, the lung and the liver. The patient passed away five months after initial presentation. Cutaneous melanoma metastasizing to the orbit has poor prognosis. Patients often have advanced disease at the time of presentation and orbital metastases may be the initial sign. A detailed history is paramount in making timely diagnosis.
Melanoma is a skin cancer that can be deadly. Members of families with a strong history of melanoma have a high risk of melanoma occurrence or recurrence. Enhanced survival in these family members could be influenced by their knowledge of melanoma risk and by simple behaviors to decrease their risk or detect melanoma in its early, most curable, stage. Yet, there is minimal exploration on communication of risk or risk-modifying behaviors in melanoma at-risk families. In this study we described...
Loescher, Lois J.; Crist, Janice D.; Siaki, Leilani A. C. L.
Traditionally, distant metastatic melanoma has a poor prognosis due to lack of efficacious, FDA-approved systemic therapy and the limited use of surgical resection as a therapeutic option. More recently, new biologic therapies such as vemurafenib (Zelboraf) and ipilimumab (Yervoy) have showed strong promise and dramatically improved the landscape of stage IV melanoma therapy. Although there are numerous single-institution studies advocating the role for therapeutic surgical intervention, many...
Leung, Anna M.; Hari, Danielle M.; Morton, Donald L.
Robert O Dillman1,21Hoag Cancer Institute and Hoag Institute for Research and Education, Newport Beach, CA, USA; 2University of California Irvine, Irvine, CA, USAAbstract: Metastatic melanoma has been a target of immunotherapy for more than 4 decades. Three immunotherapeutics have received regulatory approval for treating melanoma: interferon-alpha, interleukin-2, and ipilimumab. The antitumor mechanisms of these products depend on enhancing existing immune responses, including autoimmune eff...
Full Text Available Melanoma is the most significant malignant tumor of the melanocyte system. It is characterized by a high malignant potential and an outstanding possibility for giving metastasis. Despite all investigations and progress concerning molecular genetics and immunology melanoma is a therapeutic problem even today. Vaccines are being developed with an intention not only to prevent but also to cure the disease, and the most important aim of clinical trails is to develop corresponding antitumor immunotherapy based on vaccine.
Nikolin Borislava L.
Melanoma is the most deadly skin cancer. Early diagnosis is a current challenge for clinicians. Current algorithms for skin lesions classification focus mostly on segmentation and feature extraction. This paper instead puts the emphasis on the learning process, proposing two kernel-based classifiers: support vector machines, and spin glass-Markov random fields. We benchmarked these algorithms against a state-of-the-art method on melanoma recognition. We show with extensive experiments that th...
Torre, Elisabetta La; Caputo, Barbara; Tommasi, Tatiana
A study of 953 invasive cutaneous malignant melanomas of the head and neck was performed to determine differences between lentigo maligna melanoma and other histogenetic types with regard to patients and sites affected; prognosis was analysed in 595 of these cases. The cases studied comprised all head and neck melanomas registered with the Scottish Melanoma Group between 1979 and 1992, apart from the 3% of cases that were unclassifiable or rare histogenetic types. The histogenetic types of me...
Cox, N. H.; Aitchison, T. C.; Sirel, J. M.; Mackie, R. M.
Full Text Available The behavior of melanoma cells has traditionally been studied in vitro in two-dimensional cell culture with cells adhering to plastic dishes. However, in order to mimic the three-dimensional architecture of a melanoma, as well as its interactions with the tumor microenvironment, there has been the need for more physiologically relevant models. This has been achieved by designing 3D in vitro models of melanoma, such as melanoma spheroids embedded in extracellular matrix or organotypic skin reconstructs. In vivo melanoma models have typically relied on the growth of tumor xenografts in immunocompromised mice. Several genetically engineered mouse models have now been developed which allow the generation of spontaneous melanoma. Melanoma models have also been established in other species such as zebrafish, which are more conducive to imaging and high throughput studies. We will discuss these models as well as novel techniques that are relevant to the study of the molecular mechanisms underlying melanoma progression.
Kimberley A. Beaumont
Full Text Available INTRODUÇÃO: Os tumores melanocíticos conjuntivais compreendem lesões que podem variar desde lesões benignas como os nevos conjuntivais, lesões pré-cancerosas como melanose adquirida primária com atipia até o melanoma maligno conjuntival. O reconhecimento das características clinicas destas lesões e seu diagnóstico preciso permitem o tratamento adequado, contribuindo para a redução da morbidade e mortalidade associados ao melanoma de conjuntiva. OBJETIVO: Revisão das características clinicas, diagnóstico e modalidades de tratamento clínico e cirúrgico das lesões precursoras (Nevos e melanose adquirida primária e do maligno conjuntival. MÉTODOS: Revisão de literatura através de pesquisa no banco de dados MEDLINE, PUBMED, LILACS e SciELO no período de 1980 a 2011. As palavras-chave utilizadas, individualmente ou em conjunto, foram: "conjunctival melanoma", "primary acquired melanosis", "nevi", "treatment", "chemotherapy", "recurrence", "metastasis" e "mortality". RESULTADO: Características clínicas que permitem o diagnóstico do melanoma conjuntival e sua diferenciação de outras lesões pigmentadas conjuntivais foram consideradas. O estadiamento clínico e patológico, assim como modalidades de tratamento para o melanoma maligno foram revisadas. CONCLUSÕES: Pacientes portadores de lesões pigmentadas conjuntivais devem ser avaliados por um oftalmologista especialista. A história oftalmológica, a história familiar de melanoma, e características clínicas da lesão necessitam de cuidadosa avaliação, incluindo-se a determinação do risco de malignidade. A documentação fotográfica deve ser realizada. O tratamento clínico e planejamento cirúrgico devem ser baseados na suspeita clinica. A análise histopatológica por patologista experiente é fundamental para orientação do tratamento e para identificação de fatores prognósticos, principalmente em casos de doença maligna.INTRODUCTION: Melanocytic tumors comprise a wide range of lesions. These lesions can be nevi, primary acquired melanosis with or without atypia or malignant as conjunctival melanoma. Early recognition of the clinical features allows precise diagnosis and adequate intervention, reducing the rates of metastatic disease and mortality associated with conjunctival melanoma. PURPOSE: To review clinical features, diagnosis, clinical and surgical treatment modalities of the different precursor pigmented lesions (Nevi and primary acquired melanosis and malignant melanoma. METHODS: Literature review was performed accessing the database of MEDLINE, PUBMED, LILACS e SciELO between 1980 and 2011. The keywords used, individually or combined, were: conjunctival melanoma, primary acquired melanosis, nevi, treatment, chemotherapy, recurrence, metastasis e mortality. RESULTS: Relevant clinical information for the diagnosis of malignant melanoma and differentiation from other pigmented conjunctival lesions were accessed. Clinical and pathological features and different modalities of treatment for malignant melanoma have been reviewed. CONCLUSIONS: Patients presenting with a pigmented conjunctival lesion should be evaluated by an experienced ophthalmologist. Ocular history, family history of melanoma, and clinical features of the lesion need careful assessment and malignancy risk evaluation. Digital photo documentation should be performed. Clinical or surgical planning should be done based on the clinical suspicion. Careful histopathology analysis is required for treatment orientation and prognostic factors identification, mainly in cases of malignancy.
Gustavo Amorim Novais
Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese INTRODUÇÃO: Os tumores melanocíticos conjuntivais compreendem lesões que podem variar desde lesões benignas como os nevos conjuntivais, lesões pré-cancerosas como melanose adquirida primária com atipia até o melanoma maligno conjuntival. O reconhecimento das características clinicas destas lesões e [...] seu diagnóstico preciso permitem o tratamento adequado, contribuindo para a redução da morbidade e mortalidade associados ao melanoma de conjuntiva. OBJETIVO: Revisão das características clinicas, diagnóstico e modalidades de tratamento clínico e cirúrgico das lesões precursoras (Nevos e melanose adquirida primária) e do maligno conjuntival. MÉTODOS: Revisão de literatura através de pesquisa no banco de dados MEDLINE, PUBMED, LILACS e SciELO no período de 1980 a 2011. As palavras-chave utilizadas, individualmente ou em conjunto, foram: "conjunctival melanoma", "primary acquired melanosis", "nevi", "treatment", "chemotherapy", "recurrence", "metastasis" e "mortality". RESULTADO: Características clínicas que permitem o diagnóstico do melanoma conjuntival e sua diferenciação de outras lesões pigmentadas conjuntivais foram consideradas. O estadiamento clínico e patológico, assim como modalidades de tratamento para o melanoma maligno foram revisadas. CONCLUSÕES: Pacientes portadores de lesões pigmentadas conjuntivais devem ser avaliados por um oftalmologista especialista. A história oftalmológica, a história familiar de melanoma, e características clínicas da lesão necessitam de cuidadosa avaliação, incluindo-se a determinação do risco de malignidade. A documentação fotográfica deve ser realizada. O tratamento clínico e planejamento cirúrgico devem ser baseados na suspeita clinica. A análise histopatológica por patologista experiente é fundamental para orientação do tratamento e para identificação de fatores prognósticos, principalmente em casos de doença maligna. Abstract in english INTRODUCTION: Melanocytic tumors comprise a wide range of lesions. These lesions can be nevi, primary acquired melanosis with or without atypia or malignant as conjunctival melanoma. Early recognition of the clinical features allows precise diagnosis and adequate intervention, reducing the rates of [...] metastatic disease and mortality associated with conjunctival melanoma. PURPOSE: To review clinical features, diagnosis, clinical and surgical treatment modalities of the different precursor pigmented lesions (Nevi and primary acquired melanosis) and malignant melanoma. METHODS: Literature review was performed accessing the database of MEDLINE, PUBMED, LILACS e SciELO between 1980 and 2011. The keywords used, individually or combined, were: conjunctival melanoma, primary acquired melanosis, nevi, treatment, chemotherapy, recurrence, metastasis e mortality. RESULTS: Relevant clinical information for the diagnosis of malignant melanoma and differentiation from other pigmented conjunctival lesions were accessed. Clinical and pathological features and different modalities of treatment for malignant melanoma have been reviewed. CONCLUSIONS: Patients presenting with a pigmented conjunctival lesion should be evaluated by an experienced ophthalmologist. Ocular history, family history of melanoma, and clinical features of the lesion need careful assessment and malignancy risk evaluation. Digital photo documentation should be performed. Clinical or surgical planning should be done based on the clinical suspicion. Careful histopathology analysis is required for treatment orientation and prognostic factors identification, mainly in cases of malignancy.
Gustavo Amorim, Novais; Carol Lynn, Karp.
Melanoma is a malignant melanocytic neoplasm with high mortality rate, and steadily and universally increasing incidence rates. Polypoid melanoma is considered an exophytic variant of the nodular subtype. The incidence of polypoid melanoma is extremely variable, most likely because of the different criteria used for its characterization. We presented a rare case of polypoid melanoma and superficial spreading melanoma in the same lesion. PMID:25054761
Hikawa, Renato Shintani; Kanehisa, Eliza Sayuri; Enokihara, Mílvia Maria Simões e Silva; Enokihara, Mauro Yoshiaki; Hirata, Sérgio Henrique
Background/aims: NG2 is the rat homologue of the human melanoma proteoglycan (HMP), also known as the high molecular weight melanoma associated antigen. Most cutaneous melanomas, as well as glioblastomas, chondrosarcomas, and some leukaemias express NG2 immunoreactivity, recognised using monoclonal antibody (mAb) 9.2.27. This antibody has also been used for molecular targeting in targeted ? therapy for melanoma. The purpose of this study was to evaluate the expression of NG2 immunoreactivity...
Li, Y.; Madigan, M. C.; Lai, K.; Conway, R. M.; Billson, F. A.; Crouch, R.; Allen, B. J.
Melanoma maligna merupakan neoplasma yang berasal dari pigmentasi melanosit yang mengandung pigmen melanin. Melanoma dapat muncul pada kulit, mata, anus dan genital. Walaupun jarang melanoma maligna dapat muncul pada rongga mulut dan merupakan neoplasma mukosa mulut yang mematikan. Etiologi terjadinya melanoma maligna disebabkan karena tubuh terkena sinar matahari secara terus menerus. Selain itu faktor genetik pada keluarga, trauma dan juga faktor hormonal berperan dalam terjadinya m...
Yance Helena Sihombing
Malignant melanoma is a malignant neoplasia drives from melanocytes. Malignant melanoma, the most causing death, is seen in the third place at skin cancer. Malignant melanoma shows intrinsic resistance to chemotherapeutic agents and variability in the course of the disease which are distinct features separating from other solid tumors. These features prevent the development and standardization of non-surgical treatment models of malignant melanoma. Although there is a large number of chemothe...
Esin Sakall? Çetin; P?nar Aslan Ko?ar; Nurten Özçelik
Although erythropoietin (Epo) is a known stimulator of erythropoiesis, recent evidence suggests that its biological functions are not confined to hematopoietic cells. To elucidate the role of Epo and erythropoietin receptor (EpoR) in melanoma, we examined the expression and function of these proteins in melanocytes and melanoma cells. We found increased expression of Epo in melanoma cells compared to melanocyte in vitro. EpoR was also strongly expressed in all of the melanoma cell lines and t...
Kumar, Suresh M.; Acs, Geza; Fang, Dong; Herlyn, Meenhard; Elder, David E.; Xu, Xiaowei
Full Text Available Melanomas that initially affect the lymph nodes without an identified primary lesion traditionally have been termed unknown origin metastatic melanomas (UOMM. Its etiology or natural history is not well known and there is no unanimous consensus of treatment. Although they are exceptional cases, clinical findings make us consider the existence of a group of melanomas until now regarded as UOMM. The latest theories defined them as true primary melanomas of lymph nodes with a different biological evolution.
Torres-Morientes LM, Puente-López G, Keituqwa-Yáñez T, Sánchez-González F, López-Ríos-Velasco J, Pérez-Holgado V, Pérez-Cidoncha P
Full Text Available El melanoma maligno es derivado de células dendríticas (névicas proliferantes progenitoras de lesiones. Son importantes en la histogénesis y en el riesgo de desarrollo del melanoma maligno. Del 30% al 37% de los melanomas malignos del tracto aero-digestivo superior están asociados a una lesión premaligna melanótica. Los hallazgos histopatológicos con técnicas convencionales concuerdan en considerar de valor el tamaño del tumor, las células atípicas, la distribución de las células y los márgenes de la lesión. Avances mayores en inmunología de los tumores, llevan a identificar la interacción célula tumoral- célula T. Han sido identificados y caracterizados molecularmente un número de melanomas asociados a antígenos.Advance malignant melanoma is generated from proliferating dendritic (nevic cell progenitors. They are important on the histogenesis and risk of tumor development. From 30% to 37% from high air-digestic track melanoms, there are associated with premalignant cell dendritic lesions. Histophatological approaches agree in consider size of tumor, atypical cells, distribution of this cells and borders of lesion as valued markers. Major advances in tumor irnmunology, have led to understand tumor cell-T cell interactions. A number of melanom associated antigens have been identified and molecularly characterized.
Z. J. Casariego
Full Text Available SciELO Spain | Language: Spanish Abstract in spanish El melanoma maligno es derivado de células dendríticas (névicas) proliferantes progenitoras de lesiones. Son importantes en la histogénesis y en el riesgo de desarrollo del melanoma maligno. Del 30% al 37% de los melanomas malignos del tracto aero-digestivo superior están asociados a una lesión prem [...] aligna melanótica. Los hallazgos histopatológicos con técnicas convencionales concuerdan en considerar de valor el tamaño del tumor, las células atípicas, la distribución de las células y los márgenes de la lesión. Avances mayores en inmunología de los tumores, llevan a identificar la interacción célula tumoral- célula T. Han sido identificados y caracterizados molecularmente un número de melanomas asociados a antígenos. Abstract in english Advance malignant melanoma is generated from proliferating dendritic (nevic) cell progenitors. They are important on the histogenesis and risk of tumor development. From 30% to 37% from high air-digestic track melanoms, there are associated with premalignant cell dendritic lesions. Histophatological [...] approaches agree in consider size of tumor, atypical cells, distribution of this cells and borders of lesion as valued markers. Major advances in tumor irnmunology, have led to understand tumor cell-T cell interactions. A number of melanom associated antigens have been identified and molecularly characterized.
Z. J., Casariego; J. E., Baudo.
Full Text Available SciELO Spain | Language: Spanish Abstract in spanish Los melanomas mucosos son tumores raros y de mal pronóstico. Representan alrededor del 1% del total de melanomas y el 0,5% de los tumores malignos de cabeza y cuello. Cuando se localiza en las fosas nasales, produce sintomatología tardía e inespecífica como obstrucción respiratoria, epistaxis o dolo [...] r facial. El tratamiento de elección es la cirugía combinada con quimio y radioterapia. Presentamos un caso con sobrevida de 4 años y realizamos una revisión de la literatura. Abstract in english Head and neck mucosal melanoma is a rare entity with poor prognosis. This tumour represents less than 1% of malignant melanomas and 0.5% of head and neck malignancies. Melanomas that arise in the nasal cavity present with non-specific symptoms and have a poor prognosis. Wide local excision is the tr [...] eatment of choice combined with postoperative chemoradiotherapy. We present a case with an unusual survival (4 years) and perform a review of the literature.
Luis, Sarra; Juan C., Rodríguez; Mariela, García-Valea; Aníbal, Arédez-Ferrer; Anabel, Vino; Bárbara, Guassardo.
We describe the cytologic presentation in fine needle aspirates of two examples of metastatic balloon cell melanoma. These hypervacuolated cells may be misinterpreted as adenocarcinoma or liposarcoma. Intermediate forms between the classic nonvacuolated round melanoma cell and the ballooned melanoma cell are described. PMID:6175127
Friedman, M; Rao, U; Fox, S
SkinCancerNet Article Melanoma: How It Returns, Where It Spreads Melanoma is known as "the most lethal form of skin cancer" because ... 35-48% Thyroid 25-39% Table 1: Where Melanoma Most Likely to Spread Source: Meyers ML, Balch ...
The small intestine is the most common site of gastrointestinal metastasis from cutaneous melanoma. However, the small intestine itself is rarely the site of a primary melanotic tumour. We describe a case of primary small bowel melanoma in a 70-year-old man, and discuss the features of primary and metasttic melanoma. PMID:15912983
Sanyal, Sudip; Kaman, Lileswar; Behera, Arunanshu; Kakkar, Nandita
Carcinoma of Unknown Primary Origin; Iris Melanoma; Medium/Large Size Posterior Uveal Melanoma; Mucosal Melanoma; Ocular Melanoma With Extraocular Extension; Small Size Posterior Uveal Melanoma; Stage IIB Skin Melanoma; Stage IIB Uveal Melanoma; Stage IIC Skin Melanoma; Stage IIIA Skin Melanoma; Stage IIIA Uveal Melanoma; Stage IIIB Skin Melanoma; Stage IIIB Uveal Melanoma; Stage IIIC Skin Melanoma; Stage IIIC Uveal Melanoma; Stage IV Skin Melanoma; Stage IV Uveal Melanoma
Carcinoma of Unknown Primary Origin; Iris Melanoma; Medium/Large Size Posterior Uveal Melanoma; Mucosal Melanoma; Ocular Melanoma With Extraocular Extension; Small Size Posterior Uveal Melanoma; Stage IIB Skin Melanoma; Stage IIB Uveal Melanoma; Stage IIC Skin Melanoma; Stage IIIA Skin Melanoma; Stage IIIA Uveal Melanoma; Stage IIIB Skin Melanoma; Stage IIIB Uveal Melanoma; Stage IIIC Skin Melanoma; Stage IIIC Uveal Melanoma; Stage IV Skin Melanoma; Stage IV Uveal Melanoma
Full Text Available Robert O Dillman1,21Hoag Cancer Institute and Hoag Institute for Research and Education, Newport Beach, CA, USA; 2University of California Irvine, Irvine, CA, USAAbstract: Metastatic melanoma has been a target of immunotherapy for more than 4 decades. Three immunotherapeutics have received regulatory approval for treating melanoma: interferon-alpha, interleukin-2, and ipilimumab. The antitumor mechanisms of these products depend on enhancing existing immune responses, including autoimmune effects. The combination of autologous, cytotoxic T-lymphocytes plus high-dose interleukin-2 is a promising patient-specific therapy, but has limited clinical application. Other approaches include vaccines targeting melanoma-associated antigens, and patient-specific vaccines that utilize autologous tumor. Non-patient-specific vaccine approaches target melanocyte differentiation antigens (eg, tyrosinase, Melan-A, gp100, antigens identified by cytotoxic T-lymphocytes (eg, NY-Eso-1, Melan-A/Mart-1, Mage-3, and antigens originally identified by murine monoclonal antibodies (gangliosides, gp97, gp225. Self-renewing cells in tumor cell lines may represent tumor stem cells, but vaccines derived from allogeneic tumor cell lines have yielded disappointing results in randomized trials. Patient-specific vaccines can be derived from bulk autologous tumor or autologous tumor cell lines, and intratumoral injections of immunostimulatory fusion products have shown promise. While technically more complex to manufacture, patient-specific vaccines derived from autologous tumor cell lines have the potential to target tumor stem cells and overcome interpatient tumor cell heterogeneity. This article reviews sources of melanoma-associated antigens, costimulatory agents, and clinical trial results for various melanoma vaccines. Comparing Phase II trials is difficult because of the wide range of vaccine strategies and the differences in study patient populations; therefore, randomized trials are necessary to prove the efficacy of such products. Therapeutic vaccines are more likely to enhance, rather than replace, other anti-melanoma immune therapies. In particular, effective vaccines may be synergistic with products that block T-cell immune checkpoint molecules such as ipilimumab and monoclonal antibodies that interfere with programmed death ligand-receptor interactions.Keywords: melanoma, vaccines, melanoma-associated antigens, melanoma stem cells, dendritic cells, GM-CSF, checkpoint molecules
Visceral metastases from malignant melanoma (stage M1c) confer a very poor prognosis, as documented on the most recent revised version of the TNM/AJCC staging system. Emergency surgery for intra-abdominal complications from the disease is rare. We report on our 5-year single institution experience with surgical management of metastatic melanoma to the viscera in the emergent setting. From 2009 to 2013, 14 patients with metastatic melanoma were admitted emergently due to an acute abdomen. Clinical manifestations encompassed intestinal obstruction and bleeding. Surgical procedures involved multiple enterectomies with primary anastomoses in 8 patients, and one patient underwent splenectomy, one adrenalectomy, one right colectomy, one gastric wedge resection, one gastrojejunal anastomosis, and one transanal debulking, respectively. The 30-day mortality was 7 percent. Median follow-up was 14 months. Median overall survival was 14 months. Median disease free survival was 7.5 months. One-year overall survival was 64.2 percent and 2-year overall survival was 14.2 percent. Emergency surgery for metastatic melanoma to the viscera is rare. Elective curative surgery combined with novel cytotoxic systemic therapies is under investigation in an attempt to grant survival benefit in melanoma patients with visceral disease.
Mantas, Dimitrios; Tsaparas, Petros; Gogas, Helen; Kouraklis, Gregory
We compared two melanoma-specific radioiodine labelled compunds 4-(3 dimethylamino-propylamino)-7-iodoquinoline (I) and L-3-iodo-a-methyltyrosine (IV) using hamsters. Two groups consisted of hamsters with subcutaneous or subscleral melanotic melanoma, and the third had healthy animals as controls. In comparison with the quinoline derivative (I), the tyrosine derivative (IV) proved to have some better properties as a melanoma-specific radiopharmaceutical and had its highest tumor concentration 1 h after administration. It disappeared more slowly from the tumor tissue than from the other organs thus increasing the tumor-to-organ ratio. There was no obvious difference in the biodistribution of (I) and (IV) in relation to the site of the melanoma growth. In contrast to (I), which took part in the formation of the biopolymer melanin, (IV) acted as a reversible inhibitior of the enzyme tyrosine hydroxylase. The affinity to the tyrosine hydroxylase and not the function as a melanin precursor lead to an accumulation of (IV) in the melanoma tissue. (orig./MG)
Introduction: In spite of recently approved B-RAF inhibitors and immunomodulating antibodies, metastatic melanoma has poor prognosis and novel treatments are needed. Melanoma stem cells (MSC) have been implicated in the resistance of this tumor to chemotherapy. Recently we demonstrated in a Phase I clinical trial in patients with metastatic melanoma that radioimmunotherapy (RIT) with 188-Rhenium(188Re)-6D2 antibody to melanin was a safe and effective modality. Here we investigated the interaction of MSC with RIT as a possible mechanism for RIT efficacy. Methods: Mice bearing A2058 melanoma xenografts were treated with either 1.5 mCi 188Re-6D2 antibody, saline, unlabeled 6D2 antibody or 188Re-labeled non-specific IgM. Results: On Day 28 post-treatment the tumor size in the RIT group was 4-times less than in controls (P < 0.001). The tumors were analyzed by immunohistochemistry and FACS for two MSC markers — chemoresistance mediator ABCB5 and H3K4 demethylase JARID1B. There were no significant differences between RIT and control groups in percentage of ABCB5 or JARID1B-positive cells in the tumor population. Our results demonstrate that unlike chemotherapy, which kills tumor cells but leaves behind MSC leading to recurrence, RIT kills MSC at the same rate as the rest of tumor cells. Conclusions: These results have two main implications for melanoma treatment and possibly other cancers. First, the susceptibility of ABCB5 + and JARID1B + cells to RIT in melanoma might be indicative of their susceptibility to antibody-targeted radiation in other cancers where they are present as well. Second, specifically targeting cancer stem cells with radiolabeled antibodies to ABCB5 or JARID1B might help to completely eradicate cancer stem cells in various cancers
In 2010 we treated one case of familial choroidal melanoma which was detected in a mother and a daughter at the Department of Ophthalmology and Ocular Oncology University Hospital in Krakow. The enucleation was performed in a daughter, while the mother refused to give an informed consent to the procedure despite the diagnosis of ring melanoma, and was eventually subjected to brachytherapy. In both cases histopathological examination confirmed melanoma. Both patients and their relatives have remained in a follow-up until now. Results: Inheritance may play a role in the etiology of melanoma. Therefore, each time melanoma is diagnosed, the close relatives of the patients should undergo regular eye tests. PMID:25345291
Markiewicz, Anna; Bogdali, Anna; Romanowska-Dixon, Bozena
The 5-year survival rate for patients diagnosed with Melanoma, a deadly form of skin cancer, in its latest stages is about 15%, compared to over 90% for early detection and treatment. We present an imaging system and algorithm that can be used to automatically generate a melanoma risk score to aid clinicians in the early identification of this form of skin cancer. Our system images the patient's skin at a series of different wavelengths and then analyzes several key dermoscopic features to generate this risk score. We have found that shorter wavelengths of light are sensitive to information in the superficial areas of the skin while longer wavelengths can be used to gather information at greater depths. This accompanying diagnostic computer algorithm has demonstrated much higher sensitivity and specificity than the currently commercialized system in preliminary trials and has the potential to improve the early detection of melanoma.
Martin, Justin; Krueger, James; Gareau, Daniel
Full Text Available SciELO Brazil | Language: English Abstract in portuguese INTRODUCTION: O melanoma metastático do estômago é entidade relativamente rara e de diagnóstico incomum em vida. A cirurgia é o tratamento de escolha, pois alivia os sintomas em mais de 90% dos casos e aumenta a sobrevida a longo prazo. OBJETIVO: Relatar um caso de melanoma metastático do estômago, [...] submetida à ressecção curativa e que evoluiu sem sinais de doença residual. RELATO DO CASO: Mulher de 50 anos apresentou mancha escura em leito ungueal de dedo polegar de mão direita há dois anos, evoluindo com ulceração e sangramento. A biópsia diagnosticou neoplasia melanocítica ungueal compatíveis com melanoma lentiginoso e confirmado pela imunohistoquímica que apresentou células pigmentadas HMB-45 positivas. Após um ano e meio a paciente evoluiu com metástase de melanoma em coxa esquerda e extensa lesão escavada em pequena curvatura gástrica, cuja biopsia foi compatível com melanoma metastático do estômago. Hemograma com discreta anemia (Hb: 11,1 e Ht: 33%) e LDH: 333 U/L. A paciente foi submetida à gastrectomia total com reconstrução em Y de Roux. Houve boa evolução e no 6º dia de pós-operatório teve alta hospitalar. Atualmente, no 12º mês de seguimento, a paciente permanece sem queixas, com alívio completo dos sintomas e com todos os exames de controle normais. CONCLUSÃO: O tratamento cirúrgico deve ser sempre considerado no melanoma metastático do trato gastrointestinal, pois o procedimento possui baixa morbidade e mortalidade, além de proporcionar alívio dos sintomas com melhora da qualidade de vida e aumento da sobrevida a longo prazo. Abstract in english BACKGROUND: Metastatic melanoma of the stomach is a relatively rare entity with an unusual diagnosis during life. Surgery is the treatment of choice once it alleviates the symptoms in over 90% of the cases and increases the long-term survival. CASE REPORT: A 50y woman had presented a dark spot in th [...] e ungual bed of her right-hand thumb for two years, evolving into ulceration and bleeding. The biopsy diagnosed ungual malanocytic neoplasia compatible with lentiginous melanoma confirmed by immunohistochemistry, which presented positive pigmented HMB-45 cells. After an year and a half, the patient developed metastasis of the melanoma on her left thigh and extensive ulcerated lesion in the small gastric curvature, whose biopsy was compatible with metastatic melanoma of the stomach. The hemogram found discrete anemia (Hb: 11.1 and Ht: 33%) and LDH: 333 U/L. The patient underwent total gastrectomy with reconstruction in Roux-en-Y. There was a good evolution and on the 6th post-operative day, she was discharged home. At present, in the 12th month of follow up, the patient remains without complaints, with full relief of symptoms and all normal control exams. CONCLUSION: Surgical management should always be considered for the metastatic melanoma of the gastrointestinal tract, since the procedure shows low morbidity and mortality, besides providing relief of symptoms with the improvement of the quality of life and increase in the long-term survival.
Marcelo Eustáquio, Rocha; Gilberto Pedro, Rodrigues; Samir Almeida, Borges; Fernando Gusmão, Santiago.
The vast majority of cutaneous malignant melanomas (CMM) develop from a proliferation of intraepidermal melanocytes that may progress through radial (including in situ and microinvasive stages) and vertical growth phases (VGP). The currently accepted classification of melanoma is based on the presence (eg, superficial spreading, lentigo maligna, or acral lentiginous melanoma) or absence of a radial growth phase (nodular melanoma). Although not standardized, melanoma may also be classified as to the nature of the VGP, eg, as expansile nodules composed of epithelioid cells, spindle cells, or smaller nevus-like cells supervening on one of the radial growth components previously mentioned, or developing de novo. Less common variants of the VGP include desmoplastic and neurotropic melanomas (often arising with lentiginous melanomas), and the controversial (and perhaps mainly conceptual) entity, minimal deviation melanoma. Other unusual or rare forms of melanoma are malignant blue nevus, balloon cell melanoma, and clear cell sarcoma. An extensive discussion of the differential diagnosis of the various types of melanoma is provided. PMID:8506417
Barnhill, R L; Mihm, M C
The gastrointestinal (GI) tract is a common site of melanoma metastases although reports of small bowel intussusception are relatively rare. Most patients with intussusception will be symptomatic and resection will provide significant palliation. In rare instances, patients will have solitary metastases to the small intestine, and resection can provide long-term palliation and chance for cure. We describe a case of a patient with a widely metastatic melanoma who presented with crampy abdominal pain and CT findings of small bowel metastases. Exploration revealed jejunojejunal intussusception and resection provided excellent palliation. PMID:17619936
Mucci, Tania; Long, William; Witkiewicz, Agnes; Mastrangelo, Michael J; Rosato, Ernest L; Berger, Adam C
Full Text Available SciELO Brazil | Language: English Abstract in portuguese A dermatoscopia das lesões melanocíticas tem auxiliado na decisão de biopsiar ou não uma lesão. A utilização desta ferramenta aumentou a sensibilidade e a especificidade do diagnóstico para 89% e 96%, respectivamente. No entanto, a avaliação dermatoscópica de melanomas amelanóticos ou hipomelanótico [...] s, bem como a de metástases cutâneas, pode ser difícil. Ainda falta uma padronização para a análise destas patologias, que se baseia, majoritariamente, no seu padrão vascular. Descreve-se a dermatoscopia de melanoma metastático amelanótico acral. Abstract in english Dermatoscopy of melanocytic lesions has guided the decision of when or not to biopsy a lesion. The use of this tool has increased clinical examination's sensitivity and specificity in 89% and 96% respectively. However, dermatoscopic evaluation of amelanotic or hypomelanotic melanomas, as well as met [...] astases, can be difficult. There is still no standardization for the analysis of these pathologies, which relies mostly on their vascular pattern. We describe the dermatoscopy of acral metastatic amelanotic melanoma.
Marcela Sena Teixeira, Mendes; Mariana Carvalho, Costa; Ciro Martins, Gomes; Lisley Calixto de, Araújo; Gustavo Henrique Soares, Takano.
Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese FUNDAMENTOS: Está bem definido que a radiação ultravioleta provoca depleção imunológica na pele, permitindo o desenvolvimento de tumores cutâneos malignos. A maioria dos pacientes de cânceres da pele não melanomas são considerados UVB-suscetíveis. OBJETIVOS: Estudar a UVB-suscetibilidade nos pacient [...] es com melanoma maligno e se este é um fator de risco para o desenvolvimento desse câncer. MÉTODOS: Foram selecionados 88 voluntários divididos em dois grupos: grupo-controle saudável (n=61) e grupo de portadores de melanoma (n=27), todos identificados de acordo com os critérios: tipo histológico, nível de invasão, fotótipos de pele, sexo e idade. A suscetibilidade à radiação ultravioleta B (UVB) foi medida pela reação de hipersensibilidade ao contato com o difenciprone nos voluntários sensibilizados em áreas previamente irradiadas. RESULTADOS: A suscetibilidade à radiação UVB foi de 81,5% nos pacientes com melanoma maligno e de 31,2% no grupo-controle. O risco de um indivíduo desenvolver o melanoma maligno foi 9,7 vezes maior do que nos indivíduos UVB-resistentes. CONCLUSÕES: A UVB-suscetibilidade pode ser considerada um fator de risco importante para o desenvolvimento do melanoma maligno. Abstract in english BACKGROUND: It is well established that UV radiation provokes an immunological depletion in the skin, enabling the development of malignant cutaneous tumors. Most nonmelanoma skin cancer patients are considered to be UVB-susceptible. OBJECTIVE: To study the behavior of UVB- susceptibility in maligna [...] nt melanoma (MM) patients and whether this is a risk factor to the development of MM. METHODS: Eighty-eight volunteers were selected and divided into two groups: healthy control group (n = 61) and MM group (n = 27), which were identified according to the following clinical criteria: histopathological type, level of invasion, skin phototype, sex and age. Susceptibility to ultraviolet B (UVB) radiation was measured by the onset of a contact hypersensitivity reaction to diphenylcyclopropenone among individuals sensitized in previously irradiated areas. RESULTS: Susceptibility to UVB radiation was 81.5 in the MM group and 31.2% in the control group. The risk of an UVB-susceptible individual to develop MM was 9.7 times higher than when UVB resistant. CONCLUSION: UVB susceptibility should be considered an important risk factor to the development of this type of cancer.
Full Text Available ... this stage, the cancer affects only the skin. • Metastatic. During this stage the cancer spreads beyond the skin. Since non-melanoma skin ... area. Cryosurgery Extreme cold can be used to treat precancerous skin conditions, such as actinic keratosis. In ...
Defective mismatch repair has been detected in human colorectal and endometrial carcinomas which exhibit microsatellite instability (MIN). The purpose of this study was to search for MIN in melanoma. Paraffin-embedded neoplastic and non-neoplastic control cells were obtained from 20 untreated individuals with cutaneous malignant melanoma. Breslow thickness ranged from 0.2-7.4 mm (mean 1.4). Cells were carefully scraped from glass slides so that tumor and control DNA could be isolated and then amplified by polymerase chain reaction (PCR) at seven separate microsatellites localized to specific chromosome regions: 1p22 (D1S187), 5q11.2-13.3 (D5S107), 6q21-23.3 (D6S357), 9p21 (IFNA), 11p15.2 (D11S861), 17p13.1 (D17S786), and 18q11 (D18S34). Heterozygosity indices were > or = 0.70. Loci from these chromosome regions were chosen because of cytogenetic abnormalities reported in melanoma (1p, 6q, 9p), location of common oncogenes (11p-HRAS, 17p-TP53), or use in other MIN studies (5q, 18q). Five individuals (25%) demonstrated MIN. There was no correlation with tissue thickness. One individual demonstrated MIN at two loci and one individual demonstrated loss of heterozygosity. The results indicate that MIN occurs in melanoma, albeit less frequently than reported in carcinomas. PMID:9666803
Talwalkar, V R; Scheiner, M; Hedges, L K; Butler, M G; Schwartz, H S
The histopathological variants of malignant melanoma include the common type (lentigo maligna, superficial spreading melanoma, nodular melanoma, acrolentiginous melanoma), spindle cell, desmoplastic, balloon cell, pleomorphic (fibrohistiocytic), myxoid, small cell melanoma and malignant blue nevus. Recently, signet-ring cell melanoma was introduced as an additional cytologic variant. We describe a 72-year-old patient with a primary signet-ring cell melanoma of the skin located on the upper arm. Histopathologic examination disclosed a melanocytic tumor extending from the epidermis to the deep reticular dermis. Numerous pleomorphic tumor cells showed large, intracellular vacuoles and oval to spindle-shaped nuclei at their periphery. Mitotic figures and multinucleated melanocytes were also observed. Some of the signet-ring cells exhibited cytoplasmatic periodic acid-Schiff (PAS)-positivity. Immunohistochemistry showed positive reaction of the tumor cells for S-100, HMB-45 protein and vimentin, confirming their melanocytic differentiation. Tumor cells were negative for cytokeratins, epithelial membrane antigen (EMA), and carcinoembryonic antigen (CEA). The signet-ring cell melanoma disclosed an invasion to Clark Level IV and tumor thickness of 2.2 mm. Signet-ring cell melanoma is a rare morphologic variant of melanoma. Its recognition is important for differentiation from other tumors featuring signet ring cells. PMID:10599947
Breier, F; Feldmann, R; Fellenz, C; Neuhold, N; Gschnait, F
Ocular melanoma is the second most common type of melanoma after cutaneous and the most common primary intraocular malignant tumor in adults. Large majority of ocular melanomas originate from uvea, while conjunctival melanomas are far less frequent. Incidence of uveal melanoma has remained stable over last three decades. Diagnosis is in most cases established by clinical examination with great accuracy. Local treatment of uveal melanoma has improved, with increased use of conservative methods...
Jovanovic, Predrag; Mihajlovic, Marija; Djordjevic-jocic, Jasmina; Vlajkovic, Slobodan; Cekic, Sonja; Stefanovic, Vladisav
A MoAb was raised against a peptide corresponding to an exposed domain of the putative tyrosine kinase receptor protein encoded by Xmrk, a gene involved in melanoma formation and/or progression in the Xiphophorus fish melanoma model. The antibody reacts specifically with cells from human melanocytic lesions, ie, common acquired nevi, primary and metastatic melanoma biopsies. No reactivity with other cells, including normal melanocytes, was observed in the biopsies or with cells in biopsies fr...
Vielkind, J. R.; Tron, V. A.; Schmidt, B. M.; Dougherty, G. J.; Ho, V. C.; Woolcock, B. W.; Sadaghiani, B.; Smith, C. J.
A study of 361 female melanoma patients and age matched controls was conducted in the four western provinces of Canada. Analysis of reproductive factors showed a significant negative association between number of livebirths and risk of melanoma. The relationship persisted for superficial spreading melanomas after adjustment for host pigmentation factors, freckling, and educational status. An inverse association between bilateral oophorectomy and risk of superficial spreading melanoma was also...
Gallagher, R. P.; Elwood, J. M.; Hill, G. B.; Coldman, A. J.; Threlfall, W. J.; Spinelli, J. J.
Animal-type melanoma is an exceedingly rare histological variant of melanoma in humans. The name was coined to reflect similar histological features to melanomas in grey horses. We present a case of animal-type melanoma. The neoplastic cells were heavily pigmented with an epithelioid morphology, round nuclei and prominent eosinophilic nucleoli. Only occasional mitotic figures were identified. The tumour cells had diffuse and nodular growth patterns with involvement of the dermis and the subcu...
Muna Sabah; Mary Leader; Mary Fahy; Elaine Kay
Xanthomas of the skin may mimic balloon cell melanoma because 1) both lesions may exhibit a diffuse dermal proliferation of cytologically similar large vacuolated or clear cells with distinct cytoplasmic membranes, 2) dermal maturation (smaller deep dermal nuclei) is absent in both lesions, 3) melanin pigment is usually absent in balloon cell melanoma, 4) cellular atypia may be minimal in balloon cell melanoma, and 5) mitoses may be absent or rare in balloon cell melanoma. We report a unique xanthoma, which further simulated melanoma by exhibiting epidermotropism and a pseudonesting pattern at the dermal-epidermal junction. The correct diagnosis was made with an immunohistochemical panel revealing tumor cell positivity for CD68 and negativity for S-100 protein and MART-1. Immunohistochemical studies may be required in the critical differential diagnosis of epidermotropic xanthoma and amelanotic balloon cell melanoma. PMID:10770441
Northcutt, A D
The Collaborative Ocular Melanoma Study (COMS) is an international, multicenter-controlled study. The organization includes an Executive Committee, Steering Committee, 6 Central Units, 32 Clinical Centers, and a Data and Safety Monitoring Committee. Scientifically, the COMS consists of (1) a randomized trial of patients with medium choroidal melanoma treated with enucleation versus iodine-125 plaque irradiation, (2) a randomized trial of patients with large choroidal melanoma treated with enucleation versus preenucleation external beam irradiation and enucleation, and (3) a prospective observational study of patients with small choroidal melanoma to determine whether a randomized trial of treatment is appropriate. In design and conduct of the COMS, special consideration is given to biostatistics and sample size considerations, iodine-125 plaque irradiation of choroidal melanoma, and coordinated ocular melanoma research. Recruitment is in progress. However, the pool of eligible patients is limited and the COMS needs the continued support and cooperation of ophthalmologists throughout the United States and Canada
The Collaborative Ocular Melanoma Study (COMS) is an international, multicenter-controlled study. The organization includes an Executive Committee, Steering Committee, 6 Central Units, 32 Clinical Centers, and a Data and Safety Monitoring Committee. Scientifically, the COMS consists of (1) a randomized trial of patients with medium choroidal melanoma treated with enucleation versus iodine-125 plaque irradiation, (2) a randomized trial of patients with large choroidal melanoma treated with enucleation versus preenucleation external beam irradiation and enucleation, and (3) a prospective observational study of patients with small choroidal melanoma to determine whether a randomized trial of treatment is appropriate. In design and conduct of the COMS, special consideration is given to biostatistics and sample size considerations, iodine-125 plaque irradiation of choroidal melanoma, and coordinated ocular melanoma research. Recruitment is in progress. However, the pool of eligible patients is limited and the COMS needs the continued support and cooperation of ophthalmologists throughout the United States and Canada.
Straatsma, B.R.; Fine, S.L.; Earle, J.D.; Hawkins, B.S.; Diener-West, M.; McLaughlin, J.A.
Full Text Available Background. The clinical presentation of desmoplastic melanoma is often challenging. We report the experience of the Melanoma Unit of Spedali Civili University Hospital of Brescia, Italy. Method. Study subjects were drawn from 1770 patients with histologica confirmed melanoma. Within this group, desmoplastic melanoma developed in 5 patients. For each diagnosed melanoma, histological characteristics, treatment, and outcomes were evaluated. Results. Of the 5 patients described in this study, 2 were males and 3 females. The average age was 62.4 years ranging from 56 to 68 years. Breslow thickness ranged from 2.1 to 12?mm with a mean thickness of 5.8?mm. Primary treatment of 5 patients included a wide local excision of their primary lesions. Conclusions. Desmoplastic melanoma is a rare neoplasm which clinically may mimic other tumours or cutaneous infiltrate of uncertain significance. The diagnosis is hiastopathological and radical resection is necessary.
A. M. Manganoni
Amelanotic vulvar melanoma is a rare type of malignant melanoma. This paper describes a case of an asymptomatic ulcerated nodule 20 mm in size. The tumor cells from the nodular lesion showed positive staining immunohistochemically for Melan-A, but negative staining with HMB-45. The cells showed negative reactivity to S-100 except in one region. The melanoma cells in the epidermis were detected in one of the specimens from the excised tumor nodule. The cells in the epidermis showed positive staining for Melan-A and S-100 and partial staining with HMB-45. The tumor was diagnosed as malignant melanoma of the vulva and immunohistochemically shown to have intratumor histological heterogeneity. This case suggests the importance of viewing non-pigmented nodules on the vulva of elderly females as potentially malignant melanoma, and that a combination of immunohistochemical stains may be useful for recognizing the stage of the melanosomes in the melanoma cells. PMID:20536668
Oiso, Naoki; Yoshida, Masuki; Kawara, Shigeru; Kawada, Akira
Experimental animal models are extremely valuable for the study of human diseases, especially those with underlying genetic components. The exploitation of various animal models, from fruitflies to mice, has led to major advances in our understanding of the etiologies of many diseases, including cancer. Cutaneous malignant melanoma is a form of cancer for which both environmental insult (i.e., UV) and hereditary predisposition are major causative factors. Fish melanoma models have been used in studies of both spontaneous and induced melanoma formation. Genetic hybrids between platyfish and swordtails, different species of the genus Xiphophorus, have been studied since the 1920s to identify genetic determinants of pigmentation and melanoma formation. Recently, transgenesis has been used to develop zebrafish and medaka models for melanoma research. This review will provide a historical perspective on the use of fish models in melanoma research, and an updated summary of current and prospective studies using these unique experimental systems. PMID:20230482
Patton, E Elizabeth; Mitchell, David L; Nairn, Rodney S
We describe a case of melanoma with the presence of comedo-like openings at dermoscopy. These structures, typical of seborrheic keratosis, represent an uncommon finding in melanoma. We emphasize the importance of searching for specific dermoscopic criteria for melanocytic lesions during the examination of a pigmented lesion, despite possible observations of characteristic structures of non-melanocytic lesions, in order to increase the accuracy in the diagnosis of melanoma. PMID:24770519
Santos, Bruno Simão dos; Ribeiro, Lucia Helena Soares; Ayres, Eloisa Leis; Vilar, Enoi Aparecida Guedes
We describe a case of melanoma with the presence of comedo-like openings at dermoscopy. These structures, typical of seborrheic keratosis, represent an uncommon finding in melanoma. We emphasize the importance of searching for specific dermoscopic criteria for melanocytic lesions during the examination of a pigmented lesion, despite possible observations of characteristic structures of non-melanocytic lesions, in order to increase the accuracy in the diagnosis of melanoma. PMID:24770519
dos Santos, Bruno Simão; Ribeiro, Lucia Helena Soares; Ayres, Eloisa Leis; Vilar, Enoi Aparecida Guedes
Despite recent insights into melanoma genetics, systematic surveys for driver mutations are challenged by an abundance of passenger mutations caused by carcinogenic ultraviolet (UV) light exposure. We developed a permutation-based framework to address this challenge, employing mutation data from intronic sequences to control for passenger mutational load on a per gene basis. Analysis of large-scale melanoma exome data by this approach discovered six novel melanoma genes (PPP6C, RAC1, SNX31, T...
Hodis, Eran; Watson, Ian R.; Kryukov, Gregory V.; Arold, Stefan T.; Imielinski, Marcin; Theurillat, Jean-philippe; Nickerson, Elizabeth; Auclair, Daniel; Li, Liren; Place, Chelsea; Dicara, Daniel; Ramos, Alex H.; Lawrence, Michael S.; Cibulskis, Kristian; Sivachenko, Andrey
Melanoma of the iris is a rare condition compared to posterior ocular tumors and in this case report we present a 51-year-old female patient with diffuse iris melanoma. Traditional COMS (Collaborative Ocular Melanoma Study) plaques are used at our institution for radiation therapy, so a novel modification of the traditional plaque was required to allow better conformance with placement on the cornea. The usual silastic insert was machined to dimensions in compliance with the cornea, placed wi...
Scanderbeg, Daniel J.; Deepta Vasudev; Rice, Roger K.; Michael Goldbaum; Mundt, Arno J.
Full Text Available Malignant melanoma rarely affects the breast. Malignant melanoma of breast is divided into two categories: primary and metastatic lesions. Primary melanoma involves the skin and less commonly the glandular parenchyma of the breast. Differentiating them is very important in deciding on treatment strategies. This case report aims to increase awareness of unusual neoplasms of the breast which requires a different surgical and adjuvant therapeutic approach. [Int J Res Med Sci 2014; 2(2.000: 755-758
Malignant melanoma rarely affects the breast. Malignant melanoma of breast is divided into two categories: primary and metastatic lesions. Primary melanoma involves the skin and less commonly the glandular parenchyma of the breast. Differentiating them is very important in deciding on treatment strategies. This case report aims to increase awareness of unusual neoplasms of the breast which requires a different surgical and adjuvant therapeutic approach. [Int J Res Med Sci 2014; 2(2.000): 755-...
Bhagyalakshmi, A.; Uma, P.; Satya Sri, K.; Kumar, S. V.
Malignant melanoma is one of the most aggressive malignancies in human and is responsible for almost 60% of lethal skin tumors. Its incidence has been increasing in white population in the past two decades. There is a complex interaction of environmental (exogenous) and endogenous, including genetic, risk factors in developing malignant melanoma. 8–12% of familial melanomas occur in a familial setting related to mutation of the CDKN2A gene that encodes p16. The aim of ...
Bizhan Bandarchi; Linglei Ma; Roya Navab; Arun Seth; Golnar Rasty
Full Text Available Cutaneous melanoma of the eyelid is a rare entity. We present a 53-year-old male who had a nevus on the left upper eyelid skin since childhood, which transformed into a huge ulcerated hanging mass in the same region. Excision of the mass was done and histopathology confirmed the diagnosis of nodular malignant melanoma. A small preauricular lymph node showed metastatic melanoma on fine needle aspiration cytology.
Cutaneous melanoma of the eyelid is a rare entity. We present a 53-year-old male who had a nevus on the left upper eyelid skin since childhood, which transformed into a huge ulcerated hanging mass in the same region. Excision of the mass was done and histopathology confirmed the diagnosis of nodular malignant melanoma. A small preauricular lymph node showed metastatic melanoma on fine needle aspiration cytology.
Pai Radha; Kini Hema; Kamath Sai; Kumar Suneet
Full Text Available Durante las últimas décadas hubo un aumento de la incidencia del melanoma cutáneo en la población caucásica del mundo, aunque este tumor puede afectar a cualquier grupo étnico. En la actualidad se considera a la exposición solar intermitente como un factor de riesgo cierto, en el desarrollo del melanoma cutáneo. La incidencia del melanoma cutáneo en Auckland, Nueva Zelanda, es la mayor del mundo. En Europa, la incidencia y la mortalidad fue creciente hasta que en la década de los 80 se estabilizó. En EEUU también se observó una estabilización de la incidencia. Con respecto a la edad, según la bibliografía consultada la incidencia aumenta a partir de los 20 años; en algunos pacientes con más de 200 nevos y sin pautas de protección solar antes de los 5 años de vida. También se observa aumento de la incidencia en los adultos mayores de 60 años de edad. Con respecto al sexo, en los EEUU y la Argentina es más frecuente en los hombres y en Europa en el sexo femenino.During the last decades there was an increase of incidence of cutaneous melanoma in Caucasian population worldwide, but this tumor can affect any ethnic group. Nowadays, the intermittent solar exposition is a well known predisposing factor. The incidence in Auckland, New Zealand, is the highest in the world. In Europe and in the USA, the incidence and mortality rates decreased until the 80's when it stabilized. Regarding the age of appearance, the incidence increases starting at 20 years of age in patients with more than 200 nevi and without history of sun protection in childhood. There was also an increase in the incidence in adults (>60 y-o. The distribution by sex in USA and Argentina is more frequent in males and in Europe in females.
R M C Leitner
Melanoma is the most dangerous form of skin cancer and the sixth leading cause of malignancy in the United States. Non-Caucasians have a decreased overall incidence of melanoma, but African Americans and other ethnic groups often have more advanced disease at initial diagnosis and higher mortality rates than Caucasian populations. Patients with more darkly pigmented skin have a higher percentage of acral lentiginous melanoma, which presents on the palms, soles, and subungual sites and carries specific genetic alterations. Increased awareness of melanoma presentation in pigmented skin may help reduce disparities between ethnic groups. PMID:25245971
Stubblefield, Jonathan; Kelly, Brent
Melanoma is the deadliest form of skin cancer with rising incidence and mortality rates. Although early-stage melanoma is highly curable, advanced-stage melanoma is refractory to treatment. This underscores the importance of prevention and early detection as well as the need to improve treatment and prognostication of human melanoma. Elucidating the underlying mechanisms of the initiation and progression of human melanoma can help identify potential targets of intervention for prevention, diagnosis, therapy, and prognosis of this disease. Aberrant DNA methylation and histone modifications are the best-established epigenetic mechanisms of carcinogenesis. The occurrence of epigenetic changes prior to clinical diagnosis of cancer and their reversibility through pharmacologic/genetic approaches offer a promising avenue for basic and translational research on human melanoma. Candidate gene(s) or genome-wide aberrant DNA methylation and histone modifications have been observed in human melanoma tumor tissues and cell lines, and correlated to cellular and functional characteristics and/or clinicopathological features of this malignancy. The present review summarizes the published researches on aberrant DNA methylation and histone modifications in connection with human melanoma. Representative studies are highlighted to set forth the current state of knowledge, gaps in the knowledgebase, and future directions in these epigenetic fields of research. Examples of epigenetic therapy applied for human melanoma in vitro, and the challenges of its in vivo application for clinical treatment of solid tumors are discussed. PMID:24895357
Besaratinia, Ahmad; Tommasi, Stella
Full Text Available Blind eyes can harbor a choroidal melanoma. We report a case of uveal melanoma presenting as staphyloma and complicated cataract in a 45-year-old female. The left eye was blind for six months. She underwent comprehensive ocular examination but fundus examination was precluded due to total cataract. The ultrasound of the eye showed a large mass filling the superior, nasal and inferonasal vitreous cavity with high surface reflectivity and low to moderate internal reflectivity. Magnetic resonance imaging (MRI confirmed the diagnosis of choroidal melanoma. The patient underwent extended enucleation and histopathology was consistent with uveal melanoma.
A group of melanocytic benign nevi are prone to be misdiagnosed as nodular or superficial spreading melanoma. This review illustrates the most frequent forms of these nevi in direct comparison with their malignant morphologic counterparts. The nevi are: hyper-cellular form of common nevus to be distinguished from nevoid melanoma, Spitz nevus (vs spitzoid melanoma), Reed nevus (vs melanoma with features of Reed nevus), cellular atypical blue nevus (vs melanoma on blue nevus), acral nevus (vs acral melanoma), Clark dysplastic nevus (vs superficial spreading melanoma), desmoplastic nevi (vs desmoplastic melanoma), benign proliferative nodules in congenital nevi (vs melanoma on congenital nevi), epithelioid blue nevus (vs animal type melanoma) and regressed nevus (vs regressed melanoma). For each single 'pair' of morphological look-alikes, a specific set of morphological, immunohistochemical and genetic criteria is provided. PMID:17653760
The development of boron-containing compounds which localize selectively in tumor may require a tumor-by-tumor type of approach that exploits any metabolic pathways unique to the particular type of tumor. Melanin-producing melanomas actively transport and metabolize aromatic amino acids for use as precursors in the synthesis of the pigment melanin. It has been shown that the boron-containing amino acid analog p-borono-phenylalanine (BPA) is selectively accumulated in melanoma tissue, producing boron concentrations in tumor that are within the range estimated to be necessary for successful boron neutron capture therapy (BNCT). We report here the results of therapy experiments carried out at the Brookhaven Medical Research Reactor (BMRR). 21 refs., 5 figs., 3 tabs
In 20 patients with melanoma and 8 healthy donors the number of lymphocytes binding type-specific immunoglobulin in peripheral blood was determined by the method of direct immunoluminescence. The content of B-and T-lymphocytes was calculated. The results obtained made it possible to find some regularities with respect to the cell concent of lymphocytes population in patients with melanoma. High values of T-cell amount were revealed mostly in the absence of metastases, the most high indices being observed in patients with prolonged absence of the recurrence and metastases after their surgical removal. There is a tendency to an increased number of T-lymphocytes under the influence of the combination treatment- surgical and pharmacological. In unfavourable course of the disease with metastasization and generalization the fall was noted in the number of T-cells. PMID:300944
Luchenko, I M
Imiquimod belongs to the class of 1H-imidazo-[4,5-c]quinolones—drugs originally developed as nucleoside analogues with the aim of finding new potential antiviral agents (Harrison et al., 1988). Indeed, Imiquimod was first released as treatment for genital warts before its actions against skin cancer were studied. Imiquimod is a relatively small sized molecule (Mr = 240.3) and is hydrophobic, allowing it to penetrate the skin epidermal barrier and therefore making it suitable for topical formulations (Gerster et al., 2005). Imiquimod has shown itself effective against skin cancers and precancerous lesions, especially basal cell cancers and actinic keratosis (Salasche et al., 2002, Beutner et al., 1999). There have been reports of Imiquimod being used as topical treatment against cutaneous metastases of melanoma and some authors have reported its use as first-line therapy against melanoma in situ (Smyth et al., 2011, Gagnon, 2011). We report a case of an invasive malignant melanoma arising de novo at the specific site of application of Imiquimod (Aldara cream 5%) for a biopsy-proven superficial BCC. Therefore while Imiquimod has added to our topical armamentarium against skin cancer, care must be exercised in prescribing this treatment and it is especially important to follow up patients regularly. PMID:25431597
Spontaneous rupture of spleen due to malignant melanoma is a rare situation, with only a few case reports in the literature. This study reports a previously healthy, 30-year-old man who came with chief complaint of acute abdominal pain to emergency room. On physical examination, abdominal tenderness and guarding were detected to be coincident with hypotension. Ultrasonography revealed mild splenomegaly with moderate free fluid in abdominopelvic cavity. Considering acute abdominal pain and hemodynamic instability, he underwent splenectomy with splenic rupture as the source of bleeding. Histologic examination showed diffuse infiltration by tumor. Immunohistochemical study (positive for S100, HMB45, and vimentin and negative for CK, CD10, CK20, CK7, CD30, LCA, EMA, and chromogranin) confirmed metastatic malignant melanoma. On further questioning, there was a past history of a nasal dark skin lesion which was removed two years ago with no pathologic examination. Spontaneous (nontraumatic) rupture of spleen is an uncommon situation and it happens very rarely due to neoplastic metastasis. Metastasis of malignant melanoma is one of the rare causes of the spontaneous rupture of spleen. PMID:24795827
Oryan, Ahmad; Davari, Aida; Daneshbod, Khosrow; Daneshbod, Yahya
Balloon cells may occur in both benign nevi and malignant melanomas. Sometimes they dominate the histological appearance and cause difficulties in biopsy interpretation. There are no specific clinical characteristics. We report a metastatic balloon cell melanoma where the primary tumour was not identified and the histological appearance mimicked that of a clear cell renal carcinoma. PMID:2748467
Akslen, L A; Myking, A O
SkinCancerNet Article Genetic Testing for Melanoma has Limits With the availability of genetic testing for melanoma, the deadliest form of skin cancer, you ... caution that we should not rely on genetic testing alone. Here’s why. Result Does Not Change Dermatologists’ ...
Melanoma is increasing in incidence. An often-unsuspected complication is metastasis to the gastrointestinal tract, which leads to bowel obstruction or intussusception. The most common symptoms in patients with gastrointestinal metastasis are vomiting, abdominal pain and abdominal distention. Metastatic disease should be suspected in any patient with gastrointestinal symptoms and a history of cutaneous melanoma. PMID:2403721
Kruse, J; Heath, R
The small and large intestines are the most common sites for metastases from cutaneous malignant melanoma. However, primary melanomas in these sites are exceedingly rare. There are several case reports of patients with primary melanoma of the small bowel, but finding of a solitary primary melanoma in the colon is exceedingly rare. We describe a patient that was operated on for bowel obstruction due to colonic intussusception resulting from a right colonic tumor. Histopathological examination confirmed a diagnosis of malignant melanoma. A thorough postoperative investigation did not reveal a primary lesion in any other site. Two years after surgery, there was no evidence for recurrent disease. The treatment and prognosis of metastatic and primary melanoma of the gastrointestinal tract is discussed as well as the embryonic base for development of primary malignant melanoma of the intestine. Primary malignant melanoma of the intestine is an extremely rare lesion that may arise in the large bowel as well. It must be differentiated from other intestinal tumors and mandates a thorough investigation to rule out the possibility of being a metastasis from another more common primary site. PMID:15279192
Avital, Shmuel; Romaguera, Rita L; Sands, Laurance; Marchetti, Floriano; Hellinger, Michael D
Full Text Available Malignant melanoma is a malignant neoplasia drives from melanocytes. Malignant melanoma, the most causing death, is seen in the third place at skin cancer. Malignant melanoma shows intrinsic resistance to chemotherapeutic agents and variability in the course of the disease which are distinct features separating from other solid tumors. These features prevent the development and standardization of non-surgical treatment models of malignant melanoma. Although there is a large number of chemotherapeutic agents used in the treatment of metastatic malignant melanoma, it hasn’t been demonstrated the survival advantage of adjuvant treatment with chemotherapeutic agents. Because of the different clinical course of malignant melanoma, the disease is thought to be closely associated with immune system. Therefore, immunomodulatory therapy models were developed. Mistletoe stimulates the immune system by increasing the number and activity of dendritic cells, thus it has been shown to effect on tumor growth and metastasis of malignant melanoma patient. Outlined in this review are the recent developments in the understanding the role of mistletoe as a complementary therapy for malignant melanoma. J Clin Exp Invest 2014; 5 (1: 145-152
Esin Sakall? Çetin
According to data from the literature and to new data from the German central registry for malignant melanomas from the German Society of Dermatology, a summary is given about the occurrence of malignant melanoma in children and adolescents up to 18 years of age. During the first 10 years of life the occurrence of a melanoma is extremely rare, but slowly increases after the first decade. Several studies have shown that young people often have amelanotic tumors resembling pyogenic granuloma. This correlates with a histopathological high number of nodular melanomas in this age group. A reason might be a delay in the clinical diagnosis of malignant melanoma in children and young adults. Clinical and histopathological examples of melanoma in young people are demonstrated. Pitfalls in differential diagnosis and simulators of malignant melanoma are described and illustrated by examples of a medium sized congenital nevus with extensive intraepithelial spread of single melanocytes resembling a superficial spreading melanoma and by a compound nevus in association with a lichen sclerosus et atrophicus. PMID:17874108
Injectable synthetic melanotropic peptides (often called melanotan) to enhance tanning are available over the Internet despite being unlicensed compounds with an unproven safety record. There have been reports of dysplastic naevi and melanoma associated with the use of melanotropic peptides. We report a case of melanotan-associated melanoma in situ. PMID:22724573
Ong, Suyin; Bowling, Jonathan
The general consensus of the seven reviewers is that occupational exposures at Lawrence Livermore National Laboratory have not been established as a causal factor for the observed excess of malignant melanoma. Several observations support the impression that some or all of the observed melanoma excess may be attributable to intense surveillance and enhanced detection of early stage melanoma lesions. Since the incidence of melanomas among Laboratory employees has not diminished, an early harvesting effect is unlikely. This suggests the distinct possibility that localized, in situ melanomas that would normally not be detected are being reported, and that in the absence of this enhanced detection, many of these early stage lesions would show little or no clinical progression. This phenomenon would explain the continued high incidence of melanomas in the absence of a physical or chemical inciting cause. A key point in this reasoning is the issue of the rate of growth of early stage melanomas, and this point remains a key question for study. Even if the observed excess cannot be explained by detection bias, the reviewers agree that the Austin and Reynolds' study does not make a convincing case for occupational factors being a cause of the high melanoma incidence. 6 refs
The authors describe a case of choroidal melanoma in a 13-year-old girl treated with plaque brachytherapy. Uveal melanoma is reported in all age groups but tends to manifest itself in adults more often than children. Childhood (melanoma represents 1% of all cases. Clinical features and treatment options in childhood melanoma are discussed. PMID:25490240
Sivalingam, Meera D; Hasanreisoglu, Murat; Shields, Carol L
Full Text Available Abstract Background Melanomas are malignant neoplasm of melanocytic origin, commonly seen on skin and various mucous membranes. Melanomas are the commonest intraocular malignant tumour in the adults. Case presentation A 50-year-old female presented with complains of painless progressive swelling in right cheek region of two months duration. Examination revealed a 6 × 4 cm bony hard swelling in right zygomatic region near and below lateral canthus of right eye with loss of vision. Investigations revealed it to be a choroidal melanoma metastatising to the zygomatic bone. Patient was successfully treated by surgery. Conclusion Choroidal melanoma, which commonly metastasizes to liver and lungs, never involves the lymph nodes and metastasis to facial bones is rare. Here we report a case of choroidal melanoma metastasizing to maxillofacial bones.
Invading melanoma spreads to local and unpredictable distant location at the early stages of its development. It is justifiable, therefore to classify the disease as a systemic disorder. This requires a systemic treatment that reaches all melanoma cells irrespective of whether they are singly dispersed and in circulation or already forming solid tumours of various sizes. Targeted radiotherapy affects directly and selectively cancer cells provided an appropriate radionuclide and its carrier are chosen. Melanoma is a pigmented tumour. Methylene blue (MTB) accumulates selectively in melanoma cells due to its exceptionally high affinity to melanin. MTB serves, therefore, as a carrier for radionuclides. 211At-MTB has proved to be particularly effective in treating disseminated melanoma when administered systemically and, at the same time, non-toxic to normal non-pigmented and pigmented organs. (author)
Invading melanoma spreads to local and unpredictable distant location at the early stages of its development. It is justifiable, therefore, to classify the disease as a systemic disorder. This requires a systemic treatment that reaches all melanoma cells irrespective of whether they are singly dispersed and in circulation or already forming solid tumours of various sizes. Targeted radiotherapy affects directly and selectively cancer cells provided an appropriate radionuclide and its carrier are chosen. Melanoma is a pigmented tumour. Methylene blue (MTB)) accumulates selectively in melanoma cells due to its exceptionally high affinity to melanin. MTB serves, therefore, as a carrier for radionuclides. 211At-MTB has proved to be particularly effective in treating disseminated melanoma when administered systemically and, at the same time, non-toxic to normal non-pigmented and pigmented organs. (authors)
Full Text Available SciELO Argentina | Language: Spanish Abstract in spanish Durante las últimas décadas hubo un aumento de la incidencia del melanoma cutáneo en la población caucásica del mundo, aunque este tumor puede afectar a cualquier grupo étnico. En la actualidad se considera a la exposición solar intermitente como un factor de riesgo cierto, en el desarrollo del mela [...] noma cutáneo. La incidencia del melanoma cutáneo en Auckland, Nueva Zelanda, es la mayor del mundo. En Europa, la incidencia y la mortalidad fue creciente hasta que en la década de los 80 se estabilizó. En EEUU también se observó una estabilización de la incidencia. Con respecto a la edad, según la bibliografía consultada la incidencia aumenta a partir de los 20 años; en algunos pacientes con más de 200 nevos y sin pautas de protección solar antes de los 5 años de vida. También se observa aumento de la incidencia en los adultos mayores de 60 años de edad. Con respecto al sexo, en los EEUU y la Argentina es más frecuente en los hombres y en Europa en el sexo femenino. Abstract in english During the last decades there was an increase of incidence of cutaneous melanoma in Caucasian population worldwide, but this tumor can affect any ethnic group. Nowadays, the intermittent solar exposition is a well known predisposing factor. The incidence in Auckland, New Zealand, is the highest in t [...] he world. In Europe and in the USA, the incidence and mortality rates decreased until the 80's when it stabilized. Regarding the age of appearance, the incidence increases starting at 20 years of age in patients with more than 200 nevi and without history of sun protection in childhood. There was also an increase in the incidence in adults (>60 y-o). The distribution by sex in USA and Argentina is more frequent in males and in Europe in females.
R M C, Leitner.
Full Text Available Purpose: To illustrate an approach to evidence-based medical practice by reporting the Collaborative Ocular Melanoma Study (COMS randomised clinical trials and cohort studies of choroidal melanoma. Methods: COMS randomised clinical trials of Iodine-125 (I-125 brachytherapy, adjunctive cohort study of visual acuity in eyes treated with brachytherapy and adjunctive natural history study. COMS randomised clinical trial of pre-enucleation radiation. Results: The COMS I-125 brachytherapy trial (N = 1,317 patients of medium-sized choroidal melanoma showed 5-year all-cause mortality of 18% [95% Confidence Interval (CI, 16-20%] and no statistically significant difference in mortality following 1-125 brachytherapy or enucleation. Adjunctive cohort natural history study (N-42 patients of patients eligible for the I-125 brachytherapy trial who deferred treatment or had no melanoma treatment had a 5-year all-cause mortality of 30% (95% CI, 18-47%. The COMS pre-enucleation radiation trial (N = 1,003 patients of large-sized choroidal melanoma showed 5-year all-cause mortality of 40% (95% CI, 37-44%. Conclusions: Evidence derived from randomised clinical trials and cohort studies shows the need for longterm (? 5 years follow-up to determine the efficacy of treatment for choroidal melanoma by any modality. The rather similar 5-year mortality for treated and untreated medium melanoma patients suggests that metastatic dissemination may occur at an early stage of choroidal melanoma. To increase longterm survival, ocular treatment of choroidal melanoma must strive for diagnosis and treatment of melanoma at an early stage when metastasis is less likely and be combined with measures to detect and treat micrometastasis
Full Text Available Melanomas oculares correspondem a 5% de todos os melanomas e 85% deles têm origem no trato uveal. Melanoma uveal é o tumor maligno intraocular primário mais comum no adulto. Relatamos neste artigo um caso de melanoma uveal em paciente, sexo feminino, 31 anos, com quadro de fotopsia, hiperemia e baixa da acuidade visual no olho esquerdo com evolução de quatro meses. Apresentava ao exame oftalmológico acuidade visual menor que 20/400, grande massa tumoral na região nasal retroiriana, com deslocamento anterior do cristalino, estreitamento da câmara anterior e descolamento seroso da retina. A ecografia sugeriu tratar-se de grande massa tumoral suspeita de melanoma de coróide com invasão do corpo ciliar. A confirmação diagnóstica foi possível por meio do exame anatomopatológico.Ocular melanomas correspond to 5% of all melanomas and 85% of them have its origin in the uveal tract. Uveal melanoma is the most commom primary intraocular malignant tumor in the adult. In this article, a case of uveal melanoma in a 31 year-old female patient, with photopsia, hyperemia and low visual acuity in the left eye with evolution of 4 months is presented. In the ophthalmologic examination, visual acuity was lower than 20/400, a large tumoral mass was noted at the nasal region behind the iris with anterior lens displacement, anterior chamber narrowing and serous retinal detachment. The ocular echography suggested a large tumoral mass as a choroidal melanoma extending to the ciliary body. The confirmation diagnosis was possible through the histopathologic examination.
Aline Amaral Fulgêncio da Cunha
Full Text Available Abstract Advanced malignant melanoma remains a challenging cancer. Over the past year, there have been 3 agents approved for treatment of melanoma by Food and Drug Administration. These include pegylated interferon alpha-2b for stage III melanoma, vemurafenib for unresectable or metastatic melanoma with BRAF V600E mutation, and ipilimumab for treatment of unresectable or metastatic melanoma. This review will also update on the development of novel agents, including tyrosine kinase inhibitors and adoptive cellular therapy.
Abstract Background Vitiligo is a common toxicity associated with immunotherapy for melanoma. Cytotoxic T lymphocytes (CTLs) against melanoma commonly target melanoma-associated antigens (MAAs) which are also expressed by melanocytes. To uncouple vitiligo from melanoma destruction, it is important to understand if CTLs can respond against melanoma and melanocytes at different levels. Methods To understand the dichotomous role of MAA-specific CTL, we characterize...
Schwartz Erich J; Stuge Tor B; Kohrt Holbrook E; Chang Gwendolen Y; Weber Jeffrey S; Lee Peter P
In the initial period after melanoma was recognised as a disease entity in the early 1800's, it was subclassified on the basis of its presumed origin (from a precursor naevus, from a melanocytic precursor lesion acquired during adult life or in previously blemish-fee skin). In 1967 the eminent American pathologist, Dr Wallace Clark, proposed a histogenetic classification for melanoma in which the disease was subdivided predominantly on the basis of histopathological features of the intra-epidermal component of the tumour adjacent to any dermal invasive component. The subtypes were superficial spreading melanoma (SSM), lentigo maligna melanoma (LMM) and nodular melanoma (NM). Whilst additional entities, including acral lentiginous melanoma, mucosal melanoma, desmoplastic melanoma and naevoid melanoma have since been recognised, SSM, LMM and NM remain in the latest (2006) version of the WHO melanoma classification. Clark's histogenetic classification has been criticised because the criteria upon which it is based include clinical features (such as the site of the melanoma) and non-tumourous histopathological features (such as the character of the associated epidermis and the degree of solar elastosis) and also because of overlap in defining features, lack of an independent association with patient outcome and minimal relevance as a determinant of clinical management. However, such criticisms fail to acknowledge its importance in highlighting the myriad of clinical and histological guises of melanoma, which if not recognized by clinicians and pathologists will inevitably lead to a delay in diagnosis and a concomitant adverse clinical outcome. Recently, mutually exclusive oncogenic mutations in melanomas involving NRAS (15-20%), BRAF (50%), CKIT (2%), and GNAQ/GNA11 (50% of uveal melanomas) have been identified. This might herald the beginning of a new molecular classification of melanoma in which the biologically distinct subsets share a common oncogenic mechanism, behave clinically in a similar fashion and require similar clinical management. These discoveries are already being successfully exploited as therapeutic targets in clinical trials of metastatic melanoma patients with promising activity. Whilst there remains much to be discovered in this rapidly evolving field, there is already great optimism that more rational and effective therapies for melanoma patients will soon be widely available. PMID:21482206
Scolyer, Richard A; Long, Georgina V; Thompson, John F
The results of phototherapy on a small series of 19 patients with uveal melanomas are presented. Laser radiation at a wavelength of 620 to 630 nm was used in conjunction with a 5 to 7.5 mg/kg dose of haematoporphyrin derivative administered 24 hours before treatment, with total doses/treatment averaging 960 J/cm2. Eleven patients received two treatments, and one received a third. The longest duration of tumour control to 30 September 1990 was 31 months. Of the 19 patients treated six had comp...
Favilla, I.; Barry, W. R.; Gosbell, A.; Ellims, P.; Burgess, F.
Researchers from Memorial Sloan-Kettering Cancer Center presented findings at the annual meeting of the American Society for Clinical Oncology from a study testing the experimental drug selumetinib as a treatment for patients with metastatic uveal melanoma. This treatment more than doubled the time to progression when compared with chemotherapy. Many patients receiving selumetinib experienced tumor shrinkage, making selumetinib the first systemic therapy ever to benefit patients with this cancer. The findings are potentially practice changing for a disease that has previously had no known effective therapy.
In a continuous series of 300 patients with cutaneous malignant melanoma the site of the primary lesion was recorded, and incidence rates per unit area of skin were calculated. These rates were high for the face, back and upper arm and low for the abdomen, buttocks, forearm and hand for both sexes. Rates for the leg were high for the women but low for the men. Tumours on the back were evenly distributed among the men but occurred less frequently on the lower back among the women. In general, ...
Elwood, J. M.; Gallagher, R. P.
The increasing number of living cutaneous melanoma patients and the increased risk of developing a second primary tumour incited us to analyse the clinical characteristics of cutaneous melanoma and define the frequency, site, and type of second primary cancers in cutaneous melanoma patients. We collected data on patients who visited the Department of Dermatology at the Radboud University Nijmegen Medical Centre and were newly diagnosed with cutaneous melanoma or metastasis of melanoma with un...
Velden, Haike M. J.; Rossum, Michelle M.; Blokx, Willeke A. M.; Boezeman, Jan B. M.; Gerritsen, Marie-jeanne P.
Full Text Available The data on melanoma associaed with melanocytic nevus are controversial. A longitudinal prospective study of 107 cases of cutaneous melanoma revealed that 9 (8.4% cases were presumed to be linked to a precursor lesion, but only in 1 (0.9% out of these cases the histopathological examination showed an associated melanocytic nevus. The vague information of a preexisting lesion of cutaneous melanoma is not sufficient to consider it a tumour precursor and it requires histopathological evidence to confirm the diagnosis.Os dados sobre risco de melanoma cutâneo nos nevos melanocíticos são ainda controversos. O estudo longitudinal prospectivo de 107 casos de melanoma cutâneo revelou que em 9/107 casos (8,4% houve presunção de lesão precursora, porém em 1/107 caso (0,9% houve comprovação histopatológica para nevo melanocítico. A informação vaga de presença de lesão precursora do melanoma cutâneo torna vulnerável sua vinculação com o tumor e implica em comprovação histopatológica.
Nurimar Conceição Fernandes
The histological appearance of benign melanocytic naevi and malignant melanomas can be variable, causing in a significant number of cases severe differential diagnostic problems. The early, thin (less than 1 mm) melanomas have to be differentiated from naevi containing dominant junctional or lentiginous component or pagetoid melanocytosis and from some epithelial tumours, while in cases of thick lesion the diagnosis of thick melanoma, Spitz naevus, deep penetrating naevus or cellular blue naevus should be considered for example. The morphology of the so-called atypical Spitz naevus and atypical pigmented spindle cell naevus show overlapping with malignant melanoma and sometimes in these cases the biological behaviour cannot be assessed. The variable appearance of malignant melanoma is illustrated by the fact that different superficial soft tissue tumours with epithelioid and/or spindle cells or with pigment can mimic it. The rare balloon cell and signet ring cell melanoma is a mimicker of primary or metastatic carcinoma and the desmoplastic variant is often misdiagnosed as benign mesenchymal lesion. Lymph node metastasis of melanoma, when the primary tumour is not known, may raise the possibility of interdigitating reticulum cell tumour or anaplastic large cell lymphoma. PMID:12704452
The incidence of cutaneous melanoma has increased significantly worldwide over the last several decades. The aim of this study is to determine clinical and morphology characteristics of primary melanoma, since some of them are important prognostic factors. This retrospective study included 172 patients. The data were collected by the Consulting team for malignant skin tumors in the Banja Luka Clinical Centre from 2009 to 2011. We did not use dermoscopy as a diagnostic tool in our investigation. We determined that melanoma occurs equally commonly in both sexes, in women in the sixth decade and the seventh in men. The most common sub-type was nodular melanoma (59.5%, Pmelanoma (11.4%). The most common localization was on the back in men (34.3%) and on the legs in women (Pmelanoma thickness from 1.0 to 4.0 mm, and 38% had a melanoma thicker than 4.0 mm. The average Breslow thickness is 4.6 mm. More women than men had melanoma thicker than 4 mm (Pprimary tumor localization was found in 31.4% of patients, more frequently in men than in women (Pmelanoma in our patients is much higher than the average in the world and the countries of Europe. The results of this study indicate a need for better unique regional registry in this part of Bosnia and Herzegovina and improvement of preventive measures in the early diagnosis of melanoma. PMID:25580786
Balaban, Jagoda; Ninkovi? Baroš, Djuka; Gruji?, Dragana; Starovi?, Dragana; ?eli?, Milanka
Malignant blue nevus (MBN) is a rare melanocytic lesion and controversy exists whether it is a melanoma or a unique entity. We sought to establish clinical behavior using a large national registry. All patients with MBN and melanoma from 1973 to 2008 were identified in the Surveillance Epidemiology and End Results tumor registry. We performed comparative and survival analysis among the two tumor types. A total of 228,038 patients were identified (227,986 with melanoma and 52 with MBN). The mean age was 57.7 years. Both lesions had similar age of presentation (55.8 vs 55.7 years, P = 0.527), sex (male 50 vs 55%, P = 0.44), and nodal positivity rate (9.6 vs 5.4%, P = 0.22). MBNs were more likely to be nonwhite (11.8 vs 1.6%, P MBN and melanoma had a similar survival (264 vs 240 months, P = 0.78) and remained similar when stratified by race (264 vs 242 months, P = 0.99) and stage (264 vs 256 months, P = 0.83). This is the largest study to date demonstrating similar clinical behavior and survival between patients with MBN and those with melanoma. We believe MBN is a variant of melanoma and suggest using a similar treatment algorithm as that of melanoma. PMID:23815995
Kachare, Swapnil Dilip; Agle, Steven C; Englert, Zachary P; Zervos, Emmanuel E; Vohra, Nasreen A; Wong, Jan H; Fitzgerald, Timothy L
Full Text Available Ellagic is a polyphenolic compound with anti-fibrotic and antioxidant properties as well as exhibits antitumor properties against various cancer cells in vitro. There are few studies, however, which examine the effects of ellagic acid on melanoma. In the present study, we observe effects of ellagic acid on melanoma cells in vitro. Three metastatic melanoma cell lines (1205Lu, WM852c and A375 were examined to determine the effects of ellagic acid on melanoma cell viability, cell-cycle, apoptosis, NF-?? activity, and IL-1? & IL-8 secretion. Cell viability assays demonstrated that ellagic acid possesses an inhibitory effect on cell proliferation at concentrations between 25 and 100 µM. In addition, ellagic acid promoted G1 cell cycle arrest, increased levels of apoptosis and decreased synthesis of IL-1? and IL-8 in melanoma cells. Ellagic acid also decreased NF-?? activity, suggesting at least one potential mechanism by which ellagic acid may exert its effects in melanoma cells. Our findings support further investigation into prospective roles for ellagic acid as a therapeutic, adjuvant, or preventive agent for melanoma.
Robert P. Dellavalle
Full Text Available Rima Chakraborty,1 Carilyn N Wieland,2 Nneka I Comfere2 1University of Missouri-Kansas City Medical School, Kansas City, MO, 2Departments of Dermatology and Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA Abstract: The advent of personalized medicine has ushered in a new era for cancer therapy with a significant impact on the management of advanced melanoma. Molecular targeted therapies have shown promise in the management of various malignancies, including melanoma, with lower toxicity profiles and better overall survival as compared with conventional therapy. The discovery of BRAF mutations in melanoma led to the development of BRAF inhibitors for the treatment of advanced melanoma. However, growing concerns over drug resistance to molecular targeted therapies including BRAF inhibitors, have spurred efforts to elucidate additional molecular targets for the treatment of advanced melanoma. In this review, we discuss the known molecular aberrations in melanoma, current and novel targeted approaches in its treatment, and drug resistance patterns. Keywords: BRAF inhibitors, metastatic melanoma, personalized medicine
Full Text Available Jung-Ki Yoon,1,2 Arthur E Frankel,3 Lynn G Feun,4 Suhendan Ekmekcioglu,1 Kevin B Kim11Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA; 2Hwasung Public Health Center, Hwasung, South Korea, 3Scott and White Cancer Research Institute, Temple, TX, USA; 4Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USAAbstract: Despite recent development of promising immunotherapeutic and targeted drugs, prognosis in patients with advanced melanoma remains poor, and a cure for this disease remains elusive in most patients. The success of melanoma therapy depends on a better understanding of the biology of melanoma and development of drugs that effectively target the relevant genes or proteins essential for tumor cell survival. Melanoma cells frequently lack argininosuccinate synthetase, an essential enzyme for arginine synthesis, and as a result they become dependent on the availability of exogenous arginine. Accordingly, a therapeutic approach involving depletion of available arginine has been shown to be effective in preclinical studies. Early clinical studies have demonstrated sufficient antitumor activity to give rise to cautious optimism. In this article, the rationale for arginine deprivation therapy is discussed. Additionally, various strategies for depleting arginine are discussed and the preclinical and clinical investigations of arginine deprivation therapy in melanoma are reviewed.Keywords: arginine deprivation, argininosuccinate synthetase, melanoma
It is generally agreed that sunlight exposure is one of the etiologic agents in malignant melanoma of fair-skinned individuals. However, the wavelengths responsible for tumorigenesis are not known, although DNA is assumed to be the target because individuals defective in the repair of UV damage to DNA are several thousandfold more prone to the disease than the average population. Heavily pigmented back-cross hybrids of the genus Xiphophorus (platyfish and swordtails) are very sensitive to melanoma induction by single exposures to UV. The authors irradiated groups of five 6-day-old fish with narrow wavelength bands at 302, 313, 365, 405, and 436 nm and score the irradiated animals for melanomas 4 months later. They used several exposures at each wavelength to obtain estimates of the sensitivity for melanoma induction as a function of exposure and wavelength. The action spectrum (sensitivity per incident photon as a function of wavelength) for melanoma induction shows appreciable sensitivity at 365, 405, and probably 436 nm, suggesting that wavelengths not absorbed directly in DNA are effective in induction. They interpret the results as indicating that light energy absorbed in melanin is effective in inducing melanomas in this animal model and that, in natural sunlight, 90-95% of melanoma induction may be attributed to wavelengths >320 nm-the UV-A and visible spectral regions. 25 refs., 4 figs., 1 tab
It is generally agreed that sunlight exposure is one of the etiologic agents in malignant melanoma of fair-skinned individuals. However, the wavelengths responsible for tumorigenesis are not known, although DNA is assumed to be the target because individuals defective in the repair of UV damage to DNA are several thousandfold more prone to the disease than the average population. Heavily pigmented back-cross hybrids of the genus Xiphophorus (platyfish and swordtails) are very sensitive to melanoma induction by single exposures to UV. The authors irradiated groups of five 6-day-old fish with narrow wavelength bands at 302, 313, 365, 405, and 436 nm and score the irradiated animals for melanomas 4 months later. They used several exposures at each wavelength to obtain estimates of the sensitivity for melanoma induction as a function of exposure and wavelength. The action spectrum (sensitivity per incident photon as a function of wavelength) for melanoma induction shows appreciable sensitivity at 365, 405, and probably 436 nm, suggesting that wavelengths not absorbed directly in DNA are effective in induction. They interpret the results as indicating that light energy absorbed in melanin is effective in inducing melanomas in this animal model and that, in natural sunlight, 90-95% of melanoma induction may be attributed to wavelengths >320 nm-the UV-A and visible spectral regions. 25 refs., 4 figs., 1 tab.
Setlow, R.B.; Grist, E.; Thompson, K.; Woodhead, A.D. (Brookhaven National Laboratory, Upton, NY (United States))
It is generally agreed that sunlight exposure is one of the etiologic agents in malignant melanoma of fair-skinned individuals. However, the wavelengths responsible for tumorigenesis are not known, although DNA is assumed to be the target because individuals defective in the repair of UV damage to DNA are several thousandfold more prone to the disease than the average population. Heavily pigmented backcross hybrids of the genus Xiphophorus (platyfish and swordtails) are very sensitive to melanoma induction by single exposures to UV. We irradiated groups of five 6-day-old fish with narrow wavelength bands at 302, 313, 365, 405, and 436 nm and scored the irradiated animals for melanomas 4 months later. We used several exposures at each wavelength to obtain estimates of the sensitivity for melanoma induction as a function of exposure and wavelength. The action spectrum (sensitivity per incident photon as a function of wavelength) for melanoma induction shows appreciable sensitivity at 365, 405, and probably 436 nm, suggesting that wavelengths not absorbed directly in DNA are effective in induction. We interpret the results as indicating that light energy absorbed in melanin is effective in inducing melanomas in this animal model and that, in natural sunlight, 90-95% of melanoma induction may be attributed to wavelengths > 320 nm-the UV-A and visible spectral regions.
Setlow, Richard B.; Grist, Eleanor; Thompson, Keith; Woodhead, Avril D.
Casos clínicos: Se presentan cuatro casos de pacientes con signos clínicos de melanosis óculi. En todos se diagnosticó melanoma de coroides. Tres acudieron con disminución de visión en ojo afecto y fueron enucleados por presentar tumores grandes y activos. En el cuarto caso el melanoma fue descubierto en una revisión rutinaria y se pudo aplicar un tratamiento conservador con braquiterapia con I125. Discusión: La melanosis óculi está infravalorada como factor de riesgo para melanoma ...
Lo?pez Caballero, C.; Ma, Saornil A?lvarez; Blanco Mateos, G.; Jm, Frutos Baraja; Lo?pez Lara, F.; Gonza?lez Sansegundo, C.
Objetivo: Vários métodos vem sendo utilizados para o tratamento dos melanomas da coróide. A proposta deste trabalho preliminar é avaliar a eficácia da termoterapia transpupilar (TTT) como tratamento primário de melanomas da coróide pequenos. Métodos: Foi realizado um trabalho prospectivo e não-randomizado para avaliar os aspectos clínicos, resposta do tumor, complicações e resultados visuais de pacientes portadores de melanomas da coróide pequenos (até 4,0 mm de espessura e 12 m...
Motomo Chojniak, Martha M.; Tércio Guia; Fausto Uno; Clélia Maria Erwenne
Cutaneous melanoma and uveal melanoma both derive from melanocytes but show remarkable differences in tumorigenesis, mode of metastatic spread, genetic alterations, and therapeutic response. In this review we discuss the differences and similarities along with the genetic research techniques available and the contribution to our current understanding of melanoma. The several chromosomal aberrations already identified prove to be very strong predictors of decreased survival in CM and UM patien...
Dion Paridaens; Annelies de Klein; Emine Kilic; Thomas van den Bosch
Los melanomas uveales son los tumores intraoculares primarios más frecuentes, con una incidencia de 8/1 000 000 al año en la raza blanca. Específicamente el melanoma de iris representa entre 5 y 7 % de los melanomas malignos de la úvea. Estos tumores pueden ser amelánicos o pigmentados y por lo general muy vascularizados. Se presenta un paciente de 18 años con antecedentes de salud, que fue atendido en el cuerpo de guardia de oftalmología refiriendo dolor ocular y disminución brusca d...
Leticia Verona Ugando; Beatriz Landrián Iglesias; Naysa Padierne González; Raquel Delgado Moya; Yamilet Leiva González
Malignant melanoma is a highly aggressive tumour with increasing -incidence and poor prognosis in the metastatic stage. In recent years, a substantial number of reports on individual miRNAs or miRNA patterns have been published providing strong evidence that miRNAs might play an important role in malignant melanoma and might help to better understand the molecular mechanisms of melanoma development and progression. A major preliminary finding was that melanoma-associated miRNAs are often located in genomic regions with frequent gains and losses in tumours. Detailed studies of different groups thereafter identified miRNAs with differential expression in benign melanocytes compared with melanoma cell lines or in benign melanocytic lesions compared with melanomas. Among these were let-7a and b, miR-23a and b, miR-148, miR-155, miR-182, miR-200c, miR-211, miR214, and miR-221 and 222. Some of these miRNAs target well-known melanoma-associated genes like the NRAS oncogene, microphthalmia-associated transcription factor (MITF), receptor tyrosine kinase c-KIT or AP-2 transcription factors (TFAP2). Although we are still far from a complete understanding of the role of miRNA-target gene interactions in malignant melanoma, these findings further underscore the notion of a direct involvement of miRNAs in melanoma biology. Very recently, a prognostic signature of six miRNAs has been identified consisting of miRNAs miR-150, miR-342-3p, miR-455-3p, miR-145, miR-155, and miR-497. High expression of these miRNAs was shown to be associated with improved long-term survival of metastatic patients. PMID:23377970
Full Text Available Melanoma of the iris is a rare condition compared to posterior ocular tumors and in this case report we presenta 51-year-old female patient with diffuse iris melanoma. Traditional COMS (Collaborative Ocular Melanoma Studyplaques are used at our institution for radiation therapy, so a novel modification of the traditional plaque was requiredto allow better conformance with placement on the cornea. The usual silastic insert was machined to dimensions incompliance with the cornea, placed without incident, and treatment delivered with excellent patient tolerance of themodified plaque.
Daniel J. Scanderbeg
In this study we present new data from experiments focused on the antitumor activity of tea tree oil (TTO), an essential oil distilled from Melaleuca alternifolia. TTO proved to be capable of inhibiting the growth of melanoma cells and of overcoming multidrug resistance (MDR), as we reported in our previous study. Moreover, the survival role of the MDR-marker P-glycoprotein appears to be involved in the mechanism of invasion of melanoma cells. The results reported herein indicate that TTO and its main active component, terpinen-4-ol, can also interfere with the migration and invasion processes of drug-sensitive and drug-resistant melanoma cells. PMID:20560116
Bozzuto, Giuseppina; Colone, Marisa; Toccacieli, Laura; Stringaro, Annarita; Molinari, Agnese
In the sequence of our studies on radiopharmaceuticals for malignant melanoma detection the results were most promising for the possible use of 125I or 123I - N-(2-diethyl amino ethyl) 4-iodobenzamide. The biodistribution in mice bearing melanoma either human or animal from 4 to 24 hrs. post i.v. injection showed high uptake in tumor tissue together with relatively low uptake in muscle, brain, lung and liver. Scintigraphic images of the tumor obtained at the same times confirmed that melanoma detection was very promising
The authors reviewed the CT studies and clinical records of 57 patients thought to have metastatic melanoma and sought CT findings that might be characteristic of metastatic melanoma. No pattern of lesion density, homogeneity, necrosis, border definition, hazing of adjacent fat, or calcification was characteristic for melanoma. However, widespread lesions in multiple organs, a combination of subcutaneous and visceral lesions, and large yet clinically silent lesions were common. Small (5mm) abnormalities in the lung, liver, spleen, and subcutaneous fat that might be considered inconsequential often represented early deposits of tumor which were enlarged on subsequent scans
Malignant melanoma most commonly occurs in the skin, and other organs are secondarily involved. Malignant melanoma presenting in the mediastinum without an extrathoracic primary is very rare. Authors report a case of malignant melanoma of the superior mediastinum without clinical history of extrathoracic malignant melanoma primarily and discuss its radiologic findings. CT shows lobulated heterogenous enhanced mass. Magnetic resonance shows mild hyperintense mass on T1 and T2-weighted images contained focal hemorrhage and necrosis, and invasion to neural foramen. In addition, positron emission tomography/computed tomography shows high standard uptake values uptake of the mass.
Malignant melanoma most commonly occurs in the skin, and other organs are secondarily involved. Malignant melanoma presenting in the mediastinum without an extrathoracic primary is very rare. Authors report a case of malignant melanoma of the superior mediastinum without clinical history of extrathoracic malignant melanoma primarily and discuss its radiologic findings. CT shows lobulated heterogenous enhanced mass. Magnetic resonance shows mild hyperintense mass on T1 and T2-weighted images contained focal hemorrhage and necrosis, and invasion to neural foramen. In addition, positron emission tomography/computed tomography shows high standard uptake values uptake of the mass.
You, Myung Won; Sung, Dong Wook; Lee, Young Kyung [Dept. of Diagnostic Radiology, Kyung Hee University Hospital, Seoul (Korea, Republic of)
Full Text Available Metastasis in choroidal melanoma is frequent on advanced diseases, involving mainly the liver, lungs and central nervous system. We report a case of cutaneous metastasis in choroidal melanoma because is an unusual condition, even in advanced disease.A ocorrência de metástases do melanoma de coróide é frequente na doença avançada, acometendo principalmente fígado, pulmões e sistema nervoso central. Relatamos um caso de melanoma de coróide com metástases cutâneas, por se tratar de acometimento raro, mesmo em casos avançados da doença.
Fabricio Lopes da Fonseca
Nestin, a marker of neural stem cells, is expressed in the stem cells of the mouse hair follicle. The nestin-expressing hair follicle stem cells can differentiate into neurons, glia, keratocytes, smooth muscle cells and melanocytes in vitro. These pluripotent nestin-expressing stem cells are keratin 15 (K15)-negative, suggesting that they are in a relatively undifferentiated state. Recent studies suggest that the epithelial stem cells are important in tumorigenesis, and nestin expression is thought to be important in tumorigenesis. In the present study, we examined the expression of the hair follicle and neural stem cell marker nestin, as well as S-100 and HMB-45, in melanoma. Nestin immunoreactivity was observed in the HMB-45-negative melanoma cells in all five cases of amelanotic nodular melanomas. Moreover, nestin immunoreactivity was observed in the dermal parts in seven of 10 cases of melanotic nodular melanomas. Especially, nestin immunoreactivity was observed in the HMB-45-negative melanoma cells in the dermal parts of all 10 cases of HMB-45-negative amelanotic and melanotic nodular melanomas. On the other hand, nestin expression was negative in 10 of 12 cases of superficial spreading melanoma. These results suggest that nestin is an important marker of HMB-45-negative melanoma cells in the dermal parts of patients with nodular melanoma. PMID:20536663
Kanoh, Maho; Amoh, Yasuyuki; Tanabe, Kenichi; Maejima, Hideki; Takasu, Hiroshi; Katsuoka, Kensei
In spite of the fact that balloon cell change has been recognized ophthalmoscopically and histologically in certain posterior choroidal melanomas, the nature and importance of this observation remain controversial. This article provides a clinicopathologic correlation in two cases of ciliary body melanoma with almost total balloon cell transformation. On the basis of special stains and electron microscopic observations, we have concluded that balloon cells in such cases represent spindle melanoma cells that have undergoing extensive cytoplasmic lipid metamorphosis. The possible mechanisms for this change are considered. Melanomas containing an abundant number of balloon cells are probably comparatively dormant and benign tumors that offer a relatively good prognosis. Although clinical recognition may be difficult, the use of needle biopsy coupled with cytologic diagnosis in selected ciliary body tumors may disclose balloon cell change and help to direct therapy. PMID:475640
Jakobiec, F A; Shields, J A; Desjardins, L; Iwamoto, T
Metastases to the hand and wrist are rare, with fewer than 200 cases reported in the literature. Phalanges are more commonly involved than metacarpal and wrist. The lung, breast and kidneys are the more common sites of primary lesions than metastasize in the hand. We present an exceptional case of melanoma that metastasized to the capitate. Melanoma can give bone metastases, but we are not aware of reports of this tumour metastatising to the carpal bones. In our knowledge, we have only found a report of metastases in the capitate, a clear-cell sarcoma of the right foot, a tumour close to melanoma with some cytogenetic differences. Hand metastases in a patient who is suffered melanoma should be ruled out if a lytic aggressive lesion appears on x-ray film or positive technetium bone scan is demonstrated.
Tomas, Xavier [Radiology Department (CDIC), Hospital Clinic, Institut d' Investigacio Biomedica August Pi i Sunyer (IDIBAPS), Facultat de Medicina, Universitat de Barcelona, Villarroel 170, Barcelona 08036 (Spain)]. E-mail: firstname.lastname@example.org; Conill, Carles [Radiotherapy Department (ICMHO), Hospital Clinic, Institut d' Investigacio Biomedica August Pi i Sunyer (IDIBAPS), Facultat de Medicina, Universitat de Barcelona, Villarroel 170, Barcelona 08036 (Spain); Combalia, Andreu [Orthopaedics Department (ICEMEQ), Hospital Clinic, Institut d' Investigacio Biomedica August Pi i Sunyer (IDIBAPS), Facultat de Medicina, Universitat de Barcelona, Villarroel 170, Barcelona 08036 (Spain); Pomes, Jaume [Radiology Department (CDIC), Hospital Clinic, Institut d' Investigacio Biomedica August Pi i Sunyer (IDIBAPS), Facultat de Medicina, Universitat de Barcelona, Villarroel 170, Barcelona 08036 (Spain); Castel, Teresa [Dermatology Department (ICMiD), Hospital Clinic, Institut d' Investigacio Biomedica August Pi i Sunyer (IDIBAPS), Facultat de Medicina, Universitat de Barcelona, Villarroel 170, Barcelona 08036 (Spain); Nicolau, Carlos [Radiology Department (CDIC), Hospital Clinic, Institut d' Investigacio Biomedica August Pi i Sunyer (IDIBAPS), Facultat de Medicina, Universitat de Barcelona, Villarroel 170, Barcelona 08036 (Spain)
... the iris. Changes in the shape of the lens help the eye focus. The ciliary body also makes the clear fluid that fills the space between the cornea and the iris. Intraocular melanoma of the ciliary body is often larger ...
Full Text Available Malignant melanoma is a rare disease in Taiwan with anincidence rate of 0.65/100,000. Excessive exposure to ultravioletradiation is not associated with most Taiwanese melanomacases. Acral lentiginous melanoma comprises 58% of cutaneousmelanoma. Advanced disease is seen in 50% of cases.Surgery, including resection of the primary melanoma, sentinellymph nodes that may harbor microscopic metastasis, clinicallyabnormal lymph nodes, and selected distant metastases, isthe most important treatment. Lymphatic mapping and sentinellymph node biopsy has changed the clinical stage in 22.2% ofour patients. Adjuvant high-dose interferon significantly prolongsprogression-free survival. However, its use in Taiwan islimited by its substantial toxicity. The prognosis of metastaticdisease remains poor with a median survival of 12 months. Inthe past, chemotherapy alone was the most common treatmentmodality for metastatic disease. Recently biochemotherapy hasbeen more commonly utilized to treat patients with metastatic melanoma.
John Wen-Cheng Chang
Introduction. Primary melanoma of the urinary bladder is very rare. As far as we know, 19 cases have been reported worldwide, usually as case reports. Case Presentation. We present a 71-year-old male patient presented with a 2-month history of hematuria. Ultrasonography revealed a 5-cm-size mass located in the bladder trigone. A transurethral resection of the bladder tumor (TURBT) revealed a malignant melanoma. Evaluation for metastatic disease was negative. The patient deceased five months later before radical treatment could be performed. Conclusion. This is one more reported case of primary melanoma of the urinary bladder. The previously reported cases of bladder melanoma are reviewed. Therapy and prognosis are discussed. PMID:22606629
El Ammari, Jalal Eddine; Ahallal, Youness; El Fassi, Mohammed Jamal; Farih, Moulay Hassan
Metastases to the hand and wrist are rare, with fewer than 200 cases reported in the literature. Phalanges are more commonly involved than metacarpal and wrist. The lung, breast and kidneys are the more common sites of primary lesions than metastasize in the hand. We present an exceptional case of melanoma that metastasized to the capitate. Melanoma can give bone metastases, but we are not aware of reports of this tumour metastatising to the carpal bones. In our knowledge, we have only found a report of metastases in the capitate, a clear-cell sarcoma of the right foot, a tumour close to melanoma with some cytogenetic differences. Hand metastases in a patient who is suffered melanoma should be ruled out if a lytic aggressive lesion appears on x-ray film or positive technetium bone scan is demonstrated
Full Text Available Spitzoid melanoma is a rare variant of melanoma, in which the clinical and histopathologic diagnoses are difficult. Data on the features of Spitzoid melanoma in children is limited in the literature, since melanoma is rarely seen in childhood. Here, we report a 10 year-old child with a Spitzoid melanoma. By the means of this case, it has been emphasized that melanoma should be considered in the differential diagnosis of vascular lesions even seen in childhood, unless the clinical and dermoscopic features are characteristic for an entity. (Journal of Current Pediatrics 2008; 6: 127-9
I??l K?l?nç Karaarslan
Full Text Available Melanoma is an intractable cancer that is aggressive, lethal, and metastatic. The prognosis of advanced melanoma is very poor because it is insensitive to chemotherapy and radiotherapy. The incidence of melanoma has been ascending stably for years worldwide, accompanied by increasing mortality. New approaches to managing this deadly disease are much anticipated to enhance the cure rate and to extend clinical benefits to patients with metastatic melanoma. Due to its high degree of immunogenicity, melanoma could be a good target for immunotherapy, which has been developed for decades and has achieved certain progress. This article provides an overview of immunotherapy for melanoma.
Tumor-control probability (TCP) was analyzed in a series of 121 patients having 239 histologically proven recurrent or metastatic malignant melanomas. These were treated with fractionated radiotherapy with various doses per fraction, total doses, and overall times. Cutaneous lesions (127, 53%) were treated with electron beams, and more deeply seated tumors (112, 47%) with 60Co or 4-8 MV X-rays. The fraction size was highly variable, and this permitted determination of the alpha/beta ratio in the multifraction linear-quadratic model, which was estimated at 0.57 Gy with 95% confidence limits [-1.07, 2.5] Gy. Treatment time had no demonstrable influence on TCP. Thus this tumor exhibits the fractionation sensitivity characteristic of a late-responding normal tissue, suggesting that an adequate fractionation schedule for malignant melanomas would be characterized by larger-than-conventional doses per fraction, possibly about 6 Gy per fraction. This is consistent with the conclusions of other authors. Tumor size, evaluated as mean tumor diameter, S, had a major impact on TCP: the number of target cells increased as a power function of S with exponent 0.72 (95% confidence limits [0.49, 0.94]. In fact, a considerable amount of the heterogeneity in the dose-response data could be removed by accounting for size. Thus, the weak or absent dose response became highly significant. When a patient had multiple lesions, the responses of these to radiotherapy tended to be similar, thus implying that results were significantly influenced by a "hidden parameter" (such as inherent radiosensitivity or immunological status). A test of the predictive value of the TCP-model was performed in a different series of 183 cutaneous and lymph node malignant melanomas. The observed dose-response relationship in this data set was in good agreement with the model prediction. A chi-square test for goodness-of-fit showed that the variation between predicted and observed results could be explained by the binomial variation on quantal response data.
Bentzen, SØren M; Overgaard, Jens
Melanoma is a malignancy that is highly curable in the early stages but has devastating consequences in later stages due to lack of response to traditional treatments. Improved understanding of the basic science of tumorigenesis has helped lead to novel targeted therapies which are producing beneficial results in patients with melanoma. Enhancement of the immune system by blockade of the cytotoxic T-lymphocyte associated antigen-4 by the monoclonal antibody ipilimumab is now approved by the U...
Amaria, Rodabe N.; Lewis, Karl D.; Gonzalez, Rene
Immune augmentation with ipilimumab, an anti-CTLA-4 monoclonal antibody, has joined the ranks of approved immunologic agents for the treatment of metastatic melanoma. Phase III studies of ipilimumab in metastatic melanoma have demonstrated an overall survival advantage as compared to other approved and investigational therapies. However, the adverse effects associated with this medication are unique and often require management with steroids or other immunosuppressants. In addition, the time ...
Jeter, Joanne M.; Cranmer, Lee D.; Hersh, Evan M.
Cutaneous melanoma originates from pigment producing melanocytes or their precursors and is considered the deadliest form of skin cancer. For the last 40 years, few treatment options were available for patients with late-stage melanoma. However, remarkable advances in the therapy field were made recently, leading to the approval of two new drugs, the mutant BRAF inhibitor vemurafenib and the immunostimulant ipilimumab. Although these drugs prolong patients' lives, neither drug cures the disea...
Slipicevic, Ana; Herlyn, Meenhard
The incidence of primary ocular malignant melanoma in blacks during the last 25 years in a large part of the Transvaal Province of South Africa is reported. Only 8 cases were diagnosed, 1 uveal, 4 conjunctival, and 3 orbital. During this same period 153 cases of primary ocular malignant melanoma were diagnosed in whites. The rarity of these tumours among blacks is stressed and the reasons for this infrequent incidence discussed.
Miller, B.; Abrahams, C.; Cole, G. C.; Proctor, N. S.
Proton beam radiotherapy of uveal melanoma can be administered as primary treatment, as salvage therapy for recurrent tumor, and as neoadjuvant therapy prior to surgical resection. The physical properties of proton beams make it possible to deliver high-doses of radiation to the tumor with relative sparing of adjacent tissues. This form of therapy is effective for a wider range of uveal melanoma than any other modality, providing exceptionally-high rates of local tumor control. This is partic...
Damato, Bertil; Kacperek, Andrzej; Errington, Doug; Heimann, Heinrich
Blind eyes can harbor a choroidal melanoma. We report a case of uveal melanoma presenting as staphyloma and complicated cataract in a 45-year-old female. The left eye was blind for six months. She underwent comprehensive ocular examination but fundus examination was precluded due to total cataract. The ultrasound of the eye showed a large mass filling the superior, nasal and inferonasal vitreous cavity with high surface reflectivity and low to moderate internal reflectivity. Magnetic resonanc...
Khetan Vikas; Gupta Kshanada; Mohan E; Gopal Lingam
The association between malignant melanoma of the choroid and paving stone degeneration noted anterior to this tumor is described in five eyes. Presumably, the paving stone lesions develop from peripheral choroidal insufficiency induced by vascular compromise from the space-occupying tumor. This phenomenon is not unique to choroidal melanomas, for we have also observed it in association with a choroidal nevus and a metastatic carcinoma to the choroid. PMID:6660713
Brown, G C; Shields, J A
Immunotherapy is an important modality in the therapy of patients with malignant melanoma. As our knowledge about this disease continues to expand, so does the immunotherapeutic armamentarium. Nevertheless, successful preclinical models do not always translate into clinically meaningful results. The authors give a comprehensive analysis of most recent advances in the immune anti-melanoma therapy, including interleukins, interferons, other cytokines, adoptive immunotherapy, biochemotherapy, as...
Alexandrescu, Doru T.; Ichim, Thomas E.; Riordan, Neil H.; Marincola, Francesco M.; Nardo, Anna Di; Kabigting, Filamer D.; Dasanu, Constantin A.
Experimental animal models are extremely valuable for the study of human diseases, especially those with underlying genetic components. The exploitation of various animal models, from fruitflies to mice, has led to major advances in our understanding of the etiologies of many diseases, including cancer. Cutaneous malignant melanoma is a form of cancer for which both environmental insult (i.e., UV) and hereditary predisposition are major causative factors. Fish melanoma models have been used i...
Patton, E. Elizabeth; Mitchell, David L.; Nairn, Rodney S.
Introduction. Primary melanoma of the urinary bladder is very rare. As far as we know, 19 cases have been reported worldwide, usually as case reports. Case Presentation. We present a 71-year-old male patient presented with a 2-month history of hematuria. Ultrasonography revealed a 5-cm-size mass located in the bladder trigone. A transurethral resection of the bladder tumor (TURBT) revealed a malignant melanoma. Evaluation for metastatic disease was negative. T...
Moulay Hassan Farih; Jalal Eddine El Ammari; Mohammed Jamal El Fassi; Youness Ahallal
A 35 year old female presented with a persistent amelanotic lesion of the nail bed of the left great toe for 1 year, associated with destruction of the overlying nail. Incision biopsy revealed a nodular malignant melanoma and the toe was amputated. There is no sign of recurrence at 18 month follow-up. As prognosis is related to local disease extent, any persistent nail bed lesion should be biopsied to exclude the possibility of malignant melanoma.
Winslet, M.; Tejan, J.
A 35 year old female presented with a persistent amelanotic lesion of the nail bed of the left great toe for 1 year, associated with destruction of the overlying nail. Incision biopsy revealed a nodular malignant melanoma and the toe was amputated. There is no sign of recurrence at 18 month follow-up. As prognosis is related to local disease extent, any persistent nail bed lesion should be biopsied to exclude the possibility of malignant melanoma. PMID:2362886
Winslet, M; Tejan, J
Full Text Available Malignant melanoma is very rare in the rectum. Prompt diagnosis and treatment is necessary as chances of metastasis is very high. A 56 year old male patient came to surgical OPD for complaint of something coming out per rectum. Polyp was identified on per rectal examination the biopsy revealed malignant melanoma. Abdominoperineal resection was done. We reported this case as it is uncommon and also there is controversy in surgical treatment of choice.
Amar Shah, Sanjay Chaudhari, Apurva Shah
The acquisition of invasive properties in melanoma is associated with a high proclivity for metastasis, but the underlying pathways are poorly characterized. The Hippo pathway plays an important role in organ size control and is dysregulated in some types of tumors. The present study, “Pro-invasive activity of the Hippo pathway effectors YAP and TAZ in cutaneous melanoma” by Nallet-Staub et al., provides the first in-depth analysis of expression of the Hippo pathway effectors YAP (yes-ass...
Sanchez, Ileine M.; Aplin, Andrew E.
Tumor-associated macrophages have been related to a worse prognosis for survival in several tumors, among them uveal melanoma. In particular for proangiogenic and anti-inflammatory M2-type macrophages, a contributory role to tumor growth has been described. This study demonstrated that most tumor-associated macrophages in uveal melanoma exhibited the M2-phenotype. Tumors with monosomy 3 that have an unfavorable prognosis exhibited significantly more M2-type macrophages than tumors with disomy...
Herwig, Martina C.; Grossniklaus, Hans E.
Radioimmunodetection utilizing monoclonal antibodies to various melanoma-associated surface antigens has been studied by several investigators during the past ten years. In the early trials, antibodies were labeled with 131I or 111In, but now 99mTc is almost exclusively used because of its more favorable energy for gamma camera imaging. Excellent specificity has been achieved in most studies, whereas sensitivity has been less good. In a recent European multicenter study on 493 patients sensitivity was 79% and specificity 96%. In this largest study on melanoma so far performed many previously unknown metastatic deposits were identified indicating that radioimmunodetection has a role in the management of metastatic disease. The clinical utility of immunoscintigraphy in localization of regional lymph node metastases has been documented in several investigations in recent years, indicating that this method can be used in the preoperative evaluation of patients. Radioimmunodetection has also been successfully used in the differential diagnosis of ocular lesions. However, conclusive evidence of improved patient outcome resulting from the earlier detection of melanoma lesions by immunoscintigraphy is still lacking. Anti-melanoma antibodies labeled with alpha- and beta-emitting isotopes are potential therapeutic agents, but so far there is little clinical experience with radioimmunotherapy of metastatic melanoma. (orig.)c melanoma. (orig.)
Full Text Available Introduction. The purpose of this study was to identify tumor characteristics of primary malignant melanoma predictive of sentinel lymph node positive status, and then to determine whether sentinel lymph node status has an impact on recurrence and survival. Material and Methods. A total of 100 patients with primary malignant skin melanoma were analyzed. The prospective melanoma database identified patients with histologically confirmed cutaneus melanoma, clinically negative and clinically positive regional lymph nodes with no evidence of distant disease, who had undergone surgery between April 2001 and May 2012. Univariate and multivariate analyses were performed to assess factors that predict sentinel lymph node positive status, recurrence and survival. Results. We identified Breslow’s thickness and lymphocytic response as independent predictors of sentinel lymph node status in cutaneous melanoma patients. Sentinel lymph node status was a significant predictor of disease free survival. Conclusion. Despite the limitation, this study confirms Breslow’s thickness and tumor lymphocytic infiltration as two factors predictive of sentinel lymph node metastasis in cutaneous melanoma patients. We also found sentinel lymph node status to be the most significant independent predictor of disease free survival and identified sentinel lymph node status as an important variable to consider when estimating the risk of regional recurrence.
Melanoma is one of the most malignant skin tumors with constantly rising incidence worldwide, especially in fair-skinned populations. Melanoma is usually diagnosed at the average age 50, but, nowadays is also diagnosed more frequently in younger adults, and very rarely in childhood. There is no unique or specific clinical presentation of a melanoma. The clinical presentation of melanomas varies depending on the anatomic localization and the type of growth, i.e., the histopathological type of the cancer. There are four major histopathological types of melanoma--superficial spreading melanoma, nodular melanoma, lentigo maligna melanoma, and acral lentiginous melanoma. Although dermatoscopy is a very useful tool in early melanoma detection, dermatoscopical features of melanomas are also variable. Therefore, experience and education in dermatoscopy is crucial in the evaluation of skin tumors. Differential diagnosis of melanomas includes a wide range of benign and malignant skin lesions, due to their clinical presentation and resemblance to various dermatological entities. In this review we present the most important aspects of clinical, dermatoscopical, and histopathological features of melanomas. PMID:24813835
Situm, Mirna; Buljan, Marija; Koli?, Maja; Vu?i?, Majda
Solitary metastasis of uveal melanoma to bone is extremely rare and usually associated with other organ involvement. We present a rare case of an ocular melanoma patient presenting with solitary metastasis to the clavicle two years after enucleation, without any other organ involvement. In this report, we tried to present our treatment strategy for the solitary metastasis of bone.
Halil Tozum; Korhan Ozkan; Krishna Reddy; Ismail Turkmen; Ufuk Ciloglu; Serkan Senol; Calogero Graci
Melanoma represents a significant malignancy in humans and dogs. Different from genetically engineered models, sporadic canine melanocytic neoplasms share several characteristics with human disease that could make dogs a more relevant preclinical model. Canine melanomas rarely arise in sun-exposed sites. Most occur in the oral cavity, with a subset having intra-epithelial malignant melanocytes mimicking the in situ component of human mucosal melanoma. The spectrum of canine melanocytic neoplasia includes benign lesions with some analogy to nevi, as well as invasive primary melanoma, and widespread metastasis. Growing evidence of distinct subtypes in humans, differing in somatic and predisposing germ-line genetic alterations, cell of origin, epidemiology, relationship to ultraviolet radiation and progression from benign to malignant tumors, may also exist in dogs. Canine and human mucosal melanomas appear to harbor BRAF, NRAS, and c-kit mutations uncommonly, compared with human cutaneous melanomas, although both species share AKT and MAPK signaling activation. We conclude that there is significant overlap in the clinical and histopathological features of canine and human mucosal melanomas. This represents opportunity to explore canine oral cavity melanoma as a preclinical model. PMID:24128326
Simpson, R Mark; Bastian, Boris C; Michael, Helen T; Webster, Joshua D; Prasad, Manju L; Conway, Catherine M; Prieto, Victor M; Gary, Joy M; Goldschmidt, Michael H; Esplin, D Glen; Smedley, Rebecca C; Piris, Adriano; Meuten, Donald J; Kiupel, Matti; Lee, Chyi-Chia R; Ward, Jerrold M; Dwyer, Jennifer E; Davis, Barbara J; Anver, Miriam R; Molinolo, Alfredo A; Hoover, Shelley B; Rodriguez-Canales, Jaime; Hewitt, Stephen M
Between 1985 and 1993 30 patients underwent radiation therapy for brain metastases from malignant melanoma. In 9 patients they had been surgically resected. All except 1 patient received whole brain irradiation with a total dose of 20 to 46 Gy/2 to 5 weeks using daily fractions of 2,0 to 4,0 Gy. In 5 patients a local boost of 20 to 25 Gy/2 weeks was administered. Survival rates were compared using the Cox-method. Univariate and multivariate analyses were performed to define prognostic subgroups. In 6/30 patients (20%) brain metastases were diagnosed at the time of primary manifestation of melanoma. In 83% of patients brain metastases developed during the first 5 years following primary diagnosis. Late manifestation was observed (18 years). Overall survival rate of the whole group was 39% at 6 months and 23% at 1 year. Univariate analysis revealed that age at diagnosis of brain metastases, time to manifestation, number of intracranial metastases and existence of extracerebral distant metastases had significant influence on survival. Sex was not found to influence survival rate. Multivariate analysis identified the existence of extracerebral distant metastases at the time of diagnosis of brain metastases as the most important prognostic factor for survival, followed by age and surgical resection. The role of fractionation was studied separately in a subgroup of patients receiving whole brain irradiation to a total dose of 39 to 42 Gy. Survival rates deteriorated when ov42 Gy. Survival rates deteriorated when overall treatment time exceeded 3 weeks. (orig./MG)
Desmoplastic melanoma (DM) is a variant of melanoma, which typically affects chronically sun-damaged skin of elderly patients. Pure DM displays a low density of fusiform melanocytes in a collagen-rich matrix. In mixed DM, tumor cell density is higher, and parts of the tumor lack abundant stromal fibrosis. Both pure and mixed DMs usually express S100 protein homogenously. We report herein an unusual biphenotypic tumor characterized by the association of a pure DM with an undifferentiated solid spindle cell nodule. It occurred on the scalp of a 66-year-old man. A biopsy of the undifferentiated spindle cell nodule was initially interpreted at a commercial laboratory as atypical fibroxanthoma. The pure DM was seen only in the excisional specimen. All cells of the pure DM stained for S100 protein and SOX10. The adjacent solid sarcomatoid spindle cell nodule lacked expression of S100 protein, SOX10, as well as melan-A, gp100, and microphthalmia-associated transcription factor in >95% of its tumor cells. Although focal expression of melanocyte differentiation antigens in the solid tumor component made us favor a combined DM with sarcomatoid dedifferentiation, we also considered the possibility of a collision scenario, that is, a pleomorphic dermal sarcoma incidentally colliding with a DM. To further assess a possible relationship of the sarcomatoid nodule with the DM, we performed next-generation sequencing analysis on each component separately. The analysis revealed shared chromosomal copy number changes and a high number of common mutations, thereby supporting the concept of a DM with a dedifferentiated sarcomatoid component. An interesting finding is the presence of mutations of the neurofibromin 1 (NF1) gene in both tumor components. PMID:24618614
Kiuru, Maija; McDermott, Gregory; Berger, Michael; Halpern, Allan C; Busam, Klaus J
Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese Melanomas oculares correspondem a 5% de todos os melanomas e 85% deles têm origem no trato uveal. Melanoma uveal é o tumor maligno intraocular primário mais comum no adulto. Relatamos neste artigo um caso de melanoma uveal em paciente, sexo feminino, 31 anos, com quadro de fotopsia, hiperemia e baix [...] a da acuidade visual no olho esquerdo com evolução de quatro meses. Apresentava ao exame oftalmológico acuidade visual menor que 20/400, grande massa tumoral na região nasal retroiriana, com deslocamento anterior do cristalino, estreitamento da câmara anterior e descolamento seroso da retina. A ecografia sugeriu tratar-se de grande massa tumoral suspeita de melanoma de coróide com invasão do corpo ciliar. A confirmação diagnóstica foi possível por meio do exame anatomopatológico. Abstract in english Ocular melanomas correspond to 5% of all melanomas and 85% of them have its origin in the uveal tract. Uveal melanoma is the most commom primary intraocular malignant tumor in the adult. In this article, a case of uveal melanoma in a 31 year-old female patient, with photopsia, hyperemia and low visu [...] al acuity in the left eye with evolution of 4 months is presented. In the ophthalmologic examination, visual acuity was lower than 20/400, a large tumoral mass was noted at the nasal region behind the iris with anterior lens displacement, anterior chamber narrowing and serous retinal detachment. The ocular echography suggested a large tumoral mass as a choroidal melanoma extending to the ciliary body. The confirmation diagnosis was possible through the histopathologic examination.
Aline Amaral Fulgêncio da, Cunha; Nara Helena Teixeira, Rodrigues; Grazziella Acácio e, Almeida; Bruno Carvalho, Picanço; João Agostini, Netto.
Full Text Available SciELO Brazil | Language: English Abstract in portuguese Melanoma Maligno é uma neoplasia de alta mortalidade, sendo raro o acometimento do aparelho ungueal. Apenas 2/3 dos pacientes procuram atendimento médico devido lesão melanocítica ungueal recente, tornando o diagnóstico tardio e com prognóstico pior que do melanoma cutâneo. Descreve-se um caso de pa [...] ciente sexo feminino, apresentando lesões ulceradas com características clínico-laboratoriais compatíveis com leishmaniose tegumentar americana. No retorno após início do tratamento foi observada melanoníquia longitudinal no primeiro quirodáctilo direito. Realizada biópsia da matriz ungueal com histopatológico compatível com melanoma in situ. Melanoníquia longitudinal não é sinal específico de melanoma. A identificação das lesões suspeitas é importante tarefa dos dermatologistas. O diagnóstico incidental de melanoma ungueal in situ do caso relatado resultou em grande impacto na sobrevida da paciente. Abstract in english Malignant Melanoma is a high mortality neoplasm. The involvement of the nail apparatus is rare, with only 2 out of 3 patients seeking medical attention as the result of recent nail melanocytic lesions. This results in late diagnosis and a prognosis worse than cutaneous melanoma. We report a female, [...] presenting with ulcerative lesions with clinical and laboratory features compatible with leishmaniasis. On return after treatment initiation a longitudinal melanonychia was observed on her first right finger. Biopsy of the nail matrix was performed. Histopathology was compatible with melanoma in situ. Longitudinal melanonychia is not a specific sign for melanoma and it is important that the dermatologist should identify the suspect lesions correctly. The incidental diagnosis of nail melanoma in situ in our case significantly impacted the patient's survival.
Ana Maria, Carreño; Sílvia Rocha, Nakajima; Silmara N., Pennini; Renato, Candido Junior; Antonio Pedro Mendes, Schettini.
Full Text Available Malignant Melanoma is a high mortality neoplasm. The involvement of the nail apparatus is rare, with only 2 out of 3 patients seeking medical attention as the result of recent nail melanocytic lesions. This results in late diagnosis and a prognosis worse than cutaneous melanoma. We report a female, presenting with ulcerative lesions with clinical and laboratory features compatible with leishmaniasis. On return after treatment initiation a longitudinal melanonychia was observed on her first right finger. Biopsy of the nail matrix was performed. Histopathology was compatible with melanoma in situ. Longitudinal melanonychia is not a specific sign for melanoma and it is important that the dermatologist should identify the suspect lesions correctly. The incidental diagnosis of nail melanoma in situ in our case significantly impacted the patient's survival.Melanoma Maligno é uma neoplasia de alta mortalidade, sendo raro o acometimento do aparelho ungueal. Apenas 2/3 dos pacientes procuram atendimento médico devido lesão melanocítica ungueal recente, tornando o diagnóstico tardio e com prognóstico pior que do melanoma cutâneo. Descreve-se um caso de paciente sexo feminino, apresentando lesões ulceradas com características clínico-laboratoriais compatíveis com leishmaniose tegumentar americana. No retorno após início do tratamento foi observada melanoníquia longitudinal no primeiro quirodáctilo direito. Realizada biópsia da matriz ungueal com histopatológico compatível com melanoma in situ. Melanoníquia longitudinal não é sinal específico de melanoma. A identificação das lesões suspeitas é importante tarefa dos dermatologistas. O diagnóstico incidental de melanoma ungueal in situ do caso relatado resultou em grande impacto na sobrevida da paciente.
Ana Maria Carreño
Full Text Available ... that may improve the body’s natural defense (immune system response) against cancer. These drugs commonly cause a rash or swelling. You may feel very tired and these drugs can cause a headache, muscle aches, a fever, or weakness. Radiation Therapy uses ...
Full Text Available ... and infection. It helps regulate body temperature, stores water and fat, and produces vitamin D. Epidermis Dermis The skin has 2 main layers: the outer epidermis and the inner dermis. The epidermis is mostly made up of flat, scale-like cells called squamous cells. Round cells, called ...
Full Text Available ... parts of the body such as the liver, lungs, or brain. In such cases, the cancer cells in the n This document is for ... nearby lymph node or nearby tissue. • Stage IV: Cancer cells have spread to the lungs or other nearby organs, skin areas, or lymph ...
Full Text Available ... for your specific condition. ©1995-2011, The Patient Education Institute, Inc. www.X-Plain.com oc180205 Last reviewed: 07/07/2011 2 Changes in chromosomes may also occur as a result of exposure to infections, drugs, tobacco, chemicals, or other factors. In the case of skin ...
A fact sheet about moles and how some moles may be related to melanoma, which is the most serious type of skin cancer. The fact sheet includes photos of differences between moles and cancer, and discusses risk factors for melanoma.
... 2012 Genome-Wide Scan Reveals Mutation Associated with Melanoma A team of international researchers supported by the ... when they divide and grow uncontrollably, develop into melanoma. Also, MITF activity is known to be amplified ...
The administration of the anti-VEGF agent, bevacizumab, decreases tube formation and migration of human ocular melanoma cells, cultured alone or with HUVECs in vitro. The authors found that systemic bevacizumab decreased the size of ocular melanoma and the number of micrometastases in a mouse model of metastatic ocular melanoma. These findings are important with regard to a potential systemic therapy for patients with ocular melanoma with micrometastasis to the liver, as there is currently no...
Yang, Hua; Jager, Martine J.; Grossniklaus, Hans E.
Melanoma is a highly malignant disease that may initially present as a poorly differentiated metastatic tumor. Therefore, the S100 immunostain, immunoreactive in 96% to 99% of melanoma, is used to evaluate poorly differentiated malignant tumors. To develop criteria for correctly diagnosing S100-negative melanomas, we studied the immunohistochemical profile of 1553 patients enrolled in ongoing National Cancer Institute clinical trials for melanoma. Seventeen patients (1%) had metastatic melano...
Aisner, Dara L.; Maker, Ajay; Rosenberg, Steven A.; Berman, David M.
Uveal melanomas are a common clinical entity that initially present in a variety of ways. Cystoid macular edema is caused by many conditions, but it is rarely associated with uveal melanoma. We report two cases of patients that presented with visually significant cystoid macular edema that was later found to be secondary to choroidal melanoma. We describe the patients’ course and treatment and provide a mechanism for the potential cause of edema in patients with uveal melanoma.
Garoon, Robert B.; Shields, Carol L.; Kaliki, Swathi; Shields, Jerry A.
Background. Visceral metastatic spread of ocular melanoma most commonly occurs via hematogenous route to the liver. Lymphatic spread of ocular melanoma into abdominal lymph nodes has not been reported previously. Case Presentation. A 47-year-old man with a history of ocular melanoma presented with a soft tissue mass on CT scan. The mass encased the portal structures of the hepaticoduodenal ligament. Image-guided biopsy revealed it to be a metastatic melanoma to lymph nodes. The patient underw...
David Aranovich; Karen Meir; Lotem, Michal M.; Liat Appelbaum; Hadar Merhav
Cellular heterogeneity is a frequently noted feature of melanoma. As reported in this issue, Kupas et al. identified heterogeneous expression of receptor activator of nuclear factor-?B (RANK) in melanoma cells in tumors and peripheral blood from patients. Increased expression of RANK was associated with the presence of metastatic disease and increased tumorigenicity in melanoma cells, raising the possibility that RANK signaling contributes to melanoma progression. PMID:21407234
Because nonsteroidal anti-inflammatory drugs (NSAIDs) inhibit tumor growth in vitro, we investigated the association between NSAIDs and melanoma to determine if there was epidemiologic evidence of a chemopreventive effect from these medications. Three hundred twenty-seven subjects with incident melanoma and 119?melanoma-free controls completed a structured interview assessing melanoma risk factors. The unadjusted odds ratio (OR) for use of nonaspirin NSAIDs was 0.58 (95% CI 0.31–1.11), in...
Jeter, Joanne M.; Bonner, Joseph D.; Johnson, Timothy M.; Gruber, Stephen B.
Carbon ion radiotherapy (C-ion RT) is an advanced modality for treating malignant melanoma. After we treated our first case of gynecological melanoma using C-ion RT in November 2004, we decided to conduct a clinical trial to evaluate its usefulness for the treatment of gynecological melanoma. The eligibility criteria for enrollment in this study were histologically proven malignant melanoma of the gynecological regions with lymph node metastasis remaining in the inguinal and pelvic regions. T...
Karasawa, Kumiko; Wakatsuki, Masaru; Kato, Shingo; Kiyohara, Hiroki; Kamada, Tadashi
Many serum biomarkers have been evaluated in melanoma but their clinical significance remains a matter of debate. In this paper, a review of the serum biomarkers for melanoma will be detailed and will be discussed from the point of view of their practical usefulness. The expression of biomarkers can be detected intracellularly or on the cell membrane of melanoma cells or noncancer cells in association with the melanoma. Some of these molecules can then be released extracellularly and be found...
Pierre Vereecken; Frank Cornelis; Nicolas Van Baren; Valérie Vandersleyen; Jean-François Baurain
Twenty-five patients with metastatic melanoma were treated with a therapeutic vaccine ("theraccine") consisting of allogeneic melanoma lysates and a novel adjuvant, DETOX (Ribi ImmunoChem Research, Inc, Hamilton, MT). Each patient received 200 antigenic units (20 x 10(6) tumor cell equivalents) subcutaneously on weeks 1, 2, 3, 4, and 6. Clinical responses included one complete remission, three partial remissions, and a long-term (17-month) stability. Two other patients had mixed responses, with partial remissions of numerous subcutaneous nodules. Sites of responsive disease included primarily the skin, but ileal, breast, and a liver metastasis also responded. Removal of residual lesions in patients with partial remissions, whose other lesions had disappeared during treatment, led to long disease-free survivals. The median duration of remission was 17 months, with four of the five responders alive for at least 24 months after treatment. An increase in precursors of cytolytic T cells (CTLs) correlated with clinical outcome, when complete, partial, and mixed responses and long-term stability were considered. The CTLs recognized melanoma-associated antigens on many cell lines, but not other types of tumor or normal lymphocytes. Skin-test reactivity to melanoma antigens and serum antibodies against the melanoma cells was unrelated to clinical response. Toxicity was minimal, restricted largely to minor soreness at the site of injection. Only five patients, four of whom were treated with repeated courses, developed severe granulomas. These results confirm that active-specific immunization with allogeneic lysates of melanoma administered with the adjuvant DETOX can induce immunity to melanoma, and can induce regressions of disease in a proportion of patients with metastatic disease with little toxicity. PMID:2139701
Mitchell, M S; Harel, W; Kempf, R A; Hu, E; Kan-Mitchell, J; Boswell, W D; Dean, G; Stevenson, L
Melanoma in hybrids of Xiphophorus is due to the unrestricted activity of a cellular oncogene locus, Tu, encoding the growth factor receptor gene Xmrk. In nonhybrid parental fish, Tu is controlled by a tumor suppressor gene. Thus, its restricted activity leads there only to a nonmalignant, species- and population-specific macromelanophore spot pattern. Prompted by enigmatic reports on nonhybrid Xiphophorus with pigmentation abnormalities resembling melanoma, we have studied pigmentation in descendants of wild-caught fish and purebred laboratory stocks derived from wild populations. Whereas most stocks exhibiting macromelanophore patterns never developed pigmentation abnormalities, an exceptional situation for some nonhybrids was found. In X. variatus carrying the macromelanophore pattern "punctatus-2" and in X. cortezi with "spotted caudal," expressivity of the pigmentation gene ranges from a few black spots to extreme melanosis and eventually to malignant melanoma. In X. maculatus with the mutant pigmentation gene striped" carrying in addition the micromelanophore pattern "anal fin black" or "lower comet," testosterone-dependent melanoma develop originating from the corresponding micromelanophore pattern. The tumors are highly malignant and express a melanoma-associated antigen. Overexpression of the Xmrk oncogene appears as the underlying molecular mechanism for tumor induction. These findings clearly demonstrate that tumors can also develop in purebred wild-type fish. The classical model for formation of hereditary melanoma in Xiphophorus hybrids does not explain the development of melanoma in the absence of hybridization. However, their existence gives additional support to the reasoning that the Xmrk oncogene associated with the macromelanophore locus is potentially injurious. PMID:7805027
Schartl, A; Malitschek, B; Kazianis, S; Borowsky, R; Schartl, M
A monoclonal antibody to a high molecular weight melanoma-associated antigen was chelated and radiolabeled with indium-111. This material shows high affinity for melanoma and thus can be used in the detection, localization and imaging of melanoma. 1 figure.
Srivastava, S.C.; Fawwaz, R.A.; Ferrone, S.
Uptake of iodine-123-iodoamphetamine has been demonstrated in malignant melanoma using planar imaging techniques and has been used to detect an ocular melanoma at 12 hr postinjection. Using SPECT technique, an ocular melanoma is identified in a 64-yr-old male at 1 hr postinjection
Uveal, especially choroidal melanoma is the most common ocular melanoma. There is no clear evidence that pregnancy impacts its development. Enucleation is generally indicated for advanced tumors. Five-year mortality rate is 53% in patients with large melanomas (>8 mm).
Grgi? Zorka; Oros Ana; Raši? Dejan; Popovi? Lazar; Popovi? Milica
Full Text Available Uveal, especially choroidal melanoma is the most common ocular melanoma. There is no clear evidence that pregnancy impacts its development. Enucleation is generally indicated for advanced tumors. Five-year mortality rate is 53% in patients with large melanomas (>8 mm.
Beginning with the observation that the human enteorvirus, Poliovirus Sabin 1, will lyse human melanoma cells in culture, clinical trials involving two patients with advance melanoma were performed. Parenteral injection of the viable Poliovirus into cutaneous melanoma metastases followed in 24 hours by oral administration of cyclophosphamide. The results of these two trials are described.
Biggs, M.W.; Eiselein, J.E.
Full Text Available Abstract Background Vitiligo is a common toxicity associated with immunotherapy for melanoma. Cytotoxic T lymphocytes (CTLs against melanoma commonly target melanoma-associated antigens (MAAs which are also expressed by melanocytes. To uncouple vitiligo from melanoma destruction, it is important to understand if CTLs can respond against melanoma and melanocytes at different levels. Methods To understand the dichotomous role of MAA-specific CTL, we characterized the functional reactivities of established CTL clones directed to MAAs against melanoma and melanocyte cell lines. Results CTL clones generated from melanoma patients were capable of eliciting MHC-restricted, MAA-specific lysis against melanocyte cell lines as well as melanoma cells. Among the tested HLA-A*0201-restricted CTL clones, melanocytes evoked equal to slightly higher degranulation and cytolytic responses as compared to melanoma cells. Moreover, MAA-specific T cells from vaccinated patients responded directly ex vivo to melanoma and melanocytes. Melanoma cells express slightly higher levels of MART-1 and gp100 than melanocytes as measured by quantitative reverse-transcriptase polymerase chain reaction (qRT-PCR and immunohistochemistry. Conclusions Our data suggest that CTLs respond to melanoma and melanocytes equally in vitro and directly ex vivo.
Schwartz Erich J
Several observations suggest that a majority of cases of malignant melanoma of the skin are linked to sun exposure. Evidence includes higher occurrence of melanoma on anatomic areas heavily exposed during recreation, development of melanoma more frequently in lightly pigmented persons, and correlation of melanoma incidence and mortality with proximity to the equator. The role of the sun exposure in the pathogenesis of melanoma remains unclear, however. Many cases of melanoma may be related to heavy doses of solar radiation received during recreation. Chronic sun exposure is not so clearly linked to the development of melanoma (except in the uncommon lentigo maligna variety). Sunspot cycles have been associated with changes in melanoma incidence; an excess of melanoma cases has been observed every 9 to 12 years after peak sunspot activity. These excess cases may be caused by more intense exposure to solar ultraviolet radiation during sunspot maxima, perhaps related to changes in the stratospheric ozone layer. These epidemiologic and clinical clues suggest that many cases of melanoma are related to sun exposure triggering the appearance of clinically evident melanoma. In this regard, solar radiation behaves as a cocarcinogen or promoter, rather than a dose-dependent carcinogen. These observations also suggest that other factors may be involved in the pathogenesis of melanoma, e.g., nevi, heredity, or exposure to chemical carcinogensgens
In the Japanese, melanoma most commonly involves the plantar surface. Among 61 patients with plantar melanoma, we diagnosed 50 patients as acral lentiginous melanoma (ALM), nine as nodular melanoma, and two as superficial spreading melanoma. Partial or complete loss of pigment was observed in four of the nine nodular melanoma cases and in the nodular portions of eight ALM cases. All 12 such nodular lesions were ulcerated. The clinical diagnosis of malignant melanoma was easily made in the eight patients with ALM by the characteristic pigmentary changes around the nodule. The presence of some remaining pigment was found to be helpful in making the diagnosis in two lesions of nodular melanoma which, at first, had been clinically diagnosed as eccrine poromas. One of two completely amelanotic nodular melanomas was strongly suspected to be a melanoma because there was a history of a pre-existing pigmented macule before the development of the nodule. The other one required histopathological differentiation from Merkel cell carcinoma. Based on these findings and compared with melanoma on other parts of the body, pigmentation noted in the ulcerative nodule of plantar melanoma seems to disappear easily. This causes difficulty in distinguishing it from other skin tumours. PMID:9068733
Kato, T; Tabata, N; Suetake, T; Tagami, H
A subset of patients with melanoma present in rare and unique clinical circumstances requiring specific considerations with respect to diagnostic and therapeutic interventions. Herein, we present our review of patients with: (1) primary mucosal melanoma of the head and neck, gastrointestinal, and genitourinary tracts; (2) primary melanoma of the eye; (3) desmoplastic melanoma; (4) subungual melanoma; (5) melanoma in special populations: children, nonwhites, as well as a discussion of familial melanoma. PMID:23563206
Kottschade, Lisa A; Grotz, Travis E; Dronca, Roxana S; Salomao, Diva R; Pulido, Jose S; Wasif, Nabil; Jakub, James W; Bagaria, Sanjay P; Kumar, Riten; Kaur, Judith S; Morita, Shane Y; Moran, Steven L; Nguyen, Jesse T; Nguyen, Emily C; Hand, Jennifer L; Erickson, Lori A; Brewer, Jerry D; Baum, Christian L; Miller, Robert C; Swanson, David L; Lowe, Val; Markovic, Svetomir N
Radioimmunoscintigraphy with monoclonal antibodies (MoAbs) to melanoma associated antigens is a new technique that can be used as an additional test to detect ocular melanomas in clinically difficult cases. Immunoscintigraphy with 99mtechnetium-labelled monoclonal antibody fragments of MoAb 225.28S in 14 patients with melanoma yielded a positive image in only six cases (43%). The expression of high molecular weight melanoma-associated antigen (HMW-MAA) was immunohistochemically assessed in me...
Schaling, D. F.; Pol, J. P.; Jager, M. J.; Kroonenburgh, M. J.; Oosterhuis, J. A.; Ruiter, D. J.
Since not only malignant melanomas but also many kinds of human cancers, for example thyroid cancer and squamous cell carcinoma, synthesize their specific protein, much attention has been paid to the establishment of selective thermal neutron capture treatment of malignant melanoma as a prototype of such cancer cells. This paper presents 10B chlorpromazine compounds and 10B1-para-boronophenylalanine (10B1-BPA) as tumor-seeking 10B compounds which themselves possess selective affinity for the specific metabolic activity of the target cancer cells. An overview of the following studies on the effects of 10B1-BPA in the thermal neutron capture treatment of melanoma is provided: 1) in vitro studies on specific enhanced melanoma cell killing effects of 10B1-BPA; 2) in vivo studies on therapeutic effects of 10B1-BPA using melanoma-bearing hamsters; and 3) preclinical therapeutic experiments using spontaneously occurring malignant melanoma in Duroc pig skin, including experiments in which melanoma was successfully cured. (Namekawa, K.)
Nail Apparatus Melanoma (NAM) is rare, particularly in Caucasians. Understanding its pathogenesis and collecting epidemiologic data may be difficult due to its location and the exiguity of the case series of this cancer. Cutaneous melanoma has been thought related to UV radiation, and NAM is considered an acral variant of melanoma, even if the nail presents a specific anatomy. Little is reported about pathogenesis, except reports suggesting traumatic injuries as a causal factor. UV exposure is debated in nail melanoma because of its structure. The nail is, in fact, a unique structure with sun-exposed and non exposed melanocytes. NAM arises from the nail melanocytes, located in the nail matrix, which is the germinative part of the nail and composed of a proximal and distal portion. The proximal nail matrix lays under the proximal nail fold that covers it and is non-sun exposed, while the distant nail matrix, clinically visible as the lunula, is sun-exposed, though lying underneath the nail plate. According to these anatomical data, NAM is a distinct melanoma type, and studies need to classify it as acral melanoma or as a particular type of melanoma with its own pathogenesis and prognostic criteria. This study investigates potential risk factors of NAM, emphasizing (i) trauma and (ii) UV exposure among our NAM patients. PMID:23153047
Fanti, P A; Dika, E; Misciali, C; Vaccari, S; Barisani, A; Piraccini, B M; Cavrin, G; Maibach, H I; Patrizi, A
Full Text Available Animal-type melanoma is an exceedingly rare histological variant of melanoma in humans. The name was coined to reflect similar histological features to melanomas in grey horses. We present a case of animal-type melanoma. The neoplastic cells were heavily pigmented with an epithelioid morphology, round nuclei and prominent eosinophilic nucleoli. Only occasional mitotic figures were identified. The tumour cells had diffuse and nodular growth patterns with involvement of the dermis and the subcutaneous tissue. The patient had a “benign cellular blue naevus” excised 9 years earlier from the same site. Review of the previous case revealed heavily pigmented epithelioid cells with similar morphology to the current case. Nuclear pleomorphism was minimal and only a single mitotic figure was present. The lesion extended to the margins of excision. The diagnosis of animal-type melanoma was made on the current case and on the previously misdiagnosed case. Recurrence of this case nine years following incomplete excision further supports the hypothesis that animal-type melanoma is a distinct histological type of malignant melanoma with an indolent clinical course.
A variety of cytomorphological features, architectural patterns and stromal changes may be observed in malignant melanomas. Hence, melanomas may mimic carcinomas, sarcomas, benign stromal tumours, lymphomas, plasmacytomas and germ cell tumours. Melanomas may be composed of large pleomorphic cells, small cells, spindle cells and may contain clear, signet-ring, pseudolipoblastic, rhabdoid, plasmacytoid or balloon cells. Various inclusions and phagocytosed material may be present in their cytoplasm. Nuclei may show bi- or multi-nucleation, lobation, inclusions, grooving and angulation. Architectural variations include fasciculation, whorling, nesting, trabeculation, pseudoglandular/pseudopapillary/pseudofollicular, pseudorosetting and angiocentric patterns. Myxoid or desmoplastic changes and very rarely pseudoangiosarcomatous change, granulomatous inflammation or osteoclastic giant cell response may be seen in the stroma. The stromal blood vessels may exhibit a haemangiopericytomatous pattern, proliferation of glomeruloid blood vessels and perivascular hyalinization. Occasionally, differentiation to nonmelanocytic structures (Schwannian, fibro-/myofibroblastic, osteocartilaginous, smooth muscle, rhabdomyoblastic, ganglionic and ganglioneuroblastic) may be observed. Typically melanomas are S100 protein, NKIC3, HMB-45, Melan-A and tyrosinase positive but some melanomas may exhibit an aberrant immunophenotype and may express cytokeratins, desmin, smooth muscle actin, KP1 (CD68), CEA, EMA and VS38. Very rarely, neurofilament protein and GFAP positivity may be seen. PMID:10792480
Banerjee, S S; Harris, M
Report on the application of a dinitrochlorobenzene ointment of 61 postoperative melanoma patients exhibiting clinical stages I and II. After contact sensitization the erythemogenic threshold concentrations of DNCB were mostly found in the range of 0,05% and 0,1%. Patients with reactions at low concentrations of 0,01% and 0,05% DNCB were in the mean 8 years younger than those with reactions at 0,1% and 0,5%, but no connection to different stages of malignant melanoma could be evaluated. 3 melanoma patients suffering from skin metastases were treated by epifocal DNCB-application. One of them became clinically tumor free since more than 1 year, whereas the two other exhibiting multicentric and/or profound tumor growth did not respond. In a 82-year-old wife a superficial lentigo maligna melanoma disappeared by DNCB-application. In none of the 61 cases we observed a "tumor enhancement" after immunoprophylaxis or adjuvant immunotherapy with DNCB. The DNCB-method in malignant melanoma is yet in the experimental stage and is not recommended for general use in practice. PMID:473840
Weidner, F; Djawari, D
Metastatic melanoma is an aggressive disease resistant to chemotherapy. Recent clinical trials have reported improved survival for two novel agents; ipilimumab, a humanized, IgG1 monoclonal antibody that blocks cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4) and vemurafenib , a BRAF (v-raf murine sarcoma viral oncogene homolog B1) inhibitor targeting an activating mutation in the serine-threonine-protein kinase BRAF gene. AREAS COVERED: The authors reviewed preclinical and clinical data examining the safety of vemurafenib in melanoma. MEDLINE and EMBASE were searched using the medical subject heading \\'vemurafenib\\' and the following text terms: melanoma, BRAF inhibition, vemurafenib. This review provides the reader with an overview of current data examining the efficacy and safety of vemurafenib in metastatic melanoma. EXPERT OPINION: Vemurafenib is an oral agent licensed for patients with BRAF V600E mutation-positive inoperable and metastatic melanoma. The most common adverse effects observed in Phase III clinical trials were dermatological events, arthralgia and fatigue. Specific dermatological toxicities included development of cutaneous squamous cell cancers and keratoacanthomas. Prolongation of the QT interval was also reported. Regular dermatological assessments and electrocardiograms are recommended. Ongoing trials are examining vemurafenib in both the adjuvant setting and metastatic setting in combination with ipilimumab and MEK inhibitors (mitogen-activated protein kinase\\/extracellular signal-regulated kinase). Understanding and overcoming mechanisms of resistance to BRAF inhibitors is the focus of ongoing research.
Jordan, Emmet John
This case report presents a very aggressive course of amelanotic nodular melanoma during pregnancy resulting in death five months after delivery. A 34 year-old Caucasian woman at 19th week of the second pregnancy was diagnosed having amelanotic nodular melanoma (tumor thickness - 2.5 mm) with metastases to the regional right inguinal lymph node. Amelanotic nodular melanoma represents malignant melanocytic tumor of the skin, which clinically mimics a variety of benign and malignant skin conditions and therefore commonly leads to delayed diagnosis. Though primary tumor was excised immediately, other treatment procedures as radical lymphadenectomy and chemotherapy were delayed, and immunotherapy was not given totally. At the 29th week of pregnancy, the woman via naturalem delivered a healthy female child, and the chemotherapy was started. Since pregnancy limits the prescription of immunotherapy and chemotherapy, the prognosis for melanoma during pregnancy detected later than in the second stage is poor and can be illustrated by our reported case. Such patients seems to be at higher risk to develop metastasis of melanoma in the internal organs and occasionally even in the fetus; therefore, they should be timely informed about that. PMID:18660642
Jasaitiene, Daiva; Valiukeviciene, Skaidra; Makstiene, Jurgita; Juodzbaliene, Edita Brone
For several decades, targeting of tumor-related vessels has been regarded as a potential anticancer therapy. Such anti-angiogenic therapy is based on the assumption that a tumor cannot grow beyond the limits of diffusion (about 1-2 mm) of oxygen and nutrients from capillaries, unless angiogenesis takes place. Vascular endothelial growth factor (VEGF) plays a key role in angiogenesis, regulating vasopermeability as well as the proliferation and migration of endothelial cells. In several types of cancer (colon carcinoma, soft tissue sarcomas and gastric cancer), serum VEGF levels are a marker for disease stage and an indicator of metastasis. VEGF levels are significantly elevated in uveal melanoma patients with metastatic disease compared to patients without metastases. Anti-angiogenic therapy, such as bevacizumab, is currently used for the treatment of metastases of several malignancies. Anti-angiogenic therapy has not yet been tested for the treatment of primary uveal melanoma or related metastatic disease. Clinicians, however, have a broad experience with anti-angiogenic agents in patients with uveal melanoma by treating the complications of radiation therapy. We will discuss tumor angiogenic processes and related molecular pathways in uveal melanoma. The role of VEGF and the potential use of current commercially and experimentally available anti-angiogenic drugs for the treatment of primary uveal melanoma and/or metastatic disease will be explained below. PMID:22042017
el Filali, Mariam; van der Velden, Pieter A; Luyten, Gregorius P M; Jager, Martine J
Loss of methylthioadenosine phosphorylase (MTAP) expression and a concomitant accumulation of 5'-methyl-thioadenosine (MTA) characterise several tumour entities including malignant melanoma. MTA affects cellular signalling, proliferation and migration not only of cancer but also surrounding cells including lymphocytes and stromal fibroblasts. The mode of action of MTA is still not known. Interestingly, MTA is a known potent inhibitor of protein arginine methyltransferases (PRMTs) and is used as a tool in studying activity and impact of PRMTs. This study aimed at analysing PRMTs in melanoma and the potential impact of MTA on tumourigenesis. Our findings demonstrate that expression of PRMT4/CARM1 and PRMT6 is deregulated in melanoma, whereas expression of the remaining PRMTs stays unchanged. General PRMT activity and, consequently, symmetric and asymmetric protein methylation are reduced significantly in melanoma cells and tissues. This is due to a loss of MTAP expression and accumulation of MTA. Reduction of protein methylation by MTA affects cell signalling and leads, for example, to an activation of extracellular signal-regulated kinase (ERK) activity. The effects of endogeneous MTA on PRMTs as presented in this study can strongly support the migratory and invasive phenotype of melanoma cells. PMID:23265702
Limm, Katharina; Ott, Corinna; Wallner, Susanne; Mueller, Daniel W; Oefner, Peter; Hellerbrand, Claus; Bosserhoff, Anja-Katrin
The molecular classification of melanoma and the advent of new drugs are changing the paradigm of therapy for advanced melanoma. A review of the recent key studies was performed, followed by a discussion in an expert forum. The aim of this review was to generate a therapeutic algorithm for stage IV melanoma. Tumor genotyping for BRAF and/or KIT should be performed before selection of therapy. For most BRAF-mutated melanoma patients and particularly those with a high tumor load, vemurafenib or other BRAF inhibitors such as dabrafenib are the treatment of choice. KIT inhibitors can be effective in KIT-mutant tumors, especially in those patients with mutations at exons 11 and 13. Ipilimumab is a good option for patients with nontargetable or nondetected mutations and those who progress under therapy with vemurafenib or a KIT inhibitor. There is still a role for conventional chemotherapy either as first-line treatment in BRAF wild-type patients or as salvage therapy in second or third line, or after other treatment modalities. Participation in clinical trials is strongly encouraged, either in first or in subsequent lines. New therapeutic options for advanced melanoma are guided by tumor genotyping. The current therapeutic algorithm includes kinase inhibitors, anti-CTLA4 therapy, immunotherapy, and chemotherapy, depending on the tumor genotype and response to previous treatments. Participation in clinical trials should always be encouraged because the treatment goal is long-term survival and potential cure in a subset of patients. PMID:24413374
Espinosa, Enrique; Grob, Jean-Jacques; Dummer, Reinhard; Rutkowski, Piotr; Robert, Caroline; Gogas, Helen; Kefford, Richard; Eggermont, Alexander M M; Martin Algarra, Salvador; Hauschild, Axel; Schadendorf, Dirk
Nodular melanoma (NM) and amelanotic/hypomelanotic melanoma (AHM) often present a challenge to the diagnosing clinician. A significant proportion of AHM are nodular in nature. Such tumors may lack features of asymmetry and altered peripheral pigmentation routinely observed in other melanoma subtypes. This lack of distinguishing clinical features can potentially result in delayed diagnosis or inappropriate treatment. This review highlights the key points in evaluating the range of lesions where AHM or NM are considered in the differential diagnosis and summarizes current evidence in relation to pigmented and vascular dermoscopic diagnostic criteria for both. PMID:21175750
Moloney, Fergal J; Menzies, Scott W
To determine whether circulating tumor-reactive T cells are present in melanoma patients, unstimulated T cells from peripheral blood were tested for recognition of HLA-A2- or HLA?A1-matched melanoma cell lines using the ELISPOT assay. Eleven out of nineteen patients with metastatic melanoma had a T cell response with up to 0.81%, 0.78%, 0.53%, 0.12%, 0.10%, 0.09%, 0.07%, 0.06%, 0.06%, 0.04% and 0.04% of peripheral blood mononuclear cells (PBMC) secreting IFN gamma upon exposure to va...
Full Text Available Cutaneous malignant melanoma is the most lethal form of skin cancer and an increasingly common disease worldwide. It remains one of the most treatment-refractory malignancies. The current treatment options for patients with metastatic melanoma are limited and in most cases non-curative. This review focuses on conventional chemotherapeutic drugs for melanoma treatment, by a single or combinational agent approach, but also summarizes some potential novel phytoagents discovered from dietary vegetables or traditional herbal medicines as alternative options or future medicine for melanoma prevention. We explore the mode of actions of these natural phytoagents against metastatic melanoma.
Kyaw Minn Hsan
This document provides a historical summary and recommendations on melanoma in the Lawrence Livermore National Laboratory (LLNL) workforce. Melanoma of the skin comprises about 3.5% of the incidence (38,000 new cases in 1991) and 1.7% of the mortality (8500 deaths in 1991) of all cancer in the U.S. However, for several decades it has shown the fastest rate of increase of any cancer site. The following areas are discussed: background and recognition of increased melanoma at LLNL, history of melanoma studies at LLNL, results from occupational factors study, overall conclusion on increased melanoma incidence, and recommendations for future management.
Moore, D.H. II; Hatch, F.
Full Text Available Melanoma of the hand represents a complicated clinical entity. Anatomic features of the hand create challenges in successful management of melanoma not encountered elsewhere in the body. The objectives of this article are to outline current standards for managing melanoma of the hand including diagnosis, surgical, and chemotherapeutic management. Particular emphasis will be placed on currently debated topics of the role of sentinel lymph node biopsy, the role of Mohs micrographic surgery, tissue sparing management of subungual melanoma, and the consideration of melanoma of the hand as a distinct entity based on clinical and molecular studies.
John Brad Turner
Full Text Available Purpose: To report a patient with small juxtapapillary choroidal melanoma with chromosome 3 monosomy treated with I 125 plaque and transpupillary thermotherapy (TTT. A 64-year-old Caucasian male presented with painless blurred vision of the left eye. Ocular examination disclosed a small juxtapapillary choroidal melanocytic tumor with overlying subretinal fluid and orange pigment. Ultrasound showed an elevated choroidal mass of 2 mm thickness with low reflectivity on A-scan and hollowness on B scan, consistent with a small choroidal melanoma. The patient was treated with plaque I 125 radiotherapy combined with one session of TTT. Genetic testing of the tumor cells obtained by fine needle aspiration biopsy showed chromosome 3 monosomy. At 1 year after treatment, the tumor was regressed with resolution of subretinal fluid and 20/40 visual acuity. A small choroidal melanoma can manifest monosomy of chromosome 3, a known predictive factor for the development of systemic metastasis.
Full Text Available We report a case of minimally invasive surgery in the management of metastasis to the spleen. A 67-year-old male patient with possible splenic soft tissue melanoma metastasis was referred to our hospital. He had a history of an excised soft tissue melanoma from his back eight months earlier, and the control abdominal computer tomography (CT scan revealed a hypodense spleen lesion. The patient underwent laparoscopic surgery to diagnose and treat the splenic lesion. The splenectomy was performed and the histological examination revealed a melanoma. The patient had a good postoperative course and was discharged on the second postoperative day. On his 12-month follow-up there was no sign of recurrence. The laparoscopic approach is a safe and effective alternative for treatment of splenic metastases.
Trindade Manoel Roberto
Full Text Available Malign melanom is a disease affecting many organs but rarely seen in gallbladder. Distinction of isolated tumors from primary gallbladder tumors or metastatic disease can not be made in most cases. Mainly the complaints of acute cholecystitis appears. Mostly this clinical condition is not doubted when the primary tumor is not found. In cases with poor prognosis , very few patients benefit from surgery. The role of surgery is limited in malign melanoma of gallbladder because of low experience. Different surgical procedures should be applied to primary gallbladder melanoma and metastatic disease. Patients should be evaluated in a multidisciplinary manner with new therapeutic methods. We report here on an unusual case of gallbladder melanoma that was diagnosed by pathological examination in 46-year-old woman.
Cytogenetic analysis of melanoma and nonmelanoma skin cancers has revealed recurrent aberrations, the frequency of which is reflective of malignant potential. Highly aberrant karyotypes are seen in melanoma, squamous cell carcinoma, actinic keratosis, Merkel cell carcinoma and cutaneous lymphomas with more stable karyotypes seen in basal cell carcinoma, keratoacanthoma, Bowen's disease and dermatofibrosarcoma protuberans. Some aberrations are common among a number of skin cancer types including rearrangements and numerical abnormalities of chromosome 1, -3p, +3q, partial or entire trisomy 6, trisomy 7, +8q, -9p, +9q, partial or entire loss of chromosome 10, -17p, +17q and partial or entire gain of chromosome 20. Combination of cytogenetic analysis with other molecular genetic techniques has enabled the identification of not only aberrant chromosomal regions, but also the genes that contribute to a malignant phenotype. This review provides a comprehensive summary of the pertinent cytogenetic aberrations associated with a variety of melanoma and nonmelanoma skin cancers. PMID:25207365
Carless, Melanie A; Griffiths, Lyn R
Full Text Available Oral malignant melanoma is a rare disease. The common sites of its occurrence are the palate and gingiva with the maxillary arch being affected 80% of the time. Because of their presence at relatively obscure areas in the oral cavity, most of the malignant melanomas of the oral cavity are diagnosed at a late stage. These lesions are associated with poor prognosis. The dental clinician must therefore carefully examine the head, neck, and oral cavity, and any pigmented lesion that may exhibit growth potential must be biopsied. This article describes a case of malignant melanoma that was present in the oral cavity and briefly reviews the relevant literature that explains the nature of this lesion.
We report a case of primary gastric malignant melanoma that was diagnosed after curative resection but initially misdiagnosed as adenocarcinoma. A 68-year-old woman was referred to our department for surgery for gastric adenocarcinoma presenting as a polypoid lesion with central ulceration located in the upper body of the stomach. The preoperative diagnosis was confirmed by endoscopic biopsy. We performed laparoscopic total gastrectomy, and the final pathologic evaluation led to the diagnosis of primary gastric malignant melanoma without a primary lesion detected in the body. To the best of our knowledge, primary gastric malignant melanoma is extremely rare, and this is the first case reported in our country. According to the literature, it has aggressive biologic activity compared with adenocarcinoma, and curative resection is the only promising treatment strategy. In our case, the patient received an early diagnosis and underwent curative gastrectomy with radical lymphadenectomy, and no recurrence was noted for about two years. PMID:25580362
Cho, Jun-Min; Lee, Chang Min; Jang, You-Jin; Park, Sung-Soo; Park, Seong-Heum; Kim, Seung-Joo; Mok, Young-Jae; Kim, Chong-Suk; Lee, Ju-Han
To develop the method to induce the appearance of differentiation in amelanotic melanoma, experimental control of differentiation in B-16 melanoma cells of mice was discussed. Human melanoma cells and yellow melanin pigment cells useful for a fundamental study of radiotherapy for cancer were cultured and were differentiated into some lines. Melanotic B-16 cells and amelanotic B-16 cells were irradiated with thermal neutron (neutron: 2.7 x 1012, ?-dose: 32.3 rad) after they were cultured in culture solution containing 10 ?/ml of 10B-dopa for 13 hours. A fine structure 5 hours after the irradiation in one of 5 experimental cases showed aggregated disintegration of melanin pigment particles, markedly deformed and fragmentized nucleus, and structural changes in cell membrane. (Tsunoda, M.)
Full Text Available The majority of patients diagnosed with melanoma present with thin lesions and generally these patients have a good prognosis. However, 5% of patients with early melanoma (< 1mm thick will have recurrence and die within 10 years, despite no evidence of local or metastatic spread at the time of diagnosis. Thus, there is a need for additional prognostic markers to help identify those patients that may be at risk of recurrent disease. Many studies and several meta-analyses have compared gene and protein expression in melanocytes, naevi, primary and metastatic melanoma in an attempt to find informative prognostic markers for these patients. However, although a large number of putative biomarkers have been described, few of these molecules are informative when used in isolation. The best approach is likely to involve a combination of molecules. We believe one approach could be to analyze the expression of a group of interacting proteins that regulate different aspects of the metastatic pathway. This is because a primary lesion expressing proteins involved in multiple stages of metastasis may be more likely to lead to secondary disease than one that does not. This review focuses on five putative biomarkers - melanoma cell adhesion molecule (MCAM, galectin-3 (gal-3, matrix metalloproteinase 2 (MMP-2, chondroitin sulfate proteoglycan 4 (CSPG4 and paired box 3 (PAX3. The goal is to provide context around what is known about the contribution of these biomarkers to melanoma biology and metastasis. Although each of these molecules have been independently identified as likely biomarkers, it is clear from our analyses that each are closely linked with each other, with intertwined roles in melanoma biology.
Full Text Available Melanoma is an invasive malignancy with a high frequency of blood-borne metastases, but circulating tumor cells (CTCs have not been readily isolated. We adapted microfluidic CTC capture to a tamoxifen-driven B-RAF/PTEN mouse melanoma model. CTCs were detected in all tumor-bearing mice and rapidly declined after B-RAF inhibitor treatment. CTCs were shed early from localized tumors, and a short course of B-RAF inhibition following surgical resection was sufficient to dramatically suppress distant metastases. The large number of CTCs in melanoma-bearing mice enabled a comparison of RNA-sequencing profiles with matched primary tumors. A mouse melanoma CTC-derived signature correlated with invasiveness and cellular motility in human melanoma. CTCs were detected in smaller numbers in patients with metastatic melanoma and declined with successful B-RAF-targeted therapy. Together, the capture and molecular characterization of CTCs provide insight into the hematogenous spread of melanoma.
Melanoma is an invasive malignancy with a high frequency of blood-borne metastases, but circulating tumor cells (CTCs) have not been readily isolated. We adapted microfluidic CTC capture to a tamoxifen-driven B-RAF/PTEN mouse melanoma model. CTCs were detected in all tumor-bearing mice and rapidly declined after B-RAF inhibitor treatment. CTCs were shed early from localized tumors, and a short course of B-RAF inhibition following surgical resection was sufficient to dramatically suppress distant metastases. The large number of CTCs in melanoma-bearing mice enabled a comparison of RNA-sequencing profiles with matched primary tumors. A mouse melanoma CTC-derived signature correlated with invasiveness and cellular motility in human melanoma. CTCs were detected in smaller numbers in patients with metastatic melanoma and declined with successful B-RAF-targeted therapy. Together, the capture and molecular characterization of CTCs provide insight into the hematogenous spread of melanoma. PMID:24746818
Luo, Xi; Mitra, Devarati; Sullivan, Ryan J; Wittner, Ben S; Kimura, Anya M; Pan, Shiwei; Hoang, Mai P; Brannigan, Brian W; Lawrence, Donald P; Flaherty, Keith T; Sequist, Lecia V; McMahon, Martin; Bosenberg, Marcus W; Stott, Shannon L; Ting, David T; Ramaswamy, Sridhar; Toner, Mehmet; Fisher, David E; Maheswaran, Shyamala; Haber, Daniel A
Full Text Available 278 cases of cutaneous malignant melanoma admitted in „Emergency Clinic Hospital” Iasi between 1996-2006 have been described. Our cases showed that cutaneous malignant melanoma prevailed in females, has the highest incidence in the fourth decade, and is mostly located in lower limbs. Malignant melanoma occured on healthy skin (205 cases, congenital nevus (9 cases, preexisting nevus (29 cases, lentigo maligna (14 cases, and as a subungual form (21 cases. Our cases have been classified as lentigo maligna, superficial spreading melanoma, nodular melanoma and as melanoma arising in a giant congenital nevus. The retrospective comparison of our data reveals that in the evaluation of cutaneous malignant melanoma prognosis clinical parameters, as well as morphological ones, reprezented by Clark’s levels of invasion, Breslow’s thickness, tumour infiltrating lymphocytes, ulceration and vascular invasion, should be considered.
Full Text Available After a disease-free period of 10 years, a surgically treated case of cutaneous malignant melanoma is usually not followed up further and there is a tendency to assume that the disease is cured. Late recurrence (after 10 years of cutaneous malignant melanoma, though infrequent, has been documented well in Western countries. In our country, the malignant melanoma is still considered uncommon and there is no data regarding its late recurrence. We report a case of pulmonary malignant melanoma as a late metastatic manifestation of primary plantar malignant melanoma in a 61-year-old man who presented with hemoptysis; metastatic malignant melanoma of the lung occurred 12 years after resection of primary malignant melanoma of sole of the right foot.
Clinical reports of primary sphenoid sinus melanoma and isolated gastric metastatic melanoma are rare. Thus, to the best of our knowledge, the present study reports the first case of isolated gastric metastasis from a sphenoid sinus melanoma. The aim of the present study was to discuss the clinicopathological and radiographic characteristics, the treatment strategy and the prognosis of sphenoid sinus metastatic malignant melanoma of the stomach. Although almost 60% of patients who succumb to melanoma exhibit gastrointestinal metastases at autopsy, antemortem diagnosis is uncommon; this is predominantly due to gastric metastatic melanoma presenting with non-specific symptoms similar to other common gastrointestinal diseases. Gastrectomy may prolong overall survival and improve the quality of life for gastric metastatic melanoma patients, and the present case emphasizes the importance of palliative surgery in such cases.
ZHAO, LIANJUN; YAN, JING; LI, LI; WEI, JIA; LI, LIN; QIAN, XIAOPING; LIU, BAORUI; ZOU, ZHENGYUN
Full Text Available Metastatic melanoma (MM presents a treatment challenge to oncologists worldwide. Dacarbazine is the first line chemotherapy treatment for MM, though the overall response rates are very poor. Recently, the v-raf murine sarcoma viral oncogene homolog B1 (BRAF V600 mutation was found to play a main role in MM. This mutation is present in 40-60% of melanoma patients. Vemurafenib is a BRAF kinase inhibitor that showed impressive results in phase I-III trials and was thus recently approved for the treatment of MM. This paper will briefly focus on vemurafenib in the treatment of MM and highlight concerns.
Ramon Andrade De Mello
Eighty-two patients with choroidal melanomas were treated with helium ion charged particle irradiation. Seventy-eight of 82 patients have either remained stable or demonstrated tumor shrinkage. Forty-five of 46 patients followed for at least 1 year after therapy have demonstrated tumor regression with a mean tumor shrinkage of approximately 31%. No tumor-related mortality has been observed. The most effective method of choroidal melanoma management is unclear. Charged particle external beam irradiation may be more applicable and have less ocular morbidity than either radioactive plaques or photocoagulation.
Char, D.H.; Saunders, W.; Castro, J.R.; Quivey, J.M.; Irvine, A.R.; Stone, R.D.; Crawford, J.B.; Barricks, M.; Lonn, L.I.; Hilton, G.F.
Two new mutations that collectively occur in 71 percent of malignant melanoma tumors have been discovered in what scientists call the "dark matter" of the cancer genome, where cancer-related mutations haven't been previously found. Reporting their findings in the Jan. 24 issue of Science Express, the researchers from Dana-Farber Cancer Institute and the Broad Institute said the highly "recurrent" mutations – occurring in the tumors of many people – may be the most common mutations in melanoma cells found to date.
Full Text Available Neoplasias como câncer de próstata, mama e cólon estão relacionadas à acromegalia. Raras vezes foi mencionada a associação com melanoma. Descreve-se caso de paciente com acromegalia no qual foi identificada lesão melanocítica suspeita, com posterior confirmação de melanoma. A excisão cirúrgica da lesão levou à cura da neoplasia. Chama-se a atenção para a necessidade de exame cuidadoso da pele de pacientes com acromegalia.Neoplasias such as prostate, breast, and colon cancer are commonly associated with acromegaly. However, the association of the latter with melanoma has been rarely mentioned. We describe the case of a patient with acromegaly in whom a suspicious melanocytic lesion was detected, and later confirmed to be melanoma by means of biopsy. Surgical excision of the lesion led to the cure of the neoplasia. More attention should be drawn to the need for careful skin examination of patients with acromegaly.
Carolina Garcia Soares Leães
Full Text Available Abstract Background Melanomas within the alimentary tract are usually metastatic in origin. On the other hand, primary melanomas of the gastrointestinal tract are relatively uncommon. There are several published reports of melanomas occurring in the esophagus, stomach, small bowel, and anorectum. The occurrence of primary melanoma of the colon has, however, only been rarely reported. The optimum modus operandi for the management of primary colonic melanoma remains nebulous due to the limited number of reports in literature. Methods A comprehensive search of Medline, Cochrane and Highwire was performed using the following keywords: 'melanoma', 'malignant melanoma', 'primary melanoma', 'colon', 'gastrointestinal tract', 'alimentary tract', 'digestive tract', and 'large bowel'. All patients with primary melanoma localized to the colon were included in the review. Patients with metastatic melanomas to the gastrointestinal (GI tract and primary melanomas localized to the GI tract in anatomic locations other than colon were excluded. Results There have been only 12 reported cases of primary melanoma of the colon to date. The average age of patients on presentation was 60.4 years without any significant gender predilection. Right colon (33% and cecum (33% were the most common sites for the occurrence of primary colonic melanoma while abdominal pain (58% and weight loss (50% were the most common presenting complaints. Colonoscopy is the most reliable diagnostic investigation and offers the additional advantage of obtaining tissue for diagnosis. S-100 and HMB-45 are highly sensitive and specific for the diagnosis of this malignancy. For primary colonic melanomas that have not metastasized to any distant parts of the body, surgical resection with wide margins appears to be the treatment of choice. Although the management was individualized in every case, most of the authors preferred traditional hemicolectomy as the favored surgical approach. Chemotherapeutic agents including interferons, cytokines, biological agents and radiation therapy for brain metastases have been reported as adjuvant and palliative options while considering malignant melanomas in general. The average recurrence-free interval was 2.59 years. Nine of the 12 reports documented follow-up in their patients. Two of these 9 (22.2% patients died. Conclusions Primary melanoma of the colon is a rare clinical entity. Whenever a seemingly primary melanoma is detected in an atypical location such as the colon, it is prudent to conduct a thorough clinical investigation to consider the possibility of metastatic disease. Further studies are needed to document the long term follow-up, survival advantage and safety of the management approaches employed in patients with primary colonic melanoma. Based on current data, surgical resection appears to be appropriate management for primary colonic melanomas; unless the disease has metastasized to distant sites where surgery may have a limited palliative role.
Nicola G Ghazi1, Christopher S Ketcherside1, Jason Sheehan2, Brian P Conway11Department of Ophthalmology and 2Neurosurgery, University of Virginia Health System, Charlottesville, VA, USAPurpose: To report outcomes of Gamma Knife radiosurgery (GKRS) in treating uveal melanoma lesions ineligible for standard brachytherapy.Methods: A retrospective interventional case series of uveal melanoma patients treated with GKRS between 1996 and 2004 was performed. The main outcome measures were local tumo...
Ghazi, Nicola G.; Ketcherside, Christopher S.; Jason Sheehan; Conway, Brian P.
Metastasis is the deadliest phase of cancer progression. Experimental models using immunodeficient mice have been used to gain insights into the mechanisms of metastasis. We report here the identification of a “metastasis aggressiveness gene expression signature” derived using human melanoma cells selected based on their metastatic potentials in a xenotransplant metastasis model. Comparison with expression data from human melanoma patients shows that this metastasis gene signature correla...
Xu, Lei; Shen, Steven S.; Hoshida, Yujin; Subramanian, Aravind; Ross, Ken; Brunet, Jean-philippe; Wagner, Stephan N.; Ramaswamy, Sridhar; Mesirov, Jill P.; Hynes, Richard O.
Neoplasias como câncer de próstata, mama e cólon estão relacionadas à acromegalia. Raras vezes foi mencionada a associação com melanoma. Descreve-se caso de paciente com acromegalia no qual foi identificada lesão melanocítica suspeita, com posterior confirmação de melanoma. A excisão cirúrgica da lesão levou à cura da neoplasia. Chama-se a atenção para a necessidade de exame cuidadoso da pele de pacientes com acromegalia.Neoplasias such as prostate, breast, and colon canc...
Carolina Garcia Soares Leães; Rafael Loch Batista; Cristina Micheletto Dallago; Julia Fernanda Semelmann Pereira Lima; Miriam da Costa Oliveira
Mitchell H Giles,1 Brendon J Coventry2 1Adelaide Melanoma Unit, 2Discipline of Surgery, The University of Adelaide, Royal Adelaide Hospital Adelaide, SA, Australia Background: Isolated limb infusion (ILI) using cytotoxic agents has been demonstrated to be an effective and less invasive alternative modality than isolated limb perfusion for the treatment of melanoma localized to a limb. Percutaneous catheters were inserted into the axial artery and vein of the affected limb while using a pneuma...
Mh, Giles; Bj, Coventry
Between 1 April 1979 and 31 March 1981, 904 residents of the four western provinces of Canada (population 6.5 million), were diagnosed as suffering from primary cutaneous malignant melanoma. Of 801 patients aged 20-79 years, 665 (83%) were interviewed along with control subjects chosen at random from the general population and matched for age, sex, and province. After exclusion of 70 subjects with lentigo maligna or acral lentiginous melanoma, comparisons of the 595 case-control pairs showed ...
Elwood, J. M.; Gallagher, R. P.; Hill, G. B.; Spinelli, J. J.; Pearson, J. C.; Threlfall, W.
Full Text Available SciELO Spain | Language: Spanish Abstract in spanish Casos clínicos: Se presentan cuatro casos de pacientes con signos clínicos de melanosis óculi. En todos se diagnosticó melanoma de coroides. Tres acudieron con disminución de visión en ojo afecto y fueron enucleados por presentar tumores grandes y activos. En el cuarto caso el melanoma fue descubier [...] to en una revisión rutinaria y se pudo aplicar un tratamiento conservador con braquiterapia con I125. Discusión: La melanosis óculi está infravalorada como factor de riesgo para melanoma y glaucoma. Es necesaria una revisión oftalmológica cada 6 ó 12 meses para la detección precoz de enfermedades de alto riesgo en estos pacientes. Abstract in english Cases: We present four cases of ocular melanosis. Choroidal melanoma was detected in all of them. Three eyes had decreased visual acuity and were enucleated because of their large, active tumours. In the fourth case the melanoma was detected in a routine examination and we were able to apply a prese [...] rving treatment with I125 brachytherapy. Discussion: Melanosis oculi is often underestimated as a risk factor for uveal melanoma and glaucoma. Ophthalmic surveillance, every 6 or 12 months is important, in patients with ocular melanocytosis for early detection of high risk diseases.
C, López Caballero; MA, Saornil Álvarez; G, Blanco Mateos; JM, Frutos Baraja; F, López Lara; C, González Sansegundo.
Interrelationship between melanosome and uptake of chlorpromazine (CPZ) into various melanoma cells (B16M-line, W line) having different capacity to produce melanosome and into macrophages feeding various amounts of melanosome was studied. The uptake of CPZ into melanoma cells was well correlated with the capacity to produce melanosome. The uptake of CPZ into macrophages containing melanosome increased according to feeding time and the concentration of melanosome. However, there was not a difference between the uptake of CPZ into macrophages containing latex particles and that into control cells. This fact clarified that promotion of the uptake of CPZ into macrophages containing melanosome depended on specific nature of intracellular melanosome. Therefore, specific uptake of CPZ into melanoma cells was thought to be determined initially by intracellular melanosome. These facts suggested that molecular hybrid of 10B and CPZ such as 10B12-CPZ was effective to melanotic melanoma and was ineffective to amelanotic melanoma. It will be possible to accumulate molecular hybrid of 10B and BPZ in tumors by feeding melanosome and perform thermal neutron capture treatment, if tumors excepting melanoma posses the capacity to feed melanosome. (Tsunoda, M.)
Full Text Available SciELO Brazil | Language: English Abstract in portuguese Os dados sobre risco de melanoma cutâneo nos nevos melanocíticos são ainda controversos. O estudo longitudinal prospectivo de 107 casos de melanoma cutâneo revelou que em 9/107 casos (8,4%) houve presunção de lesão precursora, porém em 1/107 caso (0,9%) houve comprovação histopatológica para nevo me [...] lanocítico. A informação vaga de presença de lesão precursora do melanoma cutâneo torna vulnerável sua vinculação com o tumor e implica em comprovação histopatológica. Abstract in english The data on melanoma associaed with melanocytic nevus are controversial. A longitudinal prospective study of 107 cases of cutaneous melanoma revealed that 9 (8.4%) cases were presumed to be linked to a precursor lesion, but only in 1 (0.9%) out of these cases the histopathological examination showed [...] an associated melanocytic nevus. The vague information of a preexisting lesion of cutaneous melanoma is not sufficient to consider it a tumour precursor and it requires histopathological evidence to confirm the diagnosis.
Nurimar Conceição, Fernandes.
Full Text Available Casos clínicos: Se presentan cuatro casos de pacientes con signos clínicos de melanosis óculi. En todos se diagnosticó melanoma de coroides. Tres acudieron con disminución de visión en ojo afecto y fueron enucleados por presentar tumores grandes y activos. En el cuarto caso el melanoma fue descubierto en una revisión rutinaria y se pudo aplicar un tratamiento conservador con braquiterapia con I125. Discusión: La melanosis óculi está infravalorada como factor de riesgo para melanoma y glaucoma. Es necesaria una revisión oftalmológica cada 6 ó 12 meses para la detección precoz de enfermedades de alto riesgo en estos pacientes.Cases: We present four cases of ocular melanosis. Choroidal melanoma was detected in all of them. Three eyes had decreased visual acuity and were enucleated because of their large, active tumours. In the fourth case the melanoma was detected in a routine examination and we were able to apply a preserving treatment with I125 brachytherapy. Discussion: Melanosis oculi is often underestimated as a risk factor for uveal melanoma and glaucoma. Ophthalmic surveillance, every 6 or 12 months is important, in patients with ocular melanocytosis for early detection of high risk diseases.
C López Caballero
Full Text Available Malignant melanoma can present a variety of histopathological patterns. Cartilaginous change in the absence of osteogenic differentiation is extremely rare in malignant melanoma, being among the least frequent of the wide range of melanoma histologic patterns. We report a case of a 47-year-old woman with a subungual nodule on her right great toe for many years. Histopathological examination of the lesion led to a diagnosis of malignant melanoma with cartilaginous differentiation devoid of concomitant osseous areas. It would appear that this unusual form of melanoma has a predilection for acral location, particularly the subungual region. Malignant melanoma with chondroid stroma should therefore be considered in the differential diagnosis of cartilaginous lesions of the toes and fingers. Careful examination of the overlying epidermis and identification of an in situ component of melanoma may be necessary in order to establish the correct diagnosis.O melanoma maligno pode apresentar uma grande variedade de padrões histopatológicos. A presença de diferenciação cartilagínea, na ausência de diferenciação osteogénica, é extremamente rara no melanoma maligno. O melanoma cartilagíneo está entre os padrões histológicos menos frequentes. Relatamos um caso de uma doente do sexo feminino de 47 anos de idade com um nódulo subungueal no 1º dedo do pé direito com muitos anos de evolução. O exame histopatológico da lesão revelou melanoma cartilagíneo, sem áreas de diferenciação osteogénica. Esta variante de melanoma parece ter predileção pela extremidades, sobretudo pela região subungueal. Assim, o melanoma maligno com diferenciação condróide, deve ser tido em consideração no diagnóstico diferencial de lesões acrais cartilagíneas. A observação cuidadosa da epiderme e a identificação de um componente do melanoma in situ podem ser necessários para estabelecer um diagnóstico correto.
Parente Joana Devesa
Full Text Available SciELO Brazil | Language: English Abstract in portuguese O melanoma maligno pode apresentar uma grande variedade de padrões histopatológicos. A presença de diferenciação cartilagínea, na ausência de diferenciação osteogénica, é extremamente rara no melanoma maligno. O melanoma cartilagíneo está entre os padrões histológicos menos frequentes. Relatamos um [...] caso de uma doente do sexo feminino de 47 anos de idade com um nódulo subungueal no 1º dedo do pé direito com muitos anos de evolução. O exame histopatológico da lesão revelou melanoma cartilagíneo, sem áreas de diferenciação osteogénica. Esta variante de melanoma parece ter predileção pela extremidades, sobretudo pela região subungueal. Assim, o melanoma maligno com diferenciação condróide, deve ser tido em consideração no diagnóstico diferencial de lesões acrais cartilagíneas. A observação cuidadosa da epiderme e a identificação de um componente do melanoma in situ podem ser necessários para estabelecer um diagnóstico correto. Abstract in english Malignant melanoma can present a variety of histopathological patterns. Cartilaginous change in the absence of osteogenic differentiation is extremely rare in malignant melanoma, being among the least frequent of the wide range of melanoma histologic patterns. We report a case of a 47-year-old woman [...] with a subungual nodule on her right great toe for many years. Histopathological examination of the lesion led to a diagnosis of malignant melanoma with cartilaginous differentiation devoid of concomitant osseous areas. It would appear that this unusual form of melanoma has a predilection for acral location, particularly the subungual region. Malignant melanoma with chondroid stroma should therefore be considered in the differential diagnosis of cartilaginous lesions of the toes and fingers. Careful examination of the overlying epidermis and identification of an in situ component of melanoma may be necessary in order to establish the correct diagnosis.
Parente, Joana Devesa; Jose Manuel Pereira da Silva, Labareda; Elvira Augusta Felgueira Leonardo Fernandes, Bartolo; Maria Fernanda Sachse Pinto Fonseca, Santos; Esmeralda Maria Seco do, Vale.
Melanoma is the most dangerous type of skin cancer. Despite the rise of public awareness, the incidence rate among the white population has been rising constantly for several decades. Systematic improvement in knowledge about the biology of pigment cells and molecular mechanisms of their neoplastic transformation has enhanced the possibility of melanoma chemoprevention. Hence, chemopreventive agents that prevent, inhibit, or reverse melanoma development are being investigated intensively. Among synthetic compounds, especially well studied are lipid-lowering drugs and cyclooxygenase inhibitors. Substances found in everyday diet, such as genistein, apigenin, quercetin, resveratrol, and curcumin may also have potential chemopreventive qualities. However, studies examining the chemopreventive activity of these compounds have shown widely varying results. Early reports on the possible chemopreventive activity of statins and fibrates were not proved by the results of randomized clinical trials. Similarly, case-control studies examining the influence of NSAIDs on the risk of melanoma do not confirm the antitumor activity of cyclooxygenase inhibitors. Further clinical trials involving carefully selected target populations as well as the identification of specific biomarkers of prognostic and predictive value seem to be essential for the evaluation of the chemopreventive activity of the studied substances. PMID:24077511
Uzarska, Ma?gorzata; Czajkowski, Rafa?; Schwartz, Robert A; Bajek, Anna; Zegarska, Barbara; Drewa, Tomasz
Pentamidine is a small molecule inhibitor of the Ca2+ binding protein S100B and disrupts the S100B-p53 protein-protein interaction; this is thought to restore wild type p53 tumour suppressor function in melanoma. Additional anti-cancer effects may be the result of inhibition of PRL family phosphatases.
Smith, Jason; Stewart, Benjamin J.; Glaysher, Sharon; Peregrin, Katherine; Knight, Louise A.; Weber, David J.; Cree, Ian A.
Full Text Available A 45-year female presented with a sudden eruption of multiple brownish black nodular lesions since 5 months over the face, trunk and extremities which were clinically diagnosed as a case of nodular malignant melanoma. Histopathologically, they revealed the secondaries from carcinoma rectum.
In this clinical trial, patients with stage III or stage IV melanoma that has been completely resected will be randomly assigned to receive adjuvant (post-surgical) treatment with either ipilimumab or high-dose interferon alfa-2b, the current standard of care.
Full Text Available Background. Malignant melanomas of the female reproductive system are rare. These are biologically highly aggressive tumors with poor prognosis. Preoperative establishment of the diagnosis is practically impossible. Therapeutic approach and treatment of patients with metastatic ovarian melanoma are highly dependent on precise histological analysis. Case report. A woman aged 48 was admitted to the clinic for occasional pains in the lower abdomen and suspected myomatous changes of the uterus. The patient underwent surgery for melanoma on her right arm five years ago. Classic hysterectomy with bilateral adnexectomy with infracolic omentectomy and selective iliac lymphadenectomy were performed. Macroscopic examination revealed an oval tumefaction on the left ovary sized 12.5 x 10 x 3.5 cm of solid structure. Tumor tissue was yellowish-brown colored, of solid structure and mostly localized subcortically with central edema. Microscopic examination showed positive reaction for HMB-45, anti-Melan-A and S-100 protein, but negative immunoreactivity for estrogen and progesterone receptors. Malignant disease caused death after a 4-year follow-up period following gynecological operation. Conclusion. The previous diagnosis of skin melanoma is also indicative of metastatic ovarian tumor, while immunohistochemical analyses confirmed the histopathological diagnosis.
In patients with metastatic melanoma, standard cytotoxic drugs such as dacarbazine have no proven impact on survival. Vemurafenib is the first BRAF protein inhibitor to be approved for the treatment of melanoma. In about half of patients with melanoma, this protein, important for cell growth, is dysregulated owing to a mutation (V600) in the gene that encodes it. An unblinded clinical trial that included 675 patients with metastatic melanoma harbouring a V600 BRAF mutation compared oral vemurafenib with intravenous dacarbazine. An interim analysis showed a statistically significant increase in the median overall survival time of about 1.5 months with vemurafenib (9.2 versus 7.7 months). These results are too preliminary to determine the survival advantage, if any, conferred by vemurafenib. About 20% of patients treated with vemurafenib developed skin cancer. The most common adverse effects were skin rash (37%), photosensitivity (33%), diarrhoea (28%), and arthralgia (54%). Vemurafenib also causes ocular disorders, including uveitis, and prolongs the QT interval in a dose-dependent manner. The potential for pharmacokinetic interactions is high: vemurafenib inhibits P-glycoprotein and CYP 1A2, and induces CYP 3A4. In practice, vemurafenib should only be used in rigorous clinical trials, on a case-by-case basis. PMID:23373092
A case of bilateral uveal melanoma in a 60-year-old woman in association with primary bilateral ovarian carcinoma is described. This is the first case in which ultrastructural studies have been performed on the ocular tumours. Seven previously described cases are summarised, and the extreme rarity of such reports would suggest that this may indeed be a new syndrome.
Mullaney, J.; Mooney, D.; O Connor, M.; Mcdonald, G. S.
Choroidal melanoma may arise de novo or transformed from a previously existing nevus. Modern cytogenetical techniques allow us to determine and classify the genetic aberrations of such tumors. We report a case of a 55-year-old man presenting a malignant transformation of a previously known choroidal nevus in his right eye. Nine years earlier, that same eye was treated with brachytherapy for a malignant melanoma. Enucleation was indicated followed by histopathological study as well as gene mutation analysis of the tumor cells. The second melanoma was anatomically independent from the first one, discarding the possibility of spreading. Cytogenetical study resulted in significant loss of the short arm of chromosome 1 and the long arm of chromosome 3. Only 21 cases of multiple uveal melanoma in the same eye are reported in the literature. To our knowledge this is the first cytogenetical report of one of such cases. It highlights the importance of follow-up in these patients, especially when risk factors like a choroidal naevus are present. PMID:23869977
Filloy, Alejandro; Caminal, J Maria; Bruzual, Maria C; Varela, Maria Del M; Gomà, Montserrat
Despite an increasing incidence of melanoma in this country, innovative new therapies are allowing patients to receive aggressive experimental treatments. Diagnostic imaging remains crucial for tumor staging and for follow-up of patients being treated with these protocols. Because metastases occur in the abdomen and pelvis in approximately 60% of patients, it is important to accurately identify all sites of tumor spread. A variety of imaging techniques are used to image these patients, with CT currently being used for staging purposes and to guide diagnostic biopsies. Other imaging techniques, such as MR, ultrasound, and fluoroscopy, are currently reserved for investigating specific complications of melanoma, such as vascular invasion, hemorrhage from a tumor, and small bowel involvement, including intussusception. Recently, whole body positron emission tomography (PET) imaging using 2-deoxy-2-fluoro-D-glucose (FDG) has been shown to be highly accurate in assessing patients with metastatic malignant melanoma. This review illustrates the spectrum of manifestations of metastatic melanoma throughout the abdomen and pelvis, including solid organ, hollow lumen, and retroperitoneal involvement, and demonstrates some of the typical and atypical manifestations that may be identified. PMID:9885779
Kamel, I R; Kruskal, J B; Gramm, H F
Patients with inflammatory bowel disease (IBD) are at higher risk of melanoma, a form of skin cancer, report researchers at Mayo Clinic. Researchers found that IBD is associated with a 37 percent greater risk for the disease. The findings were presented at the Digestive Disease Week 2013 conference in Orlando, Fla.
An experimental drug that targets the immune system, ipilimumab, has helped patients with advanced cases of melanoma live longer than expected, according to results of a large randomized clinical trial presented at the 2010 American Society of Clinical Oncology annual meeting and published June 6, 2010, in the New England Journal of Medicine.
Melanoma vaccines are usually administered after surgical resection of the tumor with the hope of eradicating the micrometastases, in high-risk patients. As we previously reported, most of the melanoma vaccines failed to show any major impact on the disease, except for the autologous whole cell vaccine. This can be explained by the heterogeneous nature of cutaneous melanoma that expresses various levels of melanoma antigens, peptides and has various genetic profiles among different patients. From an immunological point of view, it is illogic to eliminate the tumor and its specific antigens then apply allogenic type of therapy and expect a tumor response. Therefore, it is more logical is to utilize the tumor site as a source for the tumor-specific antigens. In the meantime, patients with in-transit metastases can give us an excellent opportunity to evaluate the local and systemic effects of intralesional (intratumoral) therapy, and various agents have been utilized with equivocal results. On the other hand, intralesional administration of 2 cytokines seemed to process the tumor antigens and activates thymic-derived lymphocytes (T cells). This can induce an antitumor immune response in vivo, i.e., autoimmunization (auto-vaccination), specific to each patient, and overcome tumor heterogeneity regardless to its antigenic or genetic profiles. PMID:25077889
Elias, E G; Sharma, B K
A 45-year female presented with a sudden eruption of multiple brownish black nodular lesions since 5 months over the face, trunk and extremities which were clinically diagnosed as a case of nodular malignant melanoma. Histopathologically, they revealed the secondaries from carcinoma rectum.
Chopra Adarsh; Rls, Walia; Gupta Seema; Sethi P; Bagga H
Full Text Available Abstract Serum lactate dehydrogenase (LDH is a prognostic factor for patients with stage IV melanoma. To gain insights into the biology underlying this prognostic factor, we analyzed total serum LDH, serum LDH isoenzymes, and serum lactate in up to 49 patients with metastatic melanoma. Our data demonstrate that high serum LDH is associated with a significant increase in LDH isoenzymes 3 and 4, and a decrease in LDH isoenzymes 1 and 2. Since LDH isoenzymes play a role in both glycolysis and oxidative phosphorylation (OXPHOS, we subsequently determined using tissue microarray (TMA analysis that the levels of proteins associated with mitochondrial function, lactate metabolism, and regulators of glycolysis were all elevated in advanced melanomas compared with nevic melanocytes. To investigate whether in advanced melanoma, the glycolysis and OXPHOS pathways might be linked, we determined expression of the monocarboxylate transporters (MCT 1 and 4. Analysis of a nevus-to-melanoma progression TMA revealed that MCT4, and to a lesser extend MCT1, were elevated with progression to advanced melanoma. Further analysis of human melanoma specimens using the Seahorse XF24 extracellular flux analyzer indicated that metastatic melanoma tumors derived a large fraction of energy from OXPHOS. Taken together, these findings suggest that in stage IV melanomas with normal serum LDH, glycolysis and OXPHOS may provide metabolic symbiosis within the same tumor, whereas in stage IV melanomas with high serum LDH glycolysis is the principle source of energy.
Dermoscopic features of thin melanomas: a comparative study of melanoma in situ and invasive melanomas smaller than or equal to 1mm / Caracteristicas dermatoscopicas de melanomas finos: estudo comparativo entre melanomas in situ e melanomas invasivos menores ou iguais a 1mm
Full Text Available SciELO Brazil | Language: English Abstract in portuguese FUNDAMENTOS: A dermatoscopia propicia o diagnóstico mais precoce do melanoma. A estimativa préoperatória da espessura de Breslow através da dermatoscopia poderia ser útil no planejamento da conduta cirúrgica e seleção dos pacientes para a biópsia de linfonodo sentinela. OBJETIVOS: Este estudo [...] objetiva descrever as características dermatoscópicas encontradas em melanomas finos e comparar melanomas in situ com melanomas invasivos menores ou iguais a 1 mm. MÉTODOS: Trata-se de estudo observacional, retrospectivo, no qual avaliouse o registro fotográfico da dermatoscopia de 41 melanomas finos. Três observadores avaliaram em conjunto 14 critérios dermatoscópicos. RESULTADOS: Dentre os melanomas finos, os critérios mais encontrados foram: presença de assimetria nos dois eixos em 95% (39 casos), 3 ou mais cores em 80,4% (33 casos), pontos ou glóbulos atípicos em 58,5% (24 casos) e rede atípica ou estrias radiadas em 53,6% (22 casos). O grupo dos melanomas invasivos apresentou com maior frequência e significância estatística (p Abstract in english BACKGROUND: Dermoscopy allows the early detection of melanomas. The preoperative determination of Breslow index by dermoscopy could be useful in planning the surgical approach and in selecting patients for sentinel lymph node biopsy. OBJECTIVES: This study aims at describing the dermoscopic fe [...] atures of thin melanomas and comparing melanomas in situ with invasive melanomas less than or equal to 1 mm thick. METHODS: This was an observational retrospective study in which the dermoscopy photographs of 41 thin melanomas were evaluated. Three observers evaluated together 14 dermoscopic criteria. RESULTS: Among thin melanomas, the most frequent criteria were presence of asymmetry in two axes in 95% of cases (39 cases), 3 or more colors in 80.4% of cases (33 cases), atypical dots or globules in 58.5% of cases (24 cases) and atypical network or streaks in 53.6% of cases (22 cases). The group of invasive melanomas presented with a higher frequency and statistical significance (p
Vanessa Priscilla Martins da, Silva; Juliana Kida, Ikino; Mariana Mazzochi, Sens; Daniel Holthausen, Nunes; Gabriella, Di Giunta.
Nine cases of primary melanotic melanoma, three cases of metastatic amelanotic melanoma, and 26 cases of pigmented and unpigmented tumors other than melanoma were examined with the touch-fluorescence method using preparations from the cut surface of the lesions. Fluorescent melanoma cells were easily detected with a fluorescence microscope in all the cases of malignant melanoma whether the melanoma was melanotic or amelanotic. The fluorescent melanoma cells could be divided into three types by configuration: round, spindle-shaped, and pleomorphic. The main cell type of superficial spreading melanoma was round and that of nodular melanoma and acral lentiginous melanoma was chiefly pleomorphic. Fluorescent tumor cells were not seen in pigmented and unpigmented tumors other than melanoma, except in pigmented basal cell epithelioma; this fact made it possible to apply this method routinely for quick diagnosis of malignant melanoma during operation. PMID:3955511
Morishima, T; Nagashima, N; Hanawa, S; Fukada, E; Kanematsu, S; Shibata, A
The epidemiology of extracutaneous melanoma (ECM) is sparsely reported upon in the literature, and studies to date have been limited both by time and by geographic gaps in available data. Utilizing a comprehensive provincial cancer registry, we sought to analyze the incidence and survival rates of ECM on the basis of sex and anatomic distribution for the British Columbia, Canada population. Data on ECMs diagnosed between 1 January 1992 and 31 December 2006 were obtained from the BC Cancer Registry. Anatomical sites of ECM were classified on the basis of ICD-9 codes, and incidence rates for each site were age standardized and grouped by sex. The 5-year survival rate for each anatomical grouping was tracked until 31 December 2011. A total of 922 primary ECMs were recorded in the BC Cancer Registry between 1992 and 2006, representing 5.1% of melanoma incidence. Ocular melanomas were most frequently reported, with an age-standardized incidence rate (per million) of 10.6 for men and 8.5 for women. ECM patients were generally older at diagnosis and had poorer survival rates compared with cutaneous melanoma cases. Five-year survival rates for ECM varied markedly from 23.5% for genital lesions to 87.0% for ocular cases. Our ECM epidemiology results are largely consistent with previous studies from the USA and Europe. Where considerable differences in reported values do exist, the opportunity arises to assess the efficacy of melanoma detection, monitoring, and treatment strategies in different geographic regions. Our study represents the largest epidemiological investigation of ECM in Canada and provides a framework for future epidemiological comparisons. PMID:24722196
Haiducu, Marius L; Hinek, Anna; Astanehe, Arezoo; Lee, Tim K; Kalia, Sunil
A 59-year-old male patient had 5-month history of gait disturbance and memory impairment. His initial brain computed tomography scan showed 3.5×2.8 cm sized mass with high density in the pineal region. The tumor was hypointense on T2 weighted magnetic resonance images and hyperintense on T1 weighted magnetic resonance images with heterogenous enhancement of central portion. The tumor was totally removed via the occipital transtentorial approach. Black mass was observed in the operation field, and after surgery, histopathological examination confirmed the diagnosis of malignant melanoma. Whole spine magnetic resonance images and whole body 18-fluoro-deoxyglucose positron emission tomography could not demonstrate the primary site of this melanoma. Scrupulous physical examination of his skin and mucosa was done and dark pigmented lesion on his left leg was found, but additional studies including magnetic resonance images and skin biopsy showed negative finding. As a result, final diagnosis of primary pineal malignant melanoma was made. He underwent treatment with the whole brain radiotherapy and extended local boost irradiation without chemotherapy. His preoperative symptoms were disappeared, and no other specific neurological deficits were founded. His follow-up image studies showed no recurrence or distant metastasis until 26 weeks after surgery. Primary pineal malignant melanomas are extremely rare intracranial tumors, and only 17 cases have been reported since 1899. The most recent case report showed favorable outcome by subtotal tumor resection followed by whole brain and extended local irradiation without chemotherapy. Our case is another result to prove that total tumor resection with radiotherapy can be the current optimal treatment for primary malignant melanoma in the pineal region. PMID:25628812
Park, Jae-Hyun; Hong, Yong-Kil
The prognosis of malignant melanoma depends on the thickness of the tumour. In this study, we analysed the trends in Breslow thickness in 63 patients referred to our institution, a tertiary dermatology referral centre. The mean thickness of melanoma was 0.31 mm, which was lower than the national average of 1.10 mm. There was a significant trend towards increased melanoma thickness with increasing age, with a rate of 0.24 mm (95% CI 0.12-0.37) for each additional 10 years of age above the age of 20 years. This trend was only apparent in cases of self-diagnosed melanomas; the thickness of tumours diagnosed by a dermatologist did not show any dependence on patient age. As the mortality from melanoma increases with age, this study suggests that dermatologists should include older people in screening programmes for melanoma.
Trolle, L; Henrik-Nielsen, R
Full Text Available Abstract Introduction We describe an original case of progressive severe dysphagia caused by a posterior mediastinal metastatic melanoma of unknown origin. To the best of our knowledge, such an event has never been described before in the literature. Case presentation A progressive severe dysphagia case is reported induced by a melanoma of unknown origin (metastatic to a posterior mediastinal lymph node. At the time of diagnosis, the lesion appeared as a large posterior mediastinal mass mimicking a neurogenic tumour with oesophageal involvement. After complete resection, pathological assessment of the tumour by immunohistochemistry was consistent with nodal metastatic melanoma. Conclusion This report of a posterior mediastinal lymph node melanoma is unique. The nodal origin is definitely unusual: a primary melanoma should always be carefully ruled out. In fact no other evidence, a part from the absence of the tumour elsewhere, can support the diagnosis of a primary nodal melanoma.
Melanoma is a primary malignancy that is known to metastasize to the brain and often causes death. The ability to image the growth of brain melanoma in vivo can provide new insights into its evolution and response to therapies. In our study, we use a reflection mode photoacoustic microscopy (PAM) system to detect the growth of melanoma brain tumor in a small animal model. The melanoma tumor cells are implanted in the brain of a mouse at the beginning of the test. Then, PAM is used to scan the region of implantation in the mouse brain, and the growth of the melanoma is monitored until the death of the animal. It is demonstrated that PAM is capable of detecting and monitoring the brain melanoma growth noninvasively in vivo.
Staley, Jacob; Grogan, Patrick; Samadi, Abbas K.; Cui, Huizhong; Cohen, Mark S.; Yang, Xinmai
We report here a rare case of metastatic malignant melanoma presenting as ileo-ileal intussusception. A 66-year-old man revealed a past medical history of excision of malignant melanoma, followed by axillary lymph node spread treated with block dissection and radiotherapy. He presented with symptoms of small bowel obstruction and subsequent CT revealed a likely nodular intussusception. Resection confirmed the intussusception and histological analysis confirmed the lead point as metastatic malignant melanoma. It has been reported that up to 5% of those with malignant melanoma will present with bowel metastases before death, yet autopsy studies estimate approximately 60% of those with melanomas have GI metastases. Intussusceptions themselves account for only 1-5% of intestinal obstructions in adults. The magnitude of silent metastases highlights the need to take those with a previous malignant melanoma presenting with GI symptoms seriously as surgery can affect survival. PMID:24971832
Yerrakalva, D; Ackroyd, R; Lee, F
Full Text Available Abstract The incidence of malignant melanoma has rapidly increased in recent years. Evidence points to the role of inheritance in melanoma development, but specific genetic risk factors are not well understood. Recent reports indicate a high prevalence of somatic mutations of the BRAF gene in melanomas and melanocytic nevi. Here we report that germ-line single nucleotide polymorphisms (SNPs in BRAF are significantly associated with melanoma in German males, but not females. At-risk haplotypes of BRAF are shown. Based upon their frequencies, we estimate that BRAF could account for a proportion attributable risk of developing melanoma of 4% in the German population. The causal variant has yet to be determined. The burden of disease associated with this variant is greater than that associated with the major melanoma susceptibility locus CDKN2A, which has an estimated attributable risk of less than 1%.
The incidence of malignant melanoma has rapidly increased in recent years. Evidence points to the role of inheritance in melanoma development, but specific genetic risk factors are not well understood. Recent reports indicate a high prevalence of somatic mutations of the BRAF gene in melanomas and melanocytic nevi. Here we report that germ-line single nucleotide polymorphisms (SNPs) in BRAF are significantly associated with melanoma in German males, but not females. At-risk haplotypes of BRAF are shown. Based upon their frequencies, we estimate that BRAF could account for a proportion attributable risk of developing melanoma of 4% in the German population. The causal variant has yet to be determined. The burden of disease associated with this variant is greater than that associated with the major melanoma susceptibility locus CDKN2A, which has an estimated attributable risk of less than 1%. PMID:14617374
Meyer, Peter; Sergi, Consolato; Garbe, Claus
Melanoma is characterized by its high metastatic propensity. Melanoma metastasis is associated with an activation of signaling pathways that are responsible for embryogenesis. Wnt signaling pathway is considered as one of the key signaling cascades, whose aberrant activation results in melanoma development. Wnt signaling includes a complex network of intracellular interactions. Its ligands are able to initiate at least three signal transduction pathways: canonical and two noncanonical. Accord...
Gnuchev, N. V.; Georgiev, G. P.; Kibardin, ?. V.; Kulikova, ?. V.; Larin, S. S.
Melanoma begins with benign nevi and progresses to radial growth phase (RGP) and to vertical growth phase [(VGP), metastatic phenotype]. The molecular changes associated with these transitions are not yet well defined. However, transcriptional regulation of some genes that are critical in melanoma progression is beginning to be elucidated. The first part of this review will focus on our recent studies demonstrating that progression of human melanoma is associated with loss of expression of the transcription factor AP-2. In metastatic melanoma cells, this loss resulted in overexpression of MCAM/MUC18 and MMP-2, and lack of expression of c-KIT. In further investigations, we inactivated AP-2 in SB-2 primary cutaneous melanoma cells by using a dominant-negative AP-2, the AP-2B gene. Expression of AP-2B in SB-2 cells augmented their tumorigenicity in nude mice and upregulated MMP-2 expression and activity. We have also recently demonstrated that loss of AP-2 expression in metastatic melanoma cells resulted in overproduction of the thrombin receptor, PAR-1. Other studies have shown that AP-2 regulates additional genes involved in melanoma development and progression, including E-cadherin, p21/WAF-1, HER2, Bcl-2, FAS/APO-1, IGF-R-1, and VEGF. We propose that loss of AP-2 is crucial in the development of malignant melanoma. Additionally, the transition of melanoma cells from RGP to VGP is associated with overexpression of two transcription factors, CREB and ATF-1, both of which may act as survival factors for human melanoma cells. The second part of the review will briefly discuss the role of other transcription factors, including ATF-2, SNAIL, MITF, and NFkappaB in the progression of human melanoma and will summarize recent knowledge on how changes in the expression of these transcription factors contribute to acquisition of the metastatic phenotype in human melanoma. PMID:12741683
Nyormoi, Okot; Bar-Eli, Menashe
The incidence of malignant melanoma is much lower in the Japanese than in caucasians. However, amongst the various types of malignant melanoma, the subungual and periungual sites are commonly found in the Japanese. One hundred and fifty-one cases of cutaneous malignant melanoma were seen over a 25-year period at our hospital. We found that, in 34 patients (23%), the subungual region was involved, a high frequency for one institution. We have analysed these patients and looked at their treatment. The finger nails were affected in 21 cases (62%) and the toe nails in 13 cases (38%). The thumb nails or great toe nails were affected in 25 of the 34 patients (73%). In 25 patients, histopathological features of acral lentiginous melanoma were found, with four cases of superficial spreading melanoma and five of nodular amelanotic melanoma. Of the latter group, four mimicked fibrous histiocytic tumour, and one was a desmoplastic malignant melanoma. The proportion of patients presenting with stage III disease decreased after 1982, with a corresponding increase in patients whose tumour thickness was less than 4 mm (stage II). Concurrently, the prognosis for subungual malignant melanoma improved. The 5-year survival rate in each of the periods 1969-82 and 1983-93 was 53 and 87%, respectively. This is similar to that found in plantar malignant melanoma and is felt to be due to a greater public awareness of the condition and to the introduction of effective chemotherapy (the DTIC-AC nitrosurea-vincristine (DAV) regimen). Although the frequency of malignant melanoma is rather low in the Japanese, our data indicate that there is a high incidence of subungual malignant melanoma. Public awareness of the early stage of malignant melanoma seems to have improved prognosis. PMID:8731657
Kato, T; Suetake, T; Sugiyama, Y; Tabata, N; Tagami, H
278 cases of cutaneous malignant melanoma admitted in „Emergency Clinic Hospital” Iasi between 1996-2006 have been described. Our cases showed that cutaneous malignant melanoma prevailed in females, has the highest incidence in the fourth decade, and is mostly located in lower limbs. Malignant melanoma occured on healthy skin (205 cases), congenital nevus (9 cases), preexisting nevus (29 cases), lentigo maligna (14 cases), and as a subungual form (21 cases). Our cases have been classified...
Doinita Radulescu; Simona Stolnicu; Dumitriu, S.
In melanoma, the presence of promoter related hypermethylation has previously been reported, however, no methylation-based distinction has been drawn among the diverse melanoma subtypes. Here, we investigated DNA methylation changes associated with melanoma progression and links between methylation patterns and other types of somatic alterations, including the most frequent mutations and DNA copy number changes. Our results revealed that the methylome, presenting in early stage samples and as...
Ecsedi, Szilvia; Hernandez-vargas, Hector; Lima, Sheila C.; Vizkeleti, Laura; Toth, Reka; Lazar, Viktoria; Koroknai, Viktoria; Kiss, Timea; Emri, Gabriella; Herceg, Zdenko; Adany, Roza; Balazs, Margit
Choroidal melanoma is the commonest adult primary intraocular tumour,1 and usual sites of secondary spread are to liver, bone and lung. Although delayed recurrence of ipsilateral orbital melanoma is well documented, metastasis to the contralateral orbit is a rarely encountered phenomenon. We describe a case of metastatic spread to the contralateral orbit in a patient 12 years after proton beam radiotherapy of choroidal melanoma.
Sonia George; Cooke, Carole A.; Mc Ginnity, Gerald F.; Steve White; Laksmi Venkatraman
Melanoma of the hand represents a complicated clinical entity. Anatomic features of the hand create challenges in successful management of melanoma not encountered elsewhere in the body. The objectives of this article are to outline current standards for managing melanoma of the hand including diagnosis, surgical, and chemotherapeutic management. Particular emphasis will be placed on currently debated topics of the role of sentinel lymph node biopsy, the role of Mohs micrographic surgery, tis...
John Brad Turner; Brian Rinker
Epidemiological studies show female survival benefit in advanced metastatic melanoma. In investigating a possible mechanism for this female survival benefit, we have previously reported that the female steroid 17?-oestradiol significantly reduces invasion of a human melanoma cell line (A375-SM cells) and ocular melanoma cells through fibronectin. Neither cell type was found to possess oestrogen receptor-?. The aim of the current study was to obtain further information on the extent to which...
Richardson, B.; Price, A; Wagner, M.; Williams, V.; Lorigan, P.; Browne, S.; Miller, J. G.; Neil, S. Mac
To reveal the clonal architecture of melanoma and associated driver mutations, whole genome sequencing (WGS) and targeted extension sequencing were used to characterize 124 melanoma cases. Significantly mutated gene analysis using 13 WGS cases and 15 additional paired extension cases identified known melanoma genes such as BRAF, NRAS, and CDKN2A, as well as a novel gene EPHA3, previously implicated in other cancer types. Extension studies using tumors from another 96 patients discovered a lar...
Ding, Li; Kim, Minjung; Kanchi, Krishna L.; Dees, Nathan D.; Lu, Charles; Griffith, Malachi; Fenstermacher, David; Sung, Hyeran; Miller, Christopher A.; Goetz, Brian; Wendl, Michael C.; Griffith, Obi; Cornelius, Lynn A.; Linette, Gerald P.; Mcmichael, Joshua F.
The article discusses one of the problems of oncology — skin melanoma. The research objective is to study and to compare diagnostic methods of preinvasive melanoma including fluorescence diagnosis, dermatoscopy and microwave radiometry. Materials and Methods: The survey has used dermatoscope of Heine Delta 20 Company, the unit RTM-01-RES and the instrument of fluorescent diagnostics «Spectrum-Cluster.» The results suggest the possibility of early detection of melanoma with the use of derm...
Kozlov S.V.; Neretin ?.?.
Full Text Available FUNDAMENTOS: As características do melanoma acrolentiginoso (MAL diagnosticado no Brasil são pouco estudadas. OBJETIVOS: Avaliar as características do MAL diagnosticado na Unidade de Melanoma da Santa Casa de São Paulo - UMSC, comparando essa manifestação com outros subtipos e verificar se as possíveis diferenças entre eles teriam importância na determinação do diagnóstico, tratamento e prognóstico. MÉTODO: A Casuística da UMSC foi subdividida em dois grupos, um de melanoma acrolentiginoso (MAL e outro de melanoma não acrolentiginoso (NAL, que foram comparados quanto a sexo, cor, idade, espessura e nível de invasão da lesão primária, estadiamento, tempo decorrido entre a percepção do tumor e o atendimento pelo médico. RESULTADOS: A casuística correspondente ao MAL mostrou freqüência significativa de pacientes não brancos, com faixa etária mais elevada, com a lesão primária em média, mais espessa e ulcerada. Não ocorreram diferenças significativas quanto ao sexo e estadiamento, bem como com relação ao tempo decorrido entre perceber a neoplasia e procurar o médico. CONCLUSÕES: O MAL diagnosticado na UMSC ocorre, principalmente, em pacientes que normalmente não são alertados para câncer da pele (não brancos e pertencem a uma faixa etária mais elevada (portanto, do ponto de vista teórico, poderiam estar menos atentos ao início da doença. A maioria apresentou lesão espessa e ulcerada, conseqüentemente de maior risco para metástases. Essa forma de câncer é desconhecida do público em geral e mesmo por boa parcela da classe médica.BACKGROUND: The characteristics of acral lentiginous melanoma diagnosed in Brazil have been subject to few studies. OBJECTIVES: To evaluate the characteristics of acral lentiginous melanoma diagnosed at the Melanoma Unit of Santa Casa Hospital of Sao Paulo, to compare them with the other melanoma subtypes and to verify whether the possible differences between them are important in the determination of the diagnosis, treatment and prognosis. METHOD: Patients were divided into acral lentiginous melanoma and non-acral lentiginous melanoma groups and compared in reference to sex, color, age, depth and level of invasion of the primary lesion, stage, time between perceiving the tumor and seeking medical assistance. RESULTS: The cases of acral lentiginous melanoma were significantly more frequent among non-whites and the elderly, with the primary lesion, on average deeper and ulcerated, without significant differences in the sex, stage or the time elapsed between noticing the neoplasia and seeking the physician. CONCLUSIONS: Acral lentiginous melanoma diagnosed at the Melanoma Unit of Santa Casa Hospital of Sao Paulo, occurred mainly: in patients: who had not been advised about skin cancer (non-whites and patients who are elderly and therefore, theoretically, could be less liable to notice the onset of the disease. The majority also presented deeper and ulcerated lesions and consequently with a higher risk of metastasis. This kind of cancer is unknown to the public in general and even to a large number of physicians.
Full Text Available FUNDAMENTOS: A incidência e a mortalidade por melanoma cutâneo vêm aumentando em todo o mundo. Os registros brasileiros de bases populacionais não refletem precisamente a real dimensão do problema. OBJETIVOS: Estudo prospectivo de 65 casos de melanoma cutâneo observados no Hospital Universitário Clementino Fraga Filho no período de 1993 a 2003. MÉTODOS: Foram analisadas as variáveis idade, sexo, cor, localização, tipos clínico-histológicos e estadiamento. RESULTADOS: 64,7% na faixa etária de 40 a 69 anos, distribuição etária homogênea entre o sexo masculino (49,2% e o sexo feminino (50,8%, predominância de brancos (83%, localização no tronco (35,3%, tipo clínico-histológico expansivo superficial (63%/30,7% e relação de significância entre tipo acral localizado no pé em não brancos. Segundo o American Joint Committee on Cancer, em 2002, 22 casos (33,8% no estádio IA, 14 (21,5% melanomas in situ e um caso indeterminado. CONCLUSÕES: O melanoma cutâneo primário na amostra estudada mostrou padrões semelhantes aos classicamente reconhecidos e maior freqüência do estádio IA e melanoma in situ.BACKGROUND: Incidence and mortality of cutaneous melanoma are increasing all over the world. The data base for the Brazilian population is still inadequate. OBJECTIVES: Prospective study of 65 cases seen at University Hospital Clementino Fraga Filho, from 1993 to 2003. METHODS: Patient's age, sex, ethnic group, anatomic site, clinical histological presentation and staging were analyzed. RESULTS: The case distribution was 64.7% aged 40 to 69 years, males (49.2% and females (50.8%, majority white (83.1%, most lesions in the trunk (35.3%, more frequently of the clinical histological superficial spreading type (63%/30.7% and significant relationship between foot acral type in non-whites. According to American Joint Committee on Cancer 2002 system, 22 cases (33.8% in stage IA, 14 (21.5% melanomas in situ, and one indeterminate case. CONCLUSIONS: Primary cutaneous melanoma in the present study has a similar pattern to other published series and higher frequency of stage IA and in situ melanomas.
Nurimar C. Fernandes
Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese FUNDAMENTOS: A incidência e a mortalidade por melanoma cutâneo vêm aumentando em todo o mundo. Os registros brasileiros de bases populacionais não refletem precisamente a real dimensão do problema. OBJETIVOS: Estudo prospectivo de 65 casos de melanoma cutâneo observados no Hospital Universitário Cle [...] mentino Fraga Filho no período de 1993 a 2003. MÉTODOS: Foram analisadas as variáveis idade, sexo, cor, localização, tipos clínico-histológicos e estadiamento. RESULTADOS: 64,7% na faixa etária de 40 a 69 anos, distribuição etária homogênea entre o sexo masculino (49,2%) e o sexo feminino (50,8%), predominância de brancos (83%), localização no tronco (35,3%), tipo clínico-histológico expansivo superficial (63%/30,7%) e relação de significância entre tipo acral localizado no pé em não brancos. Segundo o American Joint Committee on Cancer, em 2002, 22 casos (33,8%) no estádio IA, 14 (21,5%) melanomas in situ e um caso indeterminado. CONCLUSÕES: O melanoma cutâneo primário na amostra estudada mostrou padrões semelhantes aos classicamente reconhecidos e maior freqüência do estádio IA e melanoma in situ. Abstract in english BACKGROUND: Incidence and mortality of cutaneous melanoma are increasing all over the world. The data base for the Brazilian population is still inadequate. OBJECTIVES: Prospective study of 65 cases seen at University Hospital Clementino Fraga Filho, from 1993 to 2003. METHODS: Patient's age, sex, e [...] thnic group, anatomic site, clinical histological presentation and staging were analyzed. RESULTS: The case distribution was 64.7% aged 40 to 69 years, males (49.2%) and females (50.8%), majority white (83.1%), most lesions in the trunk (35.3%), more frequently of the clinical histological superficial spreading type (63%/30.7%) and significant relationship between foot acral type in non-whites. According to American Joint Committee on Cancer 2002 system, 22 cases (33.8%) in stage IA, 14 (21.5%) melanomas in situ, and one indeterminate case. CONCLUSIONS: Primary cutaneous melanoma in the present study has a similar pattern to other published series and higher frequency of stage IA and in situ melanomas.
Nurimar C., Fernandes; Roberto, Calmon; Juan P., Maceira; Tullia, Cuzzi; Cesar S. Claudio da, Silva.
Identification of metastatic melanoma can be difficult because of its great morphological variation and mimicry of a wide variety of other tumors. The more melanoma specific melanoma markers: melanA/MART-1, HMB45, and tyrosinase, used in addition to S100 protein, each have limitations in sensitivity and specicifity. In this study, we evaluated two newer melanoma markers: monoclonal antibodies KBA62 and PNL2 to yet unidentified antigens, using a large panel of metastatic melanomas (n=214), des...
Aung, Phyu P.; Maarit-Sarlomo-Rikala; Lasota, Jerzy; Lai, Jin-ping; Wang, Zeng-feng; Miettinen, Markku
Full Text Available SciELO Colombia | Language: Spanish Abstract in spanish El melanoma lentiginoso acral (MLA) es una variante rápidamente progresiva del melanoma maligno (MM). Constituye el 5-10% de los MM y se presenta con mayor frecuencia en pacientes de raza negra, asiáticos y latinoamericanos. En Colombia, la frecuencia de MM se encuentra en aumento y el MLA es una de [...] las variantes más comunes (14,7% de todos los melanomas). La edad promedio de presentación es de 58 años, con una tasa de supervivencia menor para las personas de raza negra, asociada al diagnóstico tardío. EL MLA se localiza en las plantas, palmas y regiones subungueales y en su etiopatología se ha descrito la presencia de mutaciones en varios genes: 9p21 p16: (67%), 11q13 (CCND1) (47%), 22q11-q13 (40%) y 5p15 (20%). El diagnóstico de MLA se ha fundamentado clásicamente en la histopatología; sin embargo, otros métodos como la dermatoscopia, la evaluación del ganglio centinela y la detección de alteraciones en las proteínas del ciclo celular pueden contribuir al diagnóstico precoz y a mejorar el pronóstico tanto del MLA como del MM en general. Abstract in english Acral lentiginous melanoma (ALM) is a rapidly progressive variant of malignant melanoma (MM). It constitutes 5-10% of all cases of MM and its prevalence is higher in blacks, Asians and Latin Americans. In Colombia, the incidence of MM is increasing and ALM is one of its most common variants (14.7% o [...] f all melanoma cases). The mean age at presentation of the disease is 58 years, and the survival rate is lower in black people, partly due to delayed diagnoses. ALM is located in the soles, palms and subungual regions. Mutations in several genes have been described in the pathogenesis of ALM, namely: 9p21 (p16: 67%), 11q13 (CCND1) (47%), 22q11-q13 (40%) and 5p15 (20%). The diagnosis of ALM has been traditionally based on histopathology; however, other diagnostic tools such as dermoscopy, evaluation of the sentinel lymph node and detection of alterations in proteins that control the cell cycle, may contribute to earlier diagnoses and, consequently, improve the prognosis of both ALM and MM.
Lina María, Colmenares Roldán; Margarita, Velásquez Lopera; Gloria Andrea, Vargas Suaza.
Circulating tumor cells have emerged as prognostic biomarkers in the treatment of metastatic cancers of epithelial origins viz., breast, colorectal and prostate. These tumors express Epithelial Cell Adhesion Molecule (EpCAM) on their cell surface which is used as an antigen for immunoaffinity capture. However, EpCAM capture technologies are of limited utility for non-epithelial cancers such as melanoma. We report a method to enrich Circulating Melanoma Cells (CMCs) that does not presuppose malignant cell characteristics. CMCs were enriched by centrifugation of blood samples from healthy (N = 10) and patient (N = 11) donors, followed by RBC lysis and immunomagnetic depletion of CD45-positive leukocytes in a specialized magnetic separator. CMCs were identified by immunocytochemistry using Melan-A or S100B as melanoma markers and enumerated using automated microscopy image analyses. Separation was optimized for maximum sensitivity and recovery of CMCs. Our results indicate large number of CMCs in Stage IV melanoma patients. Analysis of survival suggested a trend toward decreased survival with increased number of CMCs. Moreover, melanoma-associated miRs were found to be higher in CMC-enriched fractions in two patients when compared with the unseparated samples, validating this method as applicable for molecular analyses. Negative selection is a promising approach for isolation of CMCs and other EpCAM -negative CTCs, and is amenable to molecular analysis of CMCs. Further studies are required to validate its efficacy at capturing specific circulating cells for genomic analysis, and xenograft studies. PMID:24811334
Joshi, Powrnima; Jacobs, Barbara; Derakhshan, Adeeb; Moore, Lee R; Elson, Paul; Triozzi, Pierre L; Borden, Ernest; Zborowski, Maciej
On the basis that melanomas are of neural crest origin and might contain somatostatin receptors, the authors utilized 111In Pentetreotide (OctreoScan) to image 16 melanoma patients with known sites of disease. Twelve of 16 patients were positive with 38 percent imaging all sites. No lesion less than 1.5 cm imaged nor did one ocular and one amelanotic melanoma. Of the five described somatostatin receptors, OctreoScan binds only 2 and 5 suggesting that not all melanomas contain those receptors....
Fletcher, W. S.; Lum, S. S.; Nance, R. W.; Pommier, R. F.; O Dorisio, M. S.
The molecular changes associated with the transition of melanoma cells from radial growth phase (RGP) to vertical growth phase (VGP, metastatic phenotype) are not yet well defined. We have demonstrated that the progression of human melanoma is associated with loss of expression of the transcription factor AP-2. In metastatic melanoma cells, this loss resulted in overexpression of MCAM/MUC18, MMP-2, the thrombin receptor (PAR-1), and lack of c-KIT expression. The transition from RGP to VGP is also associated with overexpression of the angiogenic factor IL-8. Additionally, the transition of melanoma cells from RGP to VGP is associated with overexpression of the transcription factors CREB and ATF-1, both of which may act as survival factors for human melanoma cells. Inactivation of CREB/ATF-1 activities in metastatic melanoma cells by dominant-negative CREB or by anti-ATF-1 single chain antibody fragment (ScFv), resulted in deregulation of MMP-2 and MCAM/MUC18, increased the sensitivity of melanoma cells to apoptosis, and inhibition of their tumorigenicity and metastatic potential in vivo. In this prospect article, we summarize our data on the role of AP-2 and CREB/ATF-1 in the progression of human melanoma and report on the development of new fully human antibodies anti-MCAM/MUC18 and anti-IL-8 which could serve as new modalities for the treatment of melanoma. PMID:15523674
Leslie, Michael C; Bar-Eli, Menashe
Thermal neutrons are easily absorbed by the nonradioactive isotope 10B, resulting in the emission of alpha particles and lithium atoms, which release an energy of 2.33 MeV for up to a 14-?m-diam melanoma cell. Thus, if 10B can be selectively accumulated in melanoma, it can be destroyed without injury to the surrounding normal tissues by concentrating high linear energy transfer particles. The authors have synthesized seven melanoma-seeking 10B compounds, two of which, 10B12-chlorpromazine(10B12-CPZ) and 10B1-p-boronophenylalanine(10B1-BPA), are found to be highly effective. The enhanced melanoma-killing effect of the 10B compounds is found by in vitro radiobiological analysis. A chemical assay and alpha-track analysis 28 h after systemic administration to melanoma-bearing hamsters reveals a 10B melanoma/blood ratio of 11.5 and a melanoma/liver ratio of 15. Establishment of a clinical therapeutic method for curing human melanoma without failure is underway by correlating biophysical, biochemical, biological, and therapeutic data analysis. Recently, the authors have also been working to develop neutron capture therapy using 10B-monoclonal antibodies for melanoma and were able to make some 10B conjugates with the specific m259-0 antibody
We used contact irradiation with iodine 125 seeds to treat a large, exulcerative, nodular, amelanotic malignant eyelid melanoma with metastasis to the regional lymph nodes in an 80-year-old man. The procedure was similar to iodine 125 plaque irradiation of malignant choroidal melanoma; special equipment, however, was needed to protect the eye from radiation exposure. The response of the malignant eyelid melanoma to iodine 125 plaque irradiation was similar to that of malignant melanomas of the choroid. No complications were observed in a follow-up period of 15 months. PMID:2368820
Stanowsky, A; Krey, H F; Kopp, J; Kanitz, W; Wagner, T
We used contact irradiation with iodine 125 seeds to treat a large, exulcerative, nodular, amelanotic malignant eyelid melanoma with metastasis to the regional lymph nodes in an 80-year-old man. The procedure was similar to iodine 125 plaque irradiation of malignant choroidal melanoma; special equipment, however, was needed to protect the eye from radiation exposure. The response of the malignant eyelid melanoma to iodine 125 plaque irradiation was similar to that of malignant melanomas of the choroid. No complications were observed in a follow-up period of 15 months.
Stanowsky, A.; Krey, H.F.; Kopp, J.; Kanitz, W.; Wagner, T. (Eye Clinic, Central Clinic, Augsburg (West Germany))
We used contact irradiation with iodine 125 seeds to treat a large, exulcerative, nodular, amelanotic malignant eyelid melanoma with metastasis to the regional lymph nodes in an 80-year-old man. The procedure was similar to iodine 125 plaque irradiation of malignant choroidal melanoma; special equipment, however, was needed to protect the eye from radiation exposure. The response of the malignant eyelid melanoma to iodine 125 plaque irradiation was similar to that of malignant melanomas of the choroid. No complications were observed in a follow-up period of 15 months
Distinct melanoma types exist in relation to patient characteristics, tumor morphology, histopathologic aspects and genetic background. A new diagnostic imaging tool, reflectance confocal microscopy (RCM), allows in vivo analysis of a given lesion with nearly histologic resolution while offering a dynamic view of the tissue in its 'natural' environment. The aim of this study was to analyse cell morphology of consecutive melanomas as they appear on RCM and to correlate morphology with tumor and patient characteristics. One hundred melanomas were visualized by RCM before excision. Clinical data, confocal features and histologic criteria were analysed. Four types of melanomas were identified as follows: (i) Melanomas with a predominantly dendritic cell population ('dendritic-cell melanomas') typically were thin by Breslow index; (ii) Melanomas typified by roundish melanocytes were smaller in size than dendritic cell MMs, but thicker by Breslow index, and predominantly occurred in patients with a high nevus count; (iii) Melanomas characterized by dermal nesting proliferation usually were thick by Breslow index at the time of diagnosis, although frequently smaller in size compared with the other types; and (iv) combined type melanomas may represent an evolution of dendritic cell and/or round cell types. Integration of confocal microscopy with clinical and histologic aspects may help in identifying and managing distinct tumors. PMID:24750486
Pellacani, Giovanni; De Pace, Barbara; Reggiani, Camilla; Cesinaro, Anna Maria; Argenziano, Giuseppe; Zalaudek, Iris; Soyer, H Peter; Longo, Caterina
Hybrids between certain species of the teleost Xiphophorus predictably develop melanomas. Classical Mendelian crossing experiments have allowed us to identify genetic loci involved in eliciting and in suppressing tumorigenesis. The overall picture is that melanoma formation results from functional elimination of a suppressor locus allowing abnormal expression of a melanoma locus. Melanoma formation in Xiphophorus behaves like a recessive trait. The fish melanomas consist of incompletely differentiated pigment cells and in many aspects resemble their murine and human counterparts. Cytogenetic studies of cells of the genetic melanomas have provided evidence for chromosomal abnormalities. In particular, cytogenetic manifestations of amplified DNA were detected in a cell line derived from a malignant melanoma. Amplified DNA was isolated and was found to be amplified in a particular type of genetic melanoma. Our results suggest that genetic changes in addition to elimination of suppressor genes contribute to the malignant phenotype of melanoma in Xiphophorus. It is possible that a similar situation occurs in cancers of higher vertebrates, including humans. PMID:2743831
We recently reported an increased risk of uveal melanoma among mobile phone users. Here, we present the results of a case–control study that assessed the association between mobile phone use and risk of uveal melanoma. We recruited 459 uveal melanoma case patients at the University of Duisburg-Essen and matched 455 case patients with 827 population control subjects, 133 with 180 ophthalmologist control subjects, and 187 with 187 sibling control subjects. We used a questionnaire to assess mo...
Stang, Andreas; Schmidt-pokrzywniak, Andrea; Lash, Timothy L.; Lommatzsch, Peter Karl; Taubert, Gerhard; Bornfeld, Norbert; Jo?ckel, Karl-heinz
We report here on a rare case of primary malignant melanoma of the female urethra. A 69-year-old female presented at our hospital with a several month history of dysuria, poor stream, gross hematuria, intermittent blood spots, and a painful mass at the external urethral meatus. The physical examination revealed a soft, small, chestnut-sized lesion through the urethral orifice. The mass was tan colored, ulcerated, covered with necrotic tissue, and protruded from the external urethral meatus. The mass was removed by wide local excision under spinal anesthesia. The pathological diagnosis was malignant melanoma of the urethra. Computed tomography of the abdomen as well as a whole-body bone scan showed no evidence of metastasis. The patient has been free of disease for 6 months postoperatively. We discuss the clinicopathologic features and treatment of this tumor. PMID:22468218
Song, Hyeong Cheol; Cho, Byungchul; Choi, Woo Seok; Lee, Won Ki; Lee, Yong Seong; Lee, Young Goo; Kim, Ki Kyung; Park, Sung-Ho; Kim, Jeong Won
The case of a 49-year-old woman with an intermediate-sized choroidal melanoma who was treated with stereotactic radiosurgery with good tumour resolution is presented. Sight and globe preservation were achieved. The treatment technique is discussed. Stereotactic radiosurgery or fractionated stereotactic radiotherapy techniques offer new options for selected cases with intermediate-sized choroidal melanomas with preserved vision and where large apical height dimensions suggest excessive risk of treatment-related complications from episcleral plaque therapy. Although it is widely used in the treatment of small intracranial lesions experience in treating intraocular conditions is limited. The optimal dose fractionation is unknown. A single dose of 25 Gy in this instance has produced a good tumour response with acceptable ocular morbidity. Long-term local control however is yet to be determined. Newer systems that allow better ocular immobilization are required. Copyright (1999) Blackwell Science Pty Ltd
Twenty-eight cases of posterior choroidal melanoma were treated with iodine-125 in gold eye plaques. Eleven cases were located within 3.0 mm of the optic nerve (group A), nine were within 3.0 mm of the fovea (group B), and eight were within 3.0 mm of the optic nerve and fovea (group C). The mean follow-up of group A was 46.3 months; group B, 25.5 months; and group C, 42.7 months. Complications included macular edema, cataract and tumor growth. Visual acuity remained within two lines of that tested preoperatively for 4 of 11 patients in group A, 4 of 9 in group B, and 5 of 8 in group C. These results with iodine-125 suggest it as an appropriate treatment for patients with choroidal melanoma located near optic nerve and/or macula.
Purpose: The mucous melanoma of superior aero-digestive tracts represents 1-2% of malignant melanomas, 5-10% of head and neck melanomas, and concerns particularly, the nasal cavities and naso-sinus cavities. The recurrences are frequent, often local ones, sometimes multifocal ones, the survival rate at five years is ? 30%. The Ballantyne classification distinguishes three stages: 1 localised tumors, 2 ganglions attack, 3 metastases. Are pejorative: a stage number 3 ( deep invasion, muscles, bones, cartilages) according to the Prasad classification (1: in situ or micro invasive, 2: invasion of the lamina propria), the achromia sub-type, a pseudo papillary or sarcoma, vascular emboli, necrosis. The recommendations rest on evidence level at 4. The complete excision is the rule and must be counterbalanced with the morbidity in case of orbital, dura-mater, frontal lobe, and infra temporal fossa. The adjuvant irradiation is debated.We evaluated the prognosis of mucous naso-sinus melanomas. Conclusion: The principal cause of death was the local failure. The Ballantyne classification does not take into account the extensions and overestimates the prognosis impact of ganglions invasion that is yet ?10% ( and does not justify a radiotherapy in lack of adenopathy). It underestimates probably the impact of adjuvant radiotherapy. One should be able to distinguish the unfavourable stage 1 tumors (receiving eventually a radiotherapy) and these ones of very localised stage 1 for se ones of very localised stage 1 for which it could be omitted. The fractionation and the optimal dose remain to be defined. The volume ?100 ml and the irradiation by carbon ions seem promising in term of local control but the metastases stay a problem in the recent series. (N.C.)
Full Text Available SciELO Brazil | Language: English Abstract in english We describe a case of plantar interdigital cutaneous melanoma in a 22-year-old woman who reported changes in a pigmented lesion during pregnancy. Diagnosis was late and evolution unfavourable. The purpose of this report is to draw the attention of dermatologists to the need for careful regular exami [...] nation of melanocytic lesions in pregnant women, not ignoring possible changes as always physiological.
Natalia Cammarosano, Mestnik; Joao Paulo Junqueira Magalhaes, Afonso; Milvia Maria Simoes e Silva, Enokihara; Mauro Yoshiaki, Enokihara; Adriana Maria, Porro; Sergio Henrique, Hirata.
We report here on a rare case of primary malignant melanoma of the female urethra. A 69-year-old female presented at our hospital with a several month history of dysuria, poor stream, gross hematuria, intermittent blood spots, and a painful mass at the external urethral meatus. The physical examination revealed a soft, small, chestnut-sized lesion through the urethral orifice. The mass was tan colored, ulcerated, covered with necrotic tissue, and protruded from the external urethral meatus. T...
Cho, Sung Tae; Song, Hyeong Cheol; Cho, Byungchul; Choi, Woo Seok; Lee, Won Ki; Lee, Yong Seong; Lee, Young Goo; Kim, Ki Kyung; Park, Sung-ho; Kim, Jeong Won
O melanoma deriva da transformação maligna de melanócitos e é frequentemente encontrado na pele e na região ocular. A identificação de marcadores moleculares que inequivocamente indiquem a agressividade do tumor ou que possam prever a resposta/resistência a uma terapia é uma prioridade da comunidade científica que estuda esta patologia. Mutações do gene do BRAF, maioritariamente V600E e mutações do gene do NRAS têm sido implicadas no desenvolvimento de melanom...
Tavares, Sandra Raquel Oliveira
Although rare, uveal melanoma is the most common intraocular tumor in adults. Most cases arise from the choroidal layer of the uvea, displaying a discoid, collar-button, or mushroom shaped growth. Histopathologically, neoplasms are classified by the dominant cell type: spindle, epithelioid or mixed spindle cell type. The most important prognostic factors are cell type, nucleolar size, largest tumor dimension, and mitotic figures. Patient prognosis is poor when metastases occur in the liver, o...
Miyamoto, Cristina; Balazsi, Matthew; Bakalian, Silvin; Fernandes, Bruno F.; Burnier, Miguel N.
Fundamento: los melanomas de coroides son considerados los tumores malignos más frecuentes en el adulto, aparece generalmente entre la sexta y séptima década de la vida y se diagnostica a través de la oftalmoscopia, la biomiscroscopia, el ultrasonido y la angiografía fluoresceínica. Su forma de presentación puede ser en su variante nodular o difusa la malignidad depende del tamaño del tumor, la localización, extensión extra escleral, tipo histológico, entre otros factores. La causa...
Edguez Pargas, Aymed Rodr U.; Leonor Gallardo Roca; Vez Pardo, Iris Ch U. E.; Xiomara Borrego Lastre
The incidence of, and mortality from, malignant melanoma of skin in whites are strongly influenced by socio-economic conditions. Professional and administrative workers have the highest rates of all. Clerks and salesmen have higher rates than skilled manual workers, who have higher rates than unskilled workers. Women, when classified by the occupation of their husbands, show a similar relationship to social status. The biases of incidence data from systems of cancer registration, and mortalit...
Lee, J. A.; Strickland, D.
A 67-year-old man of Chinese descent presented with a painless nodular lesion that had been present on his right forearm for the previous 3 months. A single, well-defined, dome-shaped, firm nodule with a central keratin plug surrounded by erythema was noted. Keratoacanthoma with secondary bacterial infection was suspected and the patient underwent an excision biopsy. Biopsy of the nodule and immunohistochemical staining supported a diagnosis of nodular malignant melanoma. It should be noted b...
Leelavathi Muthupalaniappen; Srijit Das2,; Norazirah Md Nor; Ali, Siti A. M.
A 45-year-old woman, complaining of sudden visual loss in the right eye (best-corrected visual acuity: 17/200), was suspected of having a malignant melanoma of the choroid. Fundus examination revealed a massive pale-colored subretinal mass temporal to the fovea, with adjoining choroidal folds and exudative retinal detachment. Ultrasonography was suggestive of posterior scleritis. Systemic evaluation was unremarkable. The patient was treated with high-dose systemic corticosteroids. The mass le...
Shukla Dhananjay; Kim Ramasamy
Uveal melanoma (UM) is a disease with many faces: ophthalmologists treat the primary tumor, but the patient faces the problem of developing metastases, which are often deadly after a short period. Recent insight, indicates the need for knowledge-based treatment of UM. The ‘pseudohypoxic’ and tumor promoting effects of bevacizumab as described in this thesis is especially relevant. Bevacizumab is frequently used off-label to treat macular edema in UM patients suffering of radiation r...
Filali, Mariam El
The outcome of patients with mucosal melanoma treated with ipilimumab is not defined. To assess the efficacy and safety of ipilimumab in this melanoma subset, we performed a multicenter, retrospective analysis of 33 patients with unresectable or metastatic mucosal melanoma treated with ipilimumab. The clinical characteristics, treatments, toxicities, radiographic assessment of disease burden by central radiology review at each site, and mutational profiles of the patients' tumors were recorded. Available peripheral blood samples were used to assess humoral immunity against a panel of cancer-testis antigens and other antigens. By the immune-related response criteria of the 30 patients who underwent radiographic assessment after ipilimumab at approximately week 12, there were 1 immune-related complete response, 1 immune-related partial response, 6 immune-related stable disease, and 22 immune-related progressive disease. By the modified World Health Organization criteria, there were 1 immune-related complete response, 1 immune-related partial response, 5 immune-related stable disease, and 23 immune-related progressive disease. Immune-related adverse events (as graded by Common Terminology Criteria for Adverse Events version 4.0) consisted of six patients with rash (four grade 1, two grade 2), three patients with diarrhea (one grade 1, two grade 3), one patient with grade 1 thyroiditis, one patient with grade 3 hepatitis, and 1 patient with grade 2 hypophysitis. The median overall survival from the time of the first dose of ipilimumab was 6.4 months (range: 1.8–26.7 months). Several patients demonstrated serologic responses to cancer-testis antigens and other antigens. Durable responses to ipilimumab were observed, but the overall response rate was low. Additional investigation is necessary to clarify the role of ipilimumab in patients with mucosal melanoma. PMID:23716015
Postow, Michael A.; Luke, Jason J.; Bluth, Mark J.; Ramaiya, Nikhil; Panageas, Katherine S.; Lawrence, Donald P.; Ibrahim, Nageatte; Flaherty, Keith T.; Sullivan, Ryan J.; Ott, Patrick A.; Callahan, Margaret K.; Harding, James J.; D'Angelo, Sandra P.; Dickson, Mark A.; Schwartz, Gary K.; Chapman, Paul B.; Gnjatic, Sacha; Wolchok, Jedd D.; Hodi, F. Stephen
As a concept sentinel lymph node biopsy seems attractive in that it attempts to identify the first lymph node, rather than the nearest node, draining a particular anatomic area where a tumour has arisen. Pathological assessment can then indicate whether metastases are present and the procedure is either a strong prognostic indicator or possibly therapeutic in itself. These comments apply to any tumour type, but with melanoma the pathological procedure is more problematic and any bene...
Cook, M. G.; Di Palma, S.
Purpose: To report a patient with small juxtapapillary choroidal melanoma with chromosome 3 monosomy treated with I 125 plaque and transpupillary thermotherapy (TTT). A 64-year-old Caucasian male presented with painless blurred vision of the left eye. Ocular examination disclosed a small juxtapapillary choroidal melanocytic tumor with overlying subretinal fluid and orange pigment. Ultrasound showed an elevated choroidal mass of 2 mm thickness with low reflectivity on A-sca...
Ghassemi Fariba; Shields Carol; Materin Miguel; Shields Jerry
It is generally agreed that sunlight exposure is one of the etiologic agents in malignant melanoma of fair-skinned individuals. However, the wavelengths responsible for tumorigenesis are not known, although DNA is assumed to be the target because individuals defective in the repair of UV damage to DNA are several thousandfold more prone to the disease than the average population. Heavily pigmented backcross hybrids of the genus Xiphophorus (platyfish and swordtails) are very sensitive to mela...
Setlow, R. B.; Grist, E.; Thompson, K.; Woodhead, A. D.
Full Text Available Nicola G Ghazi1, Christopher S Ketcherside1, Jason Sheehan2, Brian P Conway11Department of Ophthalmology and 2Neurosurgery, University of Virginia Health System, Charlottesville, VA, USAPurpose: To report outcomes of Gamma Knife radiosurgery (GKRS in treating uveal melanoma lesions ineligible for standard brachytherapy.Methods: A retrospective interventional case series of uveal melanoma patients treated with GKRS between 1996 and 2004 was performed. The main outcome measures were local tumor control, metastasis, and death.Results: Four patients with uveal melanoma treated with GKS were identified. Three tumors involved the ciliary body and one was macular with its border within 2 mm of the optic disc. Adequate globe stabilization was achieved by retrobulbar anesthesia in all cases. Pretreatment mean visual acuity was 20/30. Tumor volume as determined by magnetic resonance imaging ranged from 0.05 to 0.30 cc. Ultrasonographic greatest tumor diameter and height ranged from 11 to 18 mm (mean 14.5 mm and 2.9 to 4.5 mm (mean 3.6 mm, respectively. The peripheral dose varied from 16.5 to 30 Gray. Local tumor control was achieved in all cases over a follow up period of 6 to 96 months. Mean final visual acuity was 20/50. One eye was enucleated for neovascular glaucoma and one patient died from liver and lung metastasis.Conclusions: GKRS for uveal melanoma appears to be safe and effective. The metastasis and mortality rates appear to be comparable to those following brachytherapy and enucleation. Moreover, local tumor control and enucleation rates are similar to those following brachytherapy. The findings in this small series suggest a role for GKRS in the treatment of selected cases of uveal melanomas.Keywords: gamma knife radiosurgery, radiation therapy, uveal melanoma
Nicola G Ghazi
Full Text Available SciELO Brazil | Language: English Abstract in english BACKGROUND: Primary cutaneous melanoma still constitutes the main cause of skin cancer death in developed countries, and its incidence in recent years has been increasing in a steady, worrisome manner. OBJECTIVES: This study evaluated the clinical, epidemiological and demographic aspects of this dis [...] ease, and correlated them with patient prognosis. METHODS: Using epidemiologic and clinical data, we analyzed 84 patients with mild to severe primary cutaneous melanoma treated between 1990 and 2007. Slides containing surgical specimens were analyzed, and new slides were made from archived paraffin sections when necessary. RESULTS: The melanoma incidence was higher in areas of sun exposure, with lesions commonly observed in the trunk for males, and lower limbs for females. In addition to Breslow's thickness and ulceration (p = 0.043 and p 1 mm and 4 mm) and the mitotic index (0 when absent or 1 when >1 per mm²) allowed the establishment of a prognostic score: if the sum was equal to or over three, nearly all (91.7%) patients had systemic disease. The 5-year survival was approximately seventy percent. CONCLUSION: Because American Join Committee of Cancer Staging will update the classification of malignant tumors (TNM) staging in the near future, and introduce mitosis as a prognostic factor, our results show the importance of such a feature. Additional studies are necessary to confirm the importance of a prognostic score as proposed herein.
Moris, Anger; Henri, Friedhofer; Marina Fussae, Fukutaki; Marcus Castro, Ferreira; Gilles, Landman.
Full Text Available A 41-year-old man presented with a 6-mo history of changed defecation and rectal bleeding. A 3-cm polypoid tumor of the lower rectum was found at rectosigmoidoscopy, which proved to be a leiomyosarcoma upon biopsy. Dissemination studies did not show any metastases. He was underwent to an abdomino-perineal resection (APR. Histopathology of the specimen showed a melanoma (S-100 stain positive. Two years after the resection, metastases in the abdomen and right lung were found. He died one and half years later. Primary anorectal melanoma is a rare and very aggressive disorder. According to current data, one should always perform a S-100 stain when anorectal sarcoma is suspected. A positive S-100 stain suggests the tumour to be most likely a melanoma. Subsequently, thorough dissemination studies need to be performed. Depending on the outcome of the dissemination studies, a surgical resection has to be performed. Nowadays, a sphincter-saving local excision combined with adjuvant loco-regional radiotherapy should be preferred in case of small tumors. The same loco-regional control is achieved with less “loss of function” compared to non-sphincter saving surgery. Only in the case of large and obstructing tumors an abdomino-perineal resection is the treatment of choice.
PM van Schaik, MF Ernst, HA Meijer, K Bosscha
OBJECTIVES:: Chronic pain is a well-known complication after surgery, but the prevalence of persistent pain after melanoma surgery is unknown. This study examined the prevalence and predictors of persistent pain after melanoma surgery. METHODS:: Between September 2005 and June 2009, 448 patients underwent surgery for cutaneous melanoma at the Department of Plastic Surgery, Aalborg Hospital. A questionnaire was sent to all 402 survivors, and 350 (87.1%) responded. In addition, all patients with pain and a control group of sex-matched and age-matched patients without pain were invited to a clinical examination. RESULTS:: Thirty-four patients (9.7%) reported pain in the scar area within the last month, and 8.6% reported chronic pain. The pain was mostly mild with little impact on daily life, but 1.7% reported moderate to severe pain, and 3.4% reported at least moderate impact of pain on daily life. Sensory changes were reported by 108 patients (31.5%); 25% of these had pain compared with 3% of patients with normal sensation [P
HØimyr, Hilde; von Sperling, Marie Louise
Seventy MeV Proton beam irradiation (beam range:38 mm in the water) was applied for the treatment of 6 patients of ocular melanoma between October 1985 and July 1986 at National Institute of Radiological Sciences(NIRS). The Proton beam has more localized and uniform dose distributions than the electron beams, leading to increased delivery of the dose to tumors with out excess exposure to adjacent normal tissues. Since the accurate treatment planning was necessary for the Proton beam therapy, various studies concerned with the diagnosis of tumor localization using X-CT, MRI or ultrasonography and with the methods for fixation of the body or target using holder or plastic shell were performed. The diagnosis of ocular melanoma was established in the all cases through clinical examinations, such as indirect ophthalmoscopy, fundus photography, fluorescein angiography, ultrasonography and so on. The narrow horizontal Proton beam(10 ? 24 mm diameter) was straightly irradiated to the tumor, through the several thicked bolus, avoiding an exposure to the lens. The dose of 30 ? 60 Gy/3 ? 5 fractions/3 ? 5 weeks (TDF 90 ? 150) was prescribed. Although the follow up studies in order to estimate the tumor response and the complications are not enough to long to evaluate the results, we believe that Proton beam irradiation is considered to be an excellent therapy for the management of ocular melanomas, alternative to enucleation of affected eye. (author)eye. (author)
Full Text Available An in-vitro study of wave spectral analysis in 8 enucleated eyes was conducted in order to differentiate histological subtypes of malignant melanoma. To obtain the backscattering coefficient for the tissues, we used a broadband focussed transducer with a frequency range of 7-12 MHz and a centre frequency of 10 MHz. Experimental measurement of backscattering coefficient and attenuation coefficient at various frequencies was done by substitution techniques. The backscattering coefficient, scatterer size, and root mean square velocity fluctuation were derived by the numerical method, while the attenuation coefficient at 1 MHz was derived from attenuation coefficient at different frequencies. This study revealed that backscattering coefficient and attenuation coefficient, over a frequency range of 7-12 MHz, show an increase in the spindle cell type compared to the mixed cell type of malignant melanoma. Particularly, the scatterer size was significantly higher in the spindle cell group (p = 0.013 in contrast to the mixed cell type. Spindle cells have uniform and compact histological pattern which contributes to an increase in scatterer size and root mean square velocity fluctuation. The ultrasonically obtained parameters have been shown to have a good correlation with the histology of malignant melanoma.
Full Text Available Fundamento: los melanomas de coroides son considerados los tumores malignos más frecuentes en el adulto, aparece generalmente entre la sexta y séptima década de la vida y se diagnostica a través de la oftalmoscopia, la biomiscroscopia, el ultrasonido y la angiografía fluoresceínica. Su forma de presentación puede ser en su variante nodular o difusa la malignidad depende del tamaño del tumor, la localización, extensión extra escleral, tipo histológico, entre otros factores. La causa de muerte por esta enfermedad suele ocurrir por metástasis hepática. Objetivo: evitar el diagnóstico tardío del melanoma ocular. Caso clínico: se presenta el caso de una paciente femenina de 50 años de edad que acudió al centro oftalmológico del Hospital Universitario Manuel Ascunce Domenech, por disminución lenta de la agudeza visual del ojo derecho, detectándose al examen oftalmológico la presencia de una masa tumoral de color pardo que ocupaba la hemiretina superior, lo cual se corroboró con la observación de el ultrasonido ocular, por lo que se decidió proceder a la enucleación del globo ocular debido a las características del mismo. El estudio histopatológico confirmó la presencia de un melanoma de coroides de células tipo mixtas con infiltración a cuerpo ciliar. Los resultados del examen físico general, hematológico e imagenológico fueron negativos, descartándose la presencia de metástasis.
Aymed Rodr\\u00EDguez Pargas
The progression of melanoma toward the metastatic phenotype occurs in a defined stepwise manner. While many molecular changes take place early in melanoma development, progression toward the malignant phenotype, most notably during the transition from the radial growth phase (RGP) to the vertical growth phase (VGP) involves deregulated expression of several transcription factors. For example, the switch from RGP to VGP is associated with the loss of the transcription factor AP2? and gain of transcriptional activity of cAMP-responsive element binding protein. Together with the upregulation of microphthalmia-associated transcription factor, activating transcription factor 2, nuclear factor kappa B, and other transcription factors, these changes lead to dysregulated expression or function of important cellular adhesion molecules, matrix degrading enzymes, survival factors, as well as other factors leading to metastatic melanoma. Additionally, recent evidence suggests that microRNAs and RNA editing machinery influence the expression of transcription factors or are regulated themselves by transcription factors. Many of the downstream signaling molecules regulated by transcription factors, such as protease activated receptor-1, interleukin-8, and MCAM/MUC18 represent new treatment prospects. PMID:22684365
Mobley, Aaron K; Braeuer, Russell R; Kamiya, Takafumi; Shoshan, Einav; Bar-Eli, Menashe
We used positron emission tomography (PET) as an aid in determining whether an enlarging choroidal melanoma was viable after ophthalmic plaque thermoradiotherapy. Radioactively labelled glucose (18-F fluorodeoxyglucose (18F-FDG)) was injected into our patient for scanning. The PET evaluation revealed no evidence of increased 18F-FDG uptake in the region of the choroidal melanoma. This result supported our clinical decision to observe for continued tumor enlargement prior to re-treatment. PET offers the potential to determine whether a tumor is viable after treatment. PET has used injectable radioactive metabolites to image metabolically active tissues. Thus, clinical applications of PET have focused on its' ability to determine whether tumors were metabolically active before and after treatment. Since each patients tumor will likely differ in sensitivity to treatment, PET may offer a better end point to therapy. After radiotherapy of uveal melanoma, local control has been defined as cessation of growth or reduction in tumor size as documented by ophthalmoscopy and/or ultrasonography. If a cancer has been documented to enlarge in anatomic size, it has been considered viable. Post-treatment tumor enlargement can also be caused by radiation induced vasculopathy with hemorrhage, exudation and edema within the tumor. A physiologic assay of tissue function as provided by PET may offer a better method to differentiate the causes of post-treatment tumor enlargement. (author)ost-treatment tumor enlargement. (author)