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Sample records for cutaneous melanoma diagnosis

  1. Sun exposure before and after a diagnosis of cutaneous malignant melanoma

    DEFF Research Database (Denmark)

    Idorn, L W; Philipsen, P A; Wulf, H C

    2011-01-01

    Previous studies on ultraviolet radiation (UVR) exposure before and after a diagnosis of cutaneous malignant melanoma (CMM) have been based primarily on questionnaires. Objective measures are needed....

  2. [Ocular metastasis of cutaneous melanoma].

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    Galland, F; Balansard, B; Conrath, J; Forzano, O; Ridings, B

    2004-02-01

    We report a case of vitreal metastases from cutaneous melanoma. We describe the clinical findings and the histological aspects of the lesions, which allows us to discuss the diagnosis of masquerade syndrome and highlight the diagnostic importance of vitreous biopsy.

  3. Cutaneous melanoma.

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    Eggermont, Alexander M M; Spatz, Alan; Robert, Caroline

    2014-03-01

    In the past decade, major advances have been made in the understanding of melanoma. New predisposition genes have been reported and key somatic events, such as BRAF mutation, directly translated into therapeutic management. Surgery for localised melanoma and regional lymph node metastases is the standard of care. Sentinel-node biopsy provides precise staging, but has not been reported to affect survival. The effect of lymph-node dissection on survival is a topic of investigation. Two distinct approaches have emerged to try to extend survival in patients with metastatic melanoma: immunomodulation with anti-CTLA4 monoclonal antibodies, and targeted therapy with BRAF inhibitors or MEK inhibitors for BRAF-mutated melanoma. The combination of BRAF inhibitors and MEK inhibitors might improve progression-free survival further and, possibly, increase overall survival. Response patterns differ substantially-anti-CTLA4 immunotherapy can induce long-term responses, but only in a few patients, whereas targeted drugs induce responses in most patients, but nearly all of them relapse because of pre-existing or acquired resistance. Thus, the long-term prognosis of metastatic melanoma remains poor. Anti-PD1 and anti-PDL1 antibodies have emerged as breakthrough drugs for melanoma that have high response rates and long durability. Biomarkers that have predictive value remain elusive in melanoma, although emerging data for adjuvant therapy indicate that interferon sensitivity is associated with ulceration of the primary melanoma. Intense investigation continues for clinical and biological markers that predict clinical benefit of immunotherapeutic drugs, such as interferon alfa or anti-CTLA4 antibodies, and the mechanisms that lead to resistance of targeted drugs.

  4. Impact of Time Between Diagnosis and SLNB on Outcomes in Cutaneous Melanoma.

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    Nelson, Daniel W; Stern, Stacey; Elashoff, David E; Elashoff, Robert; Thompson, John F; Mozzillo, Nicola; Nieweg, Omgo E; Hoekstra, Harald J; Cochran, Alistair J; Faries, Mark B

    2017-08-01

    Hypothetically, delay between melanoma diagnosis and SLNB could affect outcomes, either adversely by allowing growth and dissemination of metastases, or beneficially by allowing development of an anti-melanoma immune response. Available data are conflicting about the effect of SLNB delay on patient survival. Our objective was to determine whether delay between initial diagnosis and SLNB affects outcomes in patients with cutaneous melanoma. We performed query and analysis of a large prospectively maintained database of patients with primary cutaneous melanomas undergoing SLNB. An independent dataset from MSLT-1 (Multicenter Selective Lymphadenectomy Trial-1) was used for validation. Primary outcomes included disease-free survival and melanoma-specific survival. Early and delayed SLNB were defined as less than 30 and 30 or more days from initial diagnosis, respectively. There were 2,483 patients that met inclusion criteria. Positive sentinel lymph nodes were identified in 17.4% (n = 432). Among all patients, 42% had SLNB 30 or more days after diagnosis and 37% of positive sentinel lymph nodes were at 30 or more days. No differences in sex, anatomic site, or histopathologic features were identified between the 2 groups. There was no difference in melanoma-specific survival or disease-free survival between those undergoing early or delayed SLNB. Examination of MSLT-1 trial data similarly demonstrated no difference in survival outcomes. This, the largest study on this subject to date, found no adverse impact on long-term clinical outcomes of patients due to delay of SLNB beyond 30 days. The MSLT-1 data confirm this result. Patients can be reassured that if the operation is performed 30 or more days after diagnosis, it will not cause harm. Copyright © 2017. Published by Elsevier Inc.

  5. Cutaneous malignant melanoma show geographic and socioeconomic disparities in stage at diagnosis and excess mortality

    DEFF Research Database (Denmark)

    Strömberg, Ulf; Peterson, Stefan; Holmberg, Erik

    2016-01-01

    and the national Melanoma Quality Register. Geographic and socioeconomic differences in incidence per stage at diagnosis were mapped and correlated to excess mortality. Results Disease mapping based on 9743 cases in 99 municipalities and 20 metropolitan districts showed marked, regional disparities in stage......Background Preventive measures are needed to counteract the increasing burden of cutaneous malignant melanoma (CMM). As a basis for rational melanoma prevention, we investigated geographic differences and impact from socioeconomic factors related to incidence, clinical stage at diagnosis...... and outcome. Material and methods All patients with primary invasive CMM diagnosed in 2004-2013 in the southern and the western Swedish health care regions with a population of 2.9 million adults were eligible for the study. Population-based data were obtained from the national Cancer Register...

  6. Cutaneous malignant melanoma show geographic and socioeconomic disparities in stage at diagnosis and excess mortality.

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    Strömberg, Ulf; Peterson, Stefan; Holmberg, Erik; Holmén, Anders; Persson, Bertil; Sandberg, Carin; Nilbert, Mef

    2016-08-01

    Background Preventive measures are needed to counteract the increasing burden of cutaneous malignant melanoma (CMM). As a basis for rational melanoma prevention, we investigated geographic differences and impact from socioeconomic factors related to incidence, clinical stage at diagnosis and outcome. Material and methods All patients with primary invasive CMM diagnosed in 2004-2013 in the southern and the western Swedish health care regions with a population of 2.9 million adults were eligible for the study. Population-based data were obtained from the national Cancer Register and the national Melanoma Quality Register. Geographic and socioeconomic differences in incidence per stage at diagnosis were mapped and correlated to excess mortality. Results Disease mapping based on 9743 cases in 99 municipalities and 20 metropolitan districts showed marked, regional disparities in stage-specific incidence of CMM. The incidence of stage I-II tumors was higher in the western health care region, whereas the incidence of stage III-IV CMMs was higher in the southern region. The divergent incidence patterns per stage at diagnosis were consistent across population strata based on educational level. The geographic disparities in CMM stage influenced relative survival with an excess five-year mortality ratio in the southern region versus the western region of 1.49 (95% confidence interval 1.22-1.82). The excess mortality ratio for patients with low versus high educational level was 1.81 (1.37-2.40). Conclusion Residential region and educational level influenced CMM stage and, thereby, excess mortality. These observations suggest that geographic as well as socioeconomic data should be considered in prevention of CMM.

  7. Early diagnosis of malignant melanoma: Proposal of a working formulation for the management of cutaneous pigmented lesions from the Melanoma Cooperative Group.

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    Ascierto, Paolo A; Palmieri, Giuseppe; Botti, Gerardo; Satriano, Rocco A; Stanganelli, Ignazio; Bono, Riccardo; Testori, Alessandro; Bosco, Leonardo; Daponte, Antonio; Caracò, Corrado; Chiofalo, Maria Grazia; Melucci, Maria Teresa; Calignano, Rosario; Tatangelo, Fabiana; Cochran, Alistair J; Castello, Giuseppe

    2003-06-01

    Epiluminescence microscopy (ELM) strongly improves the separation of different types of cutaneous pigmented lesions (CPL) and facilitates the early diagnosis of cutaneous melanoma (CM). ELM alone is not 100% accurate in routine diagnosis, and should not be considered the only criterion in the diagnosis of high-risk skin lesions. We have however, demonstrated close agreement between ELM classification criteria and histology in 2,731 cutaneous lesions. In the past five years, our Melanoma Cooperative Group has evaluated 61,000 skin lesions from 30,000 individuals and identified 478 cutaneous melanomas. Most newly diagnosed patients had very early stage melanoma [299 (62%) were Stage I (203 Stage IA and 96 Stage IB), by the American Joint Committee on Cancer (AJCC) criteria]. We have compared data from the patient histories and clinical evaluations with ELM-based morphological patterns to better characterize skin lesions and minimize interpretative problems. From these comparisons, we propose new guidelines for the management of CPL to provide a standard diagnostic and therapeutic approaches and to foster the early identification of lesions at risk for malignant transformation.

  8. [Descriptive study of the costs of diagnosis and treatment of cutaneous melanoma].

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    Almazán-Fernández, F M; Serrano-Ortega, S; Moreno-Villalonga, J J

    2009-11-01

    Every year, health expenditure in Spain increases and, with it, the resources dedicated to cancer treatment. Cutaneous melanoma is the skin cancer with the highest morbidity and mortality. We performed a descriptive study of the costs, based on a theoretical model, to determine the healthcare expenditure for patients with cutaneous melanoma; the objective was to define the overall costs (direct and indirect) of the diagnostic and treatment process of cutaneous melanoma, divided into different stages or diagnostic-therapeutic steps, and the possible variations in these costs. For this purpose, we used the Andalusian analytical accountancy program of hospitals and districts (COAN-hyd) and the total costs module of the COAN for 2007, applied to the protocol we use in the melanoma unit of our hospital. The most important conclusions were that the greatest health care expenditure was observed inpatients with more advanced melanomas, with a poor prognosis. Management of the diagnostic-therapeutic process by dermatologists, the appropriate use of complementary tests, and operations performed by dermatologists reduce costs.

  9. Genotyping of cutaneous melanoma.

    Science.gov (United States)

    Glitza, Isabella C; Davies, Michael A

    2014-09-01

    Until recently, treatment options for patients with metastatic melanoma were very limited. This landscape has evolved dramatically since the discovery of activating mutations in the BRAF gene in ~45% of cutaneous melanomas. Vemurafenib, dabrafenib, and trametinib have all received regulatory approval for the treatment of metastatic melanoma patients with a BRAF(V600) mutation. Based on the necessity to document the presence of a BRAF(V600) mutation to prescribe these agents, molecular testing is now the standard of care in this disease. However, the options and rationale for testing are evolving rapidly due to an improved understanding of the molecular drivers and heterogeneity of melanoma. Such testing may identify rational combinatorial approaches to prevent or overcome resistance for the approved BRAF inhibitors. In addition, new clinical strategies have been identified for a number of other molecular changes that are detected in this disease, including somatic changes in NRAS, PTEN, CDKN2A, and c-KIT, among others. This review summarizes the current understanding of the genetic landscape of mutations in melanoma, their associations with clinicopathological features, and their implications for clinical testing and treatment.

  10. Cutavirus in Cutaneous Malignant Melanoma

    DEFF Research Database (Denmark)

    Mollerup, Sarah; Fridholm, Helena; Vinner, Lasse

    2017-01-01

    A novel human protoparvovirus related to human bufavirus and preliminarily named cutavirus has been discovered. We detected cutavirus in a sample of cutaneous malignant melanoma by using viral enrichment and high-throughput sequencing. The role of cutaviruses in cutaneous cancers remains to be in......A novel human protoparvovirus related to human bufavirus and preliminarily named cutavirus has been discovered. We detected cutavirus in a sample of cutaneous malignant melanoma by using viral enrichment and high-throughput sequencing. The role of cutaviruses in cutaneous cancers remains...

  11. Cutavirus in Cutaneous Malignant Melanoma

    DEFF Research Database (Denmark)

    Mollerup, Sarah; Fridholm, Helena; Vinner, Lasse

    2017-01-01

    A novel human protoparvovirus related to human bufavirus and preliminarily named cutavirus has been discovered. We detected cutavirus in a sample of cutaneous malignant melanoma by using viral enrichment and high-throughput sequencing. The role of cutaviruses in cutaneous cancers remains to be in......A novel human protoparvovirus related to human bufavirus and preliminarily named cutavirus has been discovered. We detected cutavirus in a sample of cutaneous malignant melanoma by using viral enrichment and high-throughput sequencing. The role of cutaviruses in cutaneous cancers remains...

  12. Targeted therapies for cutaneous melanoma.

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    Kee, Damien; McArthur, Grant

    2014-06-01

    Melanoma is resistant to cytotoxic therapy, and treatment options for advanced disease have been limited historically. However, improved understanding of melanoma driver mutations, particularly those involving the mitogen-activated protein kinase pathway, has led to the development of targeted therapies that are effective in this previously treatment-refractory disease. In cutaneous melanomas with BRAF V600 mutations the selective RAF inhibitors, vemurafenib and dabrafenib, and the MEK inhibitor, trametinib, have demonstrated survival benefits. Early signals of efficacy have also been demonstrated with MEK inhibitors in melanomas with NRAS mutations, and KIT inhibitors offer promise in melanomas driven through activation of their target receptor.

  13. [Initial evaluation, diagnosis, staging, treatment, and follow-up of patients with primary cutaneous malignant melanoma. Consensus statement of the Network of Catalan and Balearic Melanoma Centers].

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    Mangas, C; Paradelo, C; Puig, S; Gallardo, F; Marcoval, J; Azon, A; Bartralot, R; Bel, S; Bigatà, X; Curcó, N; Dalmau, J; del Pozo, L J; Ferrándiz, C; Formigón, M; González, A; Just, M; Llambrich, A; Llistosella, E; Malvehy, J; Martí, R M; Nogués, M E; Pedragosa, R; Rocamora, V; Sàbat, M; Salleras, M

    2010-03-01

    The consensus statement on the management of primary cutaneous melanoma that we present here was based on selection, discussion, review, and comparison of recent literature (including national and international guidelines). The protocols for the diagnosis, treatment, and follow-up used in the hospital centers throughout Catalonia and the Balearic Isles belonging to the Network of Catalan and Balearic Melanoma Centers were also considered. The main objective of this statement was to present the overall management of melanoma patients typically used in our region at the present time. As such, the statement was not designed to be an obligatory protocol for health professionals caring for this group of patients, and neither can it nor should it be used for this purpose. Professionals reading the statement should not therefore consider it binding on their practice, and in no case can this text be used to guarantee or seek responsibility for a given medical opinion. The group of dermatologists who have signed this statement was created 3 years ago with the aim of making our authorities aware of the importance of this complex tumor, which, in comparison with other types of cancer, we believe does not receive sufficient attention in Spain. In addition, the regular meetings of the group have produced interesting proposals for collaboration in various epidemiological, clinical, and basic applied research projects on the subject of malignant melanoma in our society.

  14. Dermoscopic patterns of cutaneous melanoma metastases.

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    Rubegni, Pietro; Lamberti, Arianna; Mandato, Filomena; Perotti, Roberto; Fimiani, Michele

    2014-04-01

    In 2-8% of patients with melanoma, the first clinical manifestation of the disease may be skin metastasis. In these cases, differential diagnosis with the primary melanoma, benign melanocytic lesions, and other malignant and benign skin growths is particularly challenging. For this reason, the dermatologist's approach to cutaneous metastases of malignant melanoma calls for knowledge of the great morphological variety of these lesions. Dermoscopic characteristics associated with CMMMs have not yet been codified. The aim of the present review is to provide additional information about dermoscopic aspects of these skin lesions.

  15. CDKN2A (INK4A-ARF) mutation analysis to distinguish cutaneous melanoma metastasis from a second primary melanoma.

    NARCIS (Netherlands)

    Blokx, W.A.M.; Lesterhuis, W.J.; Andriessen, M.P.M.; Verdijk, M.A.J.; Punt, C.J.A.; Ligtenberg, M.J.L.

    2007-01-01

    The histologic differential diagnosis between a second primary cutaneous melanoma and cutaneous melanoma metastasis in a patient with a previous history of melanoma can be very difficult. This case report describes the first application of CDKN2A mutation analysis for discriminating a cutaneous

  16. Multiple cutaneous melanomas associated with gastric and brain metastases*

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    Grander, Lara Caroline; Cabral, Fernanda; Lisboa, Alice Paixão; Vale, Gabrielle; Barcaui, Carlos Baptista; Maceira, Juan Manuel Pineiro

    2016-01-01

    The occurrence of multiple primary melanomas in a single individual is rare. Most commonly, malignant melanocytic lesions subsequent to the initial diagnosis of melanoma are secondary cutaneous metastases. We report a patient with gastrointestinal bleeding from gastric metastasis of cutaneous melanoma. During clinical evaluation and staging, we discovered a brain metastasis associated with 3 synchronous primary cutaneous melanomas. We suggest the research on the mutation in the cyclin-dependent kinase inhibitor 2A (CDKN2A) (INK4a) in such cases. We also emphasize the importance of clinical examination and dermoscopy of the entire tegument, even after a malignant melanocytic lesion is identified.

  17. Microscopia confocal reflectante aplicada ao diagnóstico do melanoma cutâneo Reflectance confocal microscopy in the diagnosis of cutaneous melanoma

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    Cintia Rito

    2009-12-01

    structures and to examine the epidermis and papillary dermis with a resolution similar to that of histopathology, with a sensitivity of 97.3% and specificity of 72.3 % in the diagnosis of cutaneous melanoma. This is an important diagnostic tool, because it does not substitute post-surgical histopathological examination and allows for the rational assessment of lesions of questionable dermoscopy, thus avoiding unnecessary surgical procedures.

  18. Clinical and morphological characteristics of cutaneous melanoma.

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    Balaban, Jagoda; Ninković Baroš, Djuka; Grujić, Dragana; Starović, Dragana; Ćelić, Milanka

    2014-01-01

    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%, P<0.05), followed by superficial spreading (27.8%) and acral lentiginous melanoma (11.4%). The most common localization was on the back in men (34.3%) and on the legs in women (P<0.05). More than half of our patients (55.8%) had melanoma 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 (P<0.05). Spread of the primary tumor localization was found in 31.4% of patients, more frequently in men than in women (P<0.05). In most cases it was abstraction of lymph nodes (P<0.05). The average thickness of the melanoma 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.

  19. Sun behaviour after cutaneous malignant melanoma

    DEFF Research Database (Denmark)

    Idorn, L W; Datta, P; Heydenreich, J

    2013-01-01

    Background  It has been reported that patients with cutaneous malignant melanoma (CMM) can lower their risk of a second primary melanoma by limiting recreational sun exposure. Previous studies based on questionnaires and objective surrogate measurements indicate that before their diagnosis......, patients with CMM are exposed to higher ultraviolet radiation (UVR) doses than controls, followed by a reduction after diagnosis. Objectives  In a prospective, observational case-control study, we aimed to assess sun exposure after diagnosis of CMM by objective measurements to substantiate advice about sun...... months and 6 years before the start of the study. During a summer season participants filled in sun exposure diaries daily and wore personal electronic UVR dosimeters in a wristwatch that continuously measured time-stamped UVR doses in standard erythema dose. Results  The UVR dose of recently diagnosed...

  20. Clinicopathological and molecular aspects of cutaneous Melanoma

    NARCIS (Netherlands)

    Bogenrieder, T.

    2009-01-01

    Clinicopathological and molecular aspects of cutaneous melanoma. Melanoma arises form the transformation of neural crest-derived melanocytes, the pigment cells of the skin, which reside in the basal layer of the epidermis. Melanoma is the deadliest form of skin cancer and one of the most aggressive

  1. Choroidal Metastases From Cutaneous Melanoma.

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    Mercado, Carmel L; Toy, Brian C; Kistler, Henry B; Moshfeghi, Darius M

    2016-05-01

    A 92-year-old man presented with months of progressive blurry vision, worsening acutely in his right eye. He denied pain, diplopia, or photopsias. His history was significant for multiple myeloma, prostate cancer, and malignant melanoma of his right shoulder treated with local excision. He had local recurrence with hepatic metastasis of the melanoma treated with radiation and chemotherapy. On examination, his visual acuity was counting fingers in the right eye and 20/60 in the left eye. Amsler grid testing demonstrated metamorphopsia in the right eye. Fundus exam of the right and left eyes revealed multiple, elevated, pigmented choroidal lesions, with associated subretinal fluid in the right macula. This appearance is consistent with hematogenous metastasis of cutaneous malignant melanoma to the choroid and associated serous fluid-causing metamorphopsia. The patient was enrolled in a clinical trial combining plasmid IL-12 with pembrolizumab (Keytruda; Merck, Whitehouse Station, NJ). He passed away 2 months after initial presentation to our clinic. [Ophthalmic Surg Lasers Imaging Retina. 2016;47:497.].

  2. INFRARED THERMOGRAPHY OF CUTANEOUS MELANOMA METASTASES

    Science.gov (United States)

    Shada, Amber L.; Dengel, Lynn T.; Petroni, Gina R.; Smolkin, Mark E.; Acton, Scott; Slingluff, Craig L.

    2014-01-01

    Background Differentiating melanoma metastasis from benign cutaneous lesions currently requires biopsy or costly imaging, such as positron emission tomography scans. Melanoma metastases have been observed to be subjectively warmer than similarly appearing benign lesions. We hypothesized that infrared (IR) thermography would be sensitive and specific in differentiating palpable melanoma metastases from benign lesions. Materials and methods Seventy-four patients (36 females and 38 males) had 251 palpable lesions imaged for this pilot study. Diagnosis was determined using pathologic confirmation or clinical diagnosis. Lesions were divided into size strata for analysis: 0–5, >5–15, >15–30, and >30 mm. Images were scored on a scale from −1 (colder than the surrounding tissue) to +3 (significantly hotter than the surrounding tissue). Sensitivity and specificity were calculated for each stratum. Logistical challenges were scored. Results IR imaging was able to determine the malignancy of small (0–5 mm) lesions with a sensitivity of 39% and specificity of 100%. For lesions >5–15 mm, sensitivity was 58% and specificity 98%. For lesions >15–30 mm, sensitivity was 95% and specificity 100%, and for lesions >30 mm, sensitivity was 78% and specificity 89%. The positive predictive value was 88%–100% across all strata, and the negative predictive value was 95% for >15–30 mm lesions and 80% for >30 mm lesions. Conclusions Malignant lesions >15 mm were differentiated from benign lesions with excellent sensitivity and specificity. IR imaging was well tolerated and feasible in a clinic setting. This pilot study shows promise in the use of thermography for the diagnosis of malignant melanoma with further potential as a noninvasive tool to follow tumor responses to systemic therapies. PMID:23043862

  3. A precocidade diagnóstica do melanoma cutâneo: uma observação no sul do Brasil Early diagnosis of cutaneous melanoma: an observation in southern Brazil

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    Raquel Bonfá

    2011-04-01

    Full Text Available FUNDAMENTOS: A incidência do melanoma cutâneo e as taxas de mortalidade a ele associadas estão crescendo na maioria dos países do mundo. OBJETIVO: Descrever as características histopatológicas do melanoma cutâneo, segundo critérios do Grupo Brasileiro de Melanoma, e avaliar a precocidade diagnóstica em hospital de referência do sul do Brasil para o atendimento de melanoma. MÉTODOS: Estudo transversal com casos de melanoma cutâneo primário reconhecidos após biópsia excisional, processados no laboratório de Patologia do Complexo Hospitalar Santa Casa de Porto Alegre entre 1º/1/2000 e 15/1/2005. Outras variáveis analisadas: idade, sexo, topogra fia da lesão, subtipos histopatológicos, índice Breslow, fase de crescimento, índice de Clark, índice mitótico, infiltrado inflamatório linfocitário peritumoral e intratumoral, invasão angiolinfática e perineural, presença de úlcera e regressão, tipo de regressão, satelitose microscópica e margens cirúrgicas. RESULTADOS: Incluídos 328 casos, sendo 57% mulheres e 43% homens, com média de idade de 55,63 anos. A localização foi preferencialmente nos membros inferiores (29,26% e superiores (23,94% nas mulheres. Nos homens, predominou no dorso (35% e no tórax anterior/abdome (14,29% (pBACKGROUND: The incidence of melanoma cutaneous and the mortalities rates are rising in most countries worldwide. OBJECTIVE: to describe the histopathological characteristics of cutaneous melanoma, according to the criteria established by the Brazilian Group of Melanoma, and to evaluate early diagnosis in a cancer treatment referral center. METHODS: we performed a cross-sectional descriptive study of cases of primary cutaneous melanoma identified after excisional biopsy and processed at the pathology laboratory of Complexo Hospitalar Santa Casa between Jan 1st 2000 and Jan 15th 2005. The following variables were analyzed: age, gender, topography, histopathologic subtype, Breslow thickness

  4. Bilateral Choroidal Metastases as Presentation of Dissemination of Cutaneous Malignant Melanoma

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    S. Fernandez-Perez

    2012-01-01

    Full Text Available Case Report. A 47-year-old man presented with blurred vision in the right eye. Ophthalmoscopic examination showed several placoid, pigmented lesions in the posterior pole and midperiphery of the retina of both eyes. Results. Patient referred a cutaneous malignant melanoma on the back skin removed 6 years ago. A systemic workup revealed multiple metastases in liver and spleen. After an exhaustive study we concluded that it was a dissemination of a cutaneous malignant melanoma with bilateral choroidal metastases, liver and spleen metastases. The patient obtained clinical ocular improvement after palliative chemotherapy, although he died in the following months. Pathological examination of the lesions confirmed the diagnosis of choroidal metastases from a malignant cutaneous melanoma. Conclusions. Monitoring patients who have had cutaneous malignant melanoma is very important, since melanoma metastases may occur even many years after the diagnosis of the primary tumor. Choroidal metastases from cutaneous melanoma are uncommon but we should be aware because their appearance worsens prognosis.

  5. Cutaneous malignant melanoma: clinical aspects, imaging modalities and treatment

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    Ak, I.; Stokkel, M.P.M.; Pauwels, E.K.J. [Leiden University Medical Centre, Department of Radiology, Division of Nuclear Medicine, Leiden (Netherlands); Bergman, W. [Department of Dermatology, Leiden University Medical Centre, Leiden (Netherlands)

    2000-04-01

    Cutaneous melanoma is a highly malignant tumour of the melanocytes presenting characteristic metabolic and biological features. Early detection decreases mortality and morbidity and provides the best chance for optimal clinical management. Imaging techniques, including scintigraphy, have assumed an important role in detection strategies. As a functional modality, nuclear medicine offers a variety of possibilities to assist in the clinical management of malignant melanoma. This review discusses the clinical aspects and treatment of melanoma, and the imaging techniques used for its diagnosis, staging and follow-up. A survey of currently available techniques is presented. (orig.)

  6. Malignant cutaneous melanoma in patients from Las Tunas province

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    Alicia María Yabor Palomo

    2015-11-01

    Full Text Available Background: malignant melanoma is a highly aggressive skin neoplasia, whose incidence shows a constant and rapid increase.Objective: to characterize variables in patients diagnosed with cutaneous melanoma, whose biopsies were analyzed in the pathologic anatomy department of "Dr. Ernesto Guevara de la Serna" General Teaching Hospital from January, 2008 to December, 2014.Methods: a descriptive and cross-sectional study was performed in 31 patients treated in the place and period of time mentioned above. The official form of biopsy was used as a secondary source of collecting information and it was processed using descriptive statistics.Results: the 10,6 % of the biopsies analyzed corresponded with cutaneous melanoma, its frequency prevailed in 2011 and 2010, with a 25,8 % and 19,3 % respectively. It was evident a higher percentage in males (67,7 % and in the age group between 60 and 69 years old, with a 35,4 %. Caucasian patients were the most affected ones, with a 90,3 % and the predominant location was in the lower limbs in 45,1 % of the cases. The prevailing Clark invasion level was IV, evident by the 32,2 % of the sample, and the most frequent histological variety was the malignant nodular melanoma in 19 patients, for a 61,2 %.Conclusions: cutaneous melanoma prevailed in lower extremities in males and it had a belated diagnosis, since there was prevalence of IV Clark invasion level and nodular melanoma as the most frequent histological type.

  7. The genomic landscape of cutaneous melanoma.

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    Zhang, Tongwu; Dutton-Regester, Ken; Brown, Kevin M; Hayward, Nicholas K

    2016-05-01

    Somatic mutation analysis of melanoma has been performed at the single gene level extensively over the past several decades. This has provided considerable insight into the critical pathways controlling melanoma initiation and progression. During the last 5 yr, next-generation sequencing (NGS) has enabled even more comprehensive mutational screening at the level of multigene panels, exomes and genomes. These studies have uncovered many new and unexpected players in melanoma development. The recent landmark study from The Cancer Genome Atlas (TCGA) consortium describing the genomic architecture of 333 cutaneous melanomas provides the largest and broadest analysis to date on the somatic aberrations underlying melanoma genesis. It thus seems timely to review the mutational landscape of melanoma and highlight the key genes and cellular pathways that appear to drive this cancer.

  8. Differential diagnosis in primary and metastatic cutaneous melanoma by FT-Raman spectroscopy Diagnóstico diferencial no melanoma primário e metastático por espectroscopia FT-Raman

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    Andrea Fernandes de Oliveira

    2010-10-01

    Full Text Available PURPOSE: To qualify the FT-Raman spectral data of primary and metastatic cutaneous melanoma in order to obtain a differential diagnosis. METHODS: Ten normal human skin samples without any clinical or histopathological alterations, ten cutaneous melanoma fragments, and nine lymph node metastasis samples were used; 105, 140 and 126 spectra were obtained respectively. Each sample was divided into 2 or 3 fragments of approximately 2 mm³ and positioned in the Raman spectrometer sample holder in order to obtain the spectra; a monochrome laser light Nd:YAG at 1064 nm was used to excite the inelastic effect. RESULTS: To differentiate the three histopathological groups according to their characteristics extracted from the spectra, data discriminative analysis was undertaken. Phenylalanine, DNA, and Amide-I spectral variables stood out in the differentiation of the three groups. The percentages of correctly classified groups based on Phenylalanine, DNA, and Amide-I spectral features was 93.1%. CONCLUSION: FT-Raman spectroscopy is capable of differentiating melanoma from its metastasis, as well as from normal skin.OBJETIVO: Qualificar os dados espectrais FT-Raman do melanoma cutâneo primário e metastático e assim realizar o diagnóstico diferencial. MÉTODOS: Foram utilizadas amostras de 10 fragmentos de pele sem alterações clínicas ou histopatológicas, 10 de melanomas cutâneos e 9 de metástases linfonodais; 105, 140 and 126 espectros foram obtidos respectivamente. Cada amostra foi dividida em 2 ou 3 frações de 2 mm³ e posicionada no porta amostras do espectrômetro Raman para obtenção dos espectros, por meio da excitação do espalhamento inelástico pelo laser de Nd:YAG em 1064 nm incididos na amostra. RESULTADOS: Para diferenciar os três grupos formados de acordo com as características fornecidas pelos espectros, realizamos a análise discriminante dos dados. As variáveis espectrais Fenilalanina, DNA e Amida-I se destacaram na

  9. [Cutaneous malignant melanoma and the new drugs].

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    Nieweg, Omgo E; Gallegos-Hernández, José Francisco

    2015-01-01

    The treatment of cutaneous melanoma has historically been essentially surgical. Much progress has been made in this area, and the resection margins have been established based on tumour depth. Candidates are also identified for lymphadenectomy, avoiding the morbidity of the procedure in patients who do not require it. But little progress has been made in systemic treatment, since the 70's when the use of dacarbazine was introduced for the treatment of patients with tumour progression or distant metastasis, with disappointing results. Despite this, Dacarbazine has been the most used drug to the present. Three years ago, two new drugs were introduced, one of them based on the target therapy and other one in the immunotherapy, offering, with the obtained results, an alternative in the treatment of cutaneous melanoma The objectives of this article are to show the pathways of these drugs, to describe the current role of surgery in cutaneous melanoma, with the arrival of these drugs, as well as to know the therapeutic alternatives that are emerging for the cutaneous melanoma based on scientific evidence.

  10. Focus on cutaneous and uveal melanoma specificities.

    Science.gov (United States)

    Pandiani, Charlotte; Béranger, Guillaume E; Leclerc, Justine; Ballotti, Robert; Bertolotto, Corine

    2017-04-15

    Cutaneous melanoma (CM) and uveal melanoma (UM) derive from cutaneous and uveal melanocytes that share the same embryonic origin and display the same cellular function. However, the etiopathogenesis and biological behaviors of these melanomas are very different. CM and UM display distinct landscapes of genetic alterations and show different metastatic routes and tropisms. Hence, therapeutic improvements achieved in the last few years for the treatment of CM have failed to ameliorate the clinical outcomes of patients with UM. The scope of this review is to discuss the differences in tumorigenic processes (etiologic factors and genetic alterations) and tumor biology (gene expression and signaling pathways) between CM and UM. We develop hypotheses to explain these differences, which might provide important clues for research avenues and the identification of actionable vulnerabilities suitable for the development of new therapeutic strategies for metastatic UM. © 2017 Pandiani et al.; Published by Cold Spring Harbor Laboratory Press.

  11. Early detection of cutaneous melanoma by sequential digital dermatoscopy (SDD).

    Science.gov (United States)

    Kraus, Sophie Luise; Haenssle, Holger Andreas

    2013-06-01

    The early diagnosis and excision of cutaneous melanoma is essential for an improved prognosis of the disease. Besides the investigation of pigmented lesions with the unaided eye and conventional dermatoscopy, long-term sequential digital dermatoscopy has been shown to improve the sensitivity of melanoma detection, especially in high-risk patients. In addition to the static clinical and dermatoscopic assessment, the sequential digital dermatoscopy strategy helps to detect changes over time. This review summarizes the latest developments in the field of sequential digital dermatoscopy, describes current strategies for the selection of patients and lesions to monitor, and suggests objective criteria that should lead to an excisional biopsy.

  12. Progression of cutaneous melanoma: implications for treatment

    Science.gov (United States)

    Leong, Stanley P. L.; Mihm, Martin C.; Murphy, George F.; Hoon, Dave S. B.; Kashani-Sabet, Mohammed; Agarwala, Sanjiv S.; Zager, Jonathan S.; Hauschild, Axel; Sondak, Vernon K.; Guild, Valerie; Kirkwood, John M.

    2015-01-01

    The survival rates of melanoma, like any type of cancer, become worse with advancing stage. Spectrum theory is most consistent with the progression of melanoma from the primary site to the in-transit locations, regional or sentinel lymph nodes and beyond to the distant sites. Therefore, early diagnosis and surgical treatment before its spread is the most effective treatment. Recently, new approaches have revolutionized the diagnosis and treatment of melanoma. Genomic profiling and sequencing will form the basis for molecular taxonomy for more accurate subgrouping of melanoma patients in the future. New insights of molecular mechanisms of metastasis are summarized in this review article. Sentinel lymph node biopsy has become a standard of care for staging primary melanoma without the need for a more morbid complete regional lymph node dissection. With recent developments in molecular biology and genomics, novel molecular targeted therapy is being developed through clinical trials. PMID:22892755

  13. Lessons from Cancer Immunoediting in Cutaneous Melanoma

    Directory of Open Access Journals (Sweden)

    Mariana Aris

    2012-01-01

    Full Text Available We will revisit the dual role of the immune system in controlling and enabling tumor progression, known as cancer immunoediting. We will go through the different phases of this phenomenon, exposing the most relevant evidences obtained from experimental models and human clinical data, with special focus on Cutaneous Melanoma, an immunogenic tumor per excellence. We will describe the different immunotherapeutic strategies employed and consider current models accounting for tumor heterogeneity. And finally, we will propose a rational discussion of the progress made and the future challenges in the therapeutics of Cutaneous Melanoma, taking into consideration that tumor evolution is the resulting from a continuous feedback between tumor cells and their environment, and that different combinatorial therapeutic approaches can be implemented according to the tumor stage.

  14. Cutaneous Complications of Targeted Melanoma Therapy.

    Science.gov (United States)

    de Golian, Emily; Kwong, Bernice Y; Swetter, Susan M; Pugliese, Silvina B

    2016-11-01

    The landscape of advanced and metastatic melanoma therapy has shifted dramatically in recent years. Since 2011, eight drugs (ipilimumab, vemurafenib, dabrafenib, trametinib, cometinib, pembrolizumab, nivolumab, and talimogene laherparepvec) have received FDA approval for the treatment of advanced or metastatic melanoma, including combination regimens of both small molecule kinase and immune checkpoint inhibitors. These therapies have revolutionized the management of unresectable regional nodal and distant melanoma, providing hope of extended survival to patients. As the use of novel agents has increased, so have the cutaneous toxicities associated with these medications. While most skin reactions are low-grade and can be managed conservatively with topical therapies, malignant lesions and more serious or life-threatening drug reactions can arise during therapy, requiring prompt dermatologic recognition and treatment in order to improve patient outcome. Given the survival benefit attributed to these new agents, treating skin toxicity and maintaining patient quality of life is of paramount importance. Oncologists should be aware of the common cutaneous toxicities associated with these medications and should be encouraged to involve dermatologists in the collaborative care of advanced melanoma patients. Close communication between oncologists and dermatologists can help to avoid unnecessary dose reduction or treatment discontinuation and identify situations when treatment cessation is truly warranted.

  15. Molecular Bases of Cutaneous and Uveal Melanomas

    Directory of Open Access Journals (Sweden)

    Sudeep Gaudi

    2011-01-01

    Full Text Available Intensive research in recent years has begun to unlock the mysteries surrounding the molecular pathogenesis of melanoma, the deadliest of skin cancers. The high-penetrance, low-frequency susceptibility gene CDKN2A produces tumor suppressor proteins that function in concert with p53 and retinoblastoma protein to thwart melanomagenesis. Aberrant CDKN2A gene products have been implicated in a great many cases of familial cutaneous melanoma. Sporadic cases, on the other hand, often involve constitutive signal transduction along the mitogen-activated protein kinase (MAPK pathway, with particular focus falling upon mutated RAS and RAF protooncogenes. The proliferative effects of the MAPK pathway may be complemented by the antiapoptotic signals of the PI3K/AKT pathway. After skin, melanoma most commonly affects the eye. Data for the constitutive activation of the MAPK pathway in uveal melanoma exists as well, however, not through mutations of RAS and RAF. Rather, evidence implicates the proto-oncogene GNAQ. In the following discussion, we review the major molecular pathways implicated in both familial and sporadic cutaneous melanomagenesis, the former accounting for approximately 10% of cases. Additionally, we discuss the molecular pathways for which preliminary evidence suggests a role in uveal melanomagenesis.

  16. Data Set for Pathology Reporting of Cutaneous Invasive Melanoma

    Science.gov (United States)

    Judge, Meagan J.; Evans, Alan; Frishberg, David P.; Prieto, Victor G.; Thompson, John F.; Trotter, Martin J.; Walsh, Maureen Y.; Walsh, Noreen M.G.; Ellis, David W.

    2013-01-01

    An accurate and complete pathology report is critical for the optimal management of cutaneous melanoma patients. Protocols for the pathologic reporting of melanoma have been independently developed by the Royal College of Pathologists of Australasia (RCPA), Royal College of Pathologists (United Kingdom) (RCPath), and College of American Pathologists (CAP). In this study, data sets, checklists, and structured reporting protocols for pathologic examination and reporting of cutaneous melanoma were analyzed by an international panel of melanoma pathologists and clinicians with the aim of developing a common, internationally agreed upon, evidence-based data set. The International Collaboration on Cancer Reporting cutaneous melanoma expert review panel analyzed the existing RCPA, RCPath, and CAP data sets to develop a protocol containing “required” (mandatory/core) and “recommended” (nonmandatory/noncore) elements. Required elements were defined as those that had agreed evidentiary support at National Health and Medical Research Council level III-2 level of evidence or above and that were unanimously agreed upon by the review panel to be essential for the clinical management, staging, or assessment of the prognosis of melanoma or fundamental for pathologic diagnosis. Recommended elements were those considered to be clinically important and recommended for good practice but with lesser degrees of supportive evidence. Sixteen core/required data elements for cutaneous melanoma pathology reports were defined (with an additional 4 core/required elements for specimens received with lymph nodes). Eighteen additional data elements with a lesser level of evidentiary support were included in the recommended data set. Consensus response values (permitted responses) were formulated for each data item. Development and agreement of this evidence-based protocol at an international level was accomplished in a timely and efficient manner, and the processes described herein may

  17. Selenium for the Prevention of Cutaneous Melanoma

    Directory of Open Access Journals (Sweden)

    Douglas Grossman

    2013-03-01

    Full Text Available The role of selenium (Se supplementation in cancer prevention is controversial; effects often depend on the nutritional status of the subject and on the chemical form in which Se is provided. We used a combination of in vitro and in vivo models to study two unique therapeutic windows for intervention in the process of cutaneous melanomagenisis, and to examine the utility of two different chemical forms of Se for prevention and treatment of melanoma. We studied the effects of Se in vitro on UV-induced oxidative stress in melanocytes, and on apoptosis and cell cycle progression in melanoma cells. In vivo, we used the HGF transgenic mouse model of UV-induced melanoma to demonstrate that topical treatment with l-selenomethionine results in a significant delay in the time required for UV-induced melanoma development, but also increases the rate of growth of those tumors once they appear. In a second mouse model, we found that oral administration of high dose methylseleninic acid significantly decreases the size of human melanoma xenografts. Our findings suggest that modestly elevation of selenium levels in the skin might risk acceleration of growth of incipient tumors. Additionally, certain Se compounds administered at very high doses could have utility for the treatment of fully-malignant tumors or prevention of recurrence.

  18. Routine X-ray of the chest is not justified in staging of cutaneous melanoma patients

    DEFF Research Database (Denmark)

    Gjorup, Caroline Asirvatham; Hendel, Helle Westergren; Pilegaard, Rita Kaae

    2016-01-01

    value was 8%, and the negative predictive value was 100%. CONCLUSION: Our results suggest that CXR cannot be justified in the initial staging of cutaneous melanoma patients. The guideline for the treatment of melanoma in Denmark is under revision: The use of CXR has been omitted. FUNDING: This study......INTRODUCTION: The incidence of cutaneous melanoma is increasing in Denmark and worldwide. However, the prevalence of distant metastases at the time of diagnosis has decreased to 1%. We therefore questioned the value of routine preoperative chest X-ray (CXR) for staging asymptomatic melanoma...... patients and hypothesised that routine CXR is not justified. METHODS: A retrospective study was conducted on patients undergoing wide local excision and sentinel lymph node biopsy for cutaneous melanoma in the period from 2010 to 2014. RESULTS: A total of 603 patients were included. The mean time of follow...

  19. Melanoma-specific marker expression in skin biopsy tissues as a tool to facilitate melanoma diagnosis.

    Science.gov (United States)

    Alexandrescu, Doru T; Kauffman, C Lisa; Jatkoe, Timothy A; Hartmann, Dan P; Vener, Tatiana; Wang, Haiying; Derecho, Carlo; Rajpurohit, Yashoda; Wang, Yixin; Palma, John F

    2010-07-01

    Diagnosis of cutaneous melanoma requires accurate differentiation of true malignant tumors from highly atypical lesions, which lack the capacity to develop uncontrolled proliferation and to metastasize. We used melanoma markers from previous work to differentiate benign and atypical lesions from melanoma using paraffin-embedded tissue. This critical step in diagnosis generates the most uncertainty and discrepancy between dermatopathologists. A total of 193 biopsy tissues were selected: 47 melanomas, 48 benign nevi, and 98 atypical/suspicious, including 48 atypical nevi and 50 melanomas as later assigned by expert dermatopathologists. Performance for SILV, GDF15, and L1CAM normalized to TYR in unequivocal melanoma versus benign nevi resulted in an area under the curve (AUC) of 0.94, 0.67, and 0.5, respectively. SILV also differentiated atypical cases classified as melanoma from atypical nevi with an AUC=0.74. Furthermore, SILV showed a significant difference between suspicious melanoma and each suspicious atypia group: melanoma versus severe atypia and melanoma versus moderate atypia had P-values of 0.0077 and 0.0009, respectively. SILV showed clear discrimination between melanoma and benign unequivocal cases as well as between different atypia subgroups in the group of suspicious samples. The role and potential utility of this molecular assay as an adjunct to the morphological diagnosis of melanoma are discussed.

  20. POLE mutations in families predisposed to cutaneous melanoma

    DEFF Research Database (Denmark)

    Aoude, Lauren G; Heitzer, Ellen; Johansson, Peter

    2015-01-01

    Germline mutations in the exonuclease domain of POLE have been shown to predispose to colorectal cancers and adenomas. POLE is an enzyme involved in DNA repair and chromosomal DNA replication. In order to assess whether such mutations might also predispose to cutaneous melanoma, we interrogated...... whole-genome and exome data from probands of 34 melanoma families lacking pathogenic mutations in known high penetrance melanoma susceptibility genes: CDKN2A, CDK4, BAP1, TERT, POT1, ACD and TERF2IP. We found a novel germline mutation, POLE p.(Trp347Cys), in a 7-case cutaneous melanoma family....... Functional assays in S. pombe showed that this mutation led to an increased DNA mutation rate comparable to that seen with a Pol ε mutant with no exonuclease activity. We then performed targeted sequencing of POLE in 1243 cutaneous melanoma cases and found that a further ten probands had novel or rare...

  1. Social determinants of racial and ethnic disparities in cutaneous melanoma outcomes.

    Science.gov (United States)

    Harvey, Valerie M; Patel, Hitesh; Sandhu, Sophia; Wallington, Sherrie Flynt; Hinds, Ginette

    2014-10-01

    This article sought to elucidate how aspects of poverty and culture may contribute to race- and ethnicity-based disparities in cutaneous melanoma outcomes. We identified published studies addressing the social determinants of melanoma. Selected review articles included US-based studies comprised of patients representing adults, children, and adolescents. African Americans and Hispanics diagnosed with cutaneous melanoma are more likely to present with more advanced stages of disease at diagnosis and have higher rates of mortality than their nonminority counterparts. These disparities may be a consequence of economic, social, and cultural barriers such as low income, public forms of health insurance, lower levels of education, lower levels of melanoma awareness and knowledge, and lower rates of participation in melanoma screening. No studies in the literature examined the potential impact of social injustice, English proficiency, immigrant status, and health literacy. Substantial gaps exist in our knowledge of the pathways linking social determinants and race- and ethnicity-based disparities in melanoma. More studies are warranted to inform the development of effective interventions aimed at narrowing inequities and improving cutaneous melanoma outcomes among minority populations.

  2. Epidemiological aspects of cutaneous malignant melanoma (review).

    Science.gov (United States)

    Serraino, D; Fratino, L; Gianni, W; Campisi, C; Pietropaolo, M; Trimarco, G; Marigliano, V

    1998-01-01

    There is an increasing interest in the etiology of cutaneous malignant melanoma (CMM). Once considered a rare tumour, CMM is now the fourth commonest cancer in Australia and New Zeland, the tenth in the Usa, Canada and Scandinavia and the eighteenth in Great Britain. The growing scientific concern on the urgent need to highlight the cause/s of CMM is well documented by the large number of well-designed and well-conducted epidemiological studies reported in the last two decades. Such studies facilitated testing of many etiological hypotheses derived from earlier descriptive investigations and contributed to significant progress in understanding the etiology of such disease. The quantification of the extent to which the increases in CMM incidence and mortality rates are related to new lifestyles and to new patterns of exposure to potential carcinogenetic agents is essential in order to establish an appropriate preventive strategy. In population of mainly European origin a substantial proportion of the increased incidence of CMM is attributable to steady change from predominantly occupational to predominantly recreational exposure to solar radiation. Therefore the present review puts particular emphasis on exposure to sunlight as well as to artificial ultraviolet light, as modifiable causes of CMM. Incidence and mortality data and other potential risk factors for the development of CMM will also be briefly reviewed.

  3. GNA11 Mutation in a Patient With Cutaneous Origin Melanoma

    Science.gov (United States)

    Patel, Sapna P.; Kim, Dae Won; Lacey, Carol L.; Hwu, Patrick

    2016-01-01

    Abstract The rapid advances in the molecular biology and genetics have improved the understanding of molecular pathogenesis of v-Raf murine sarcoma viral oncogene homolog B (BRAF), feline sarcoma viral oncogene v-kit (KIT), and neuroblastoma v-Ras oncogene homolog (NRAS) mutant melanomas with the subsequent development of targeted therapeutic agents. However, only limited data are available for melanoma harboring other somatic than BRAF, KIT, and NRAS mutations. Mutations in guanine nucleotide-binding protein Q polypeptide (GNAQ) and guanine nucleotide-binding protein alpha-11 (GNA11), alpha subunits of heterotrimeric G proteins, constitutively activate mitogen-activated protein kinase (MAPK) pathway in uveal melanoma. However, there are no reports of GNA11 mutations in cutaneous melanomas. A 48-year-old woman was diagnosed with cutaneous nodular melanoma on the left scalp. Mutation analysis of the tumor revealed a GNA11 Q209L mutation. There was no evidence of uveal melanoma or malignant blue nevus in ophthalmologic exam, imaging studies, and pathology review. To our knowledge, this is the first case report to demonstrate cutaneous origin melanoma harboring a GNA11 Q209L mutation. PMID:26825879

  4. DMBT1 expression distinguishes anorectal from cutaneous melanoma

    DEFF Research Database (Denmark)

    Helmke, Burkhard Maria; Renner, Marcus; Poustka, Annemarie

    2009-01-01

    AIMS: Anorectal melanoma (AM) forms a rare but highly malignant subset of mucosal melanoma with an extremely poor prognosis. Although AMs display histological and immunohistochemical features very similar to cutaneous melanoma (CM), no association exists either with exposure to ultraviolet light...... tumours 1 (DMBT1) in cases of primary anorectal malignant melanoma and CM. METHODS AND RESULTS: Expression analyses of classical immunohistochemical markers (S100, HMB45, Melan A and MiTF) and of the protein DMBT1 were carried out in 27 cases of primary anorectal malignant melanoma and 26 cases of CM. All...... AM cases analysed showed expression of at least three of the classical markers for melanoma. However, immunohistochemistry showed 19 out of 27 AM to be positive for DMBT1, which represented a statistically significant difference (P = 0.0009) compared with CM (six out of 26), which more commonly...

  5. Asymptomatic brain metastases in patients with cutaneous metastatic malignant melanoma

    DEFF Research Database (Denmark)

    Zukauskaite, Ruta; Schmidt, Henrik; Asmussen, Jon T

    2013-01-01

    The aim of the study was to identify the frequency of asymptomatic brain metastases detected by computed tomography (CT) scans in patients with metastatic cutaneous melanoma referred to first-line systemic treatment. Between 1995 and 2009, 697 Danish patients were screened with a contrast...

  6. Melanomas of unknown primary have a mutation profile consistent with cutaneous sun-exposed melanoma.

    Science.gov (United States)

    Dutton-Regester, Ken; Kakavand, Hojabr; Aoude, Lauren G; Stark, Mitchell S; Gartside, Michael G; Johansson, Peter; O'Connor, Linda; Lanagan, Cathy; Tembe, Varsha; Pupo, Gulietta M; Haydu, Lauren E; Schmidt, Christopher W; Mann, Graham J; Thompson, John F; Scolyer, Richard A; Hayward, Nicholas K

    2013-11-01

    Melanoma of unknown primary (MUP) is an uncommon phenomenon whereby patients present with metastatic disease without an evident primary site. To determine their likely site of origin, we combined exome sequencing from 33 MUPs to assess the total rate of somatic mutations and degree of UV mutagenesis. An independent cohort of 91 archival MUPs was also screened for 46 hot spot mutations highly prevalent in melanoma including BRAF, NRAS, KIT, GNAQ, and GNA11. Results showed that the majority of MUPs exhibited high somatic mutation rates, high ratios of C>T/G>A transitions, and a high rate of BRAF (45 of 101, 45%) and NRAS (32 of 101, 32%) mutations, collectively indicating a mutation profile consistent with cutaneous sun-exposed melanomas. These data suggest that a significant proportion of MUPs arise from regressed or unrecognized primary cutaneous melanomas or arise de novo in lymph nodes from nevus cells that have migrated from the skin.

  7. Caffeine Intake, Coffee Consumption, and Risk of Cutaneous Malignant Melanoma.

    Science.gov (United States)

    Wu, Shaowei; Han, Jiali; Song, Fengju; Cho, Eunyoung; Gao, Xiang; Hunter, David J; Qureshi, Abrar A

    2015-11-01

    Caffeine has been shown to prevent ultraviolet radiation-induced carcinogenesis and to inhibit growth of melanoma cells in experimental studies. We evaluated the association among caffeine intake, coffee consumption, and melanoma risk among three large cohort studies. The analysis used data from 89,220 women in the Nurses' Health Study II (1991-2009), 74,666 women in the Nurses' Health Study (1980-2008), and 39,424 men in the Health Professionals Follow-up Study (1986-2008). We used Cox proportional hazards models to estimate the hazard ratios (HR) with 95% confidence intervals (CIs) of melanoma associated with dietary intakes. We documented 2,254 melanoma cases over 4 million person-years of follow-up. After adjustment for other risk factors, higher total caffeine intake was associated with a lower risk of melanoma (≥393 mg/day vs. caffeinated coffee consumption, whereas no association was found for decaffeinated coffee consumption and melanoma risk. Increasing caffeine intake and caffeinated coffee consumption is associated with decreased risk of cutaneous malignant melanomas.

  8. Melanoma maligno cutâneo: sistema de pontos (scoring system para auxílio no diagnóstico histopatológico Cutaneous malignant melanoma: scoring system to assist in the histopathologic diagnosis

    Directory of Open Access Journals (Sweden)

    Luiz Alberto Veronese

    2006-10-01

    Full Text Available INTRODUÇÃO: O diagnóstico histopatológico de algumas lesões melanocíticas pode ser muito difícil, mesmo para especialistas, mas há casos em que a dificuldade surge pela inadequada e subjetiva aplicação dos critérios diagnósticos. OBJETIVO: O objetivo deste estudo é desenvolver um método de aplicação sistemática desses critérios, atribuindo valores para os mais importantes. MATERIAL E MÉTODOS: Selecionaram-se os critérios mais relevantes para o diagnóstico de melanoma, atribuindo valores de 1 a 5 de acordo com sua importância. Foram escolhidos 101 casos de melanomas de tipo extensivo-superficial com menos de 2mm de espessura para análise comparativa com 33 lesões melanocíticas benignas (13 nevos de Spitz, seis de Reed, seis displásicos, três congênitos, três adquiridos, um combinado e um recorrente. RESULTADOS: A soma dos valores dados aos critérios (score apresentou diferença significativa entre lesões malignas e benignas, mostrando que esse método pode ser útil ao patologista cirúrgico generalista em sua rotina diária. CONCLUSÃO: A aplicação objetiva e sistemática dos critérios histopatológicos pelo sistema de pontos (scoring system pode ajudar o diagnóstico diferencial entre maligno e benigno em muitas lesões, porém não tendo o efeito desejado nas lesões melanocíticas de comportamento biológico indeterminado.INTRODUCTION: The histopathological diagnosis of melanocytic lesions may be very difficult, even by experts within the field. The challenge can come from inaccurate and/or subjective application of the diagnosis criteria. AIM: The goal of this study was to develop a method of systematic application of histopathological criteria as a result of the most relevant microscopic characteristics. MATERIAL AND METHODS: The most important criteria to diagnosing melanoma on histopathological bases were selected and given points ranging from 1 to 5 according to their relevance to the melanoma diagnosis

  9. Estudio del ganglio centinela: Diagnóstico y tratamiento del melanoma maligno cutáneo, estadios I y II Study of the sentinel lymph node: Diagnosis and treatment of cutaneous malignant melanoma stages I and II

    Directory of Open Access Journals (Sweden)

    Valeria Denninghoff

    2006-04-01

    Full Text Available La sobrevida a cinco años de los casos con melanoma maligno primario localizado es de aproximadamente un 80%, comparada con un 35% cuando los ganglios están comprometidos. Se estudió el/los ganglio/s centinela/s mediante hematoxilina-eosina (HE, inmunohistoquímica (IHQ y biología molecular (BM de individuos con diagnóstico de melanoma maligno estadio I o II. La población se dividió en tres grupos: HE-/IHQ+/BM+: 67% fallecieron; HE-/IHQ-/BM+: 57% fallecieron y HE-/IHQ-/BM-: el 100% de los individuos viven sin linfadenectomía, con una mediana de seguimiento de 60 meses. Los individuos que mostraron negatividad con los tres métodos tuvieron un índice de recurrencia nulo. Los datos de este estudio sugieren una nueva estadificación oncológica a nivel molecular que permitiría seleccionar a los individuos que presenten metástasis submicroscópicas para un tratamiento completo, pero también evitar linfadenectomías en muchos individuos que no tienen metástasis ganglionares, permitiendo que éstos no sufran sobretratamiento.Survival at 5 years of patients with localized primary malignant melanoma is about 80%, compared with a 35% survival in case of lymph nodes involvement. Sentinel lymph node(s from 45 subjects with diagnosis of malignant melanoma stage I or II was/were studied with hematoxylin-eosin (HE, immunohistochemistry (IHC and molecular biology (MB techniques. The population was divided into three groups: HE-/IHC+/MB+, where 67% patients died; HE-/IHC-/MB+, where 57% died; and HE-/IHC-/MB-, where 100% of the patients are alive, with no lymphadenectomy and a median follow-up of 60 months. Those subjects who showed negativity with all the three methods had a null recurrence rate. Data herein obtained suggest a new molecular oncological staging, which would allow the selection of patients with submicroscopic metastases for a complete treatment. Moreover, several patients with no lymph node metastases should not undergo lympha

  10. Cutaneous epithelioid angiosarcoma: a neoplasm with potential pitfalls in diagnosis.

    Science.gov (United States)

    Mobini, Narciss

    2009-03-01

    Angiosarcoma (AS) is a rare neoplasm. Cutaneous AS is the most common form of AS. The epithelioid variant of the disease, however, is a rare entity. This subset can histologically mimic non-vascular neoplasms and impose serious challenges in reaching the correct diagnosis. We present five patients with cutaneous epithelioid angiosarcoma (EAS); in none, the clinical diagnosis included a vascular lesion. Three patients had history of breast conservation surgery with/without radiation therapy. Other patients had no previous radiation, and there was no lymphedema in any of the cases. The histopathological examination of the biopsy specimens by hematoxylin and eosin method was not suggestive of a malignant vascular neoplasm initially and the differential diagnoses included carcinoma, malignant melanoma and atypical lymphoid infiltrate. Only after performing immunohistochemical studies that included vascular markers, a definitive diagnosis was possible. Some cases showed unusual histopathological features. Cutaneous EAS is a rare variant of cutaneous AS that can mimic a variety of more common, non-vascular neoplasms, creating a major pitfall in the diagnosis. A careful and thorough histopathological examination and a high index of suspicion, along with appropriate immunohistochemical evaluation, can help reach a correct diagnosis and provide optimal patient care.

  11. Cutaneous melanoma frequencies and seasonal trend in 20 years of observation of a population characterised by excessive sun exposure

    Science.gov (United States)

    Bonin, Serena; Albano, Antonio; di Meo, Nicola; Gatti, Alessandro; Stinco, Giuseppe; Zanconati, Fabrizio; Trevisan, Giusto

    2015-01-01

    Background Cutaneous melanoma is an aggressive form of skin cancer. It has become an increasingly common neoplasm in the most developed countries, especially among individuals of European origin. Patients and methods. Anonymous data of patients with cutaneous melanoma were collected from the diagnostic database of the University Hospital of Trieste from 1 January 1990 to 10 December 2013. Our study is based on a population which was constant over the period of observation; it was also well-defined and characterised by unrestrained sun exposure. Results The number of cutaneous melanomas increased during the period of observation with a seasonality trend and gender related differences both for anatomical sites distribution and stage of the disease. Moreover, 6% of our cohort developed multiple melanomas. Conclusions In a well-defined population devoted to excessive sun exposure the frequencies of skin melanomas roughly doubled from 1990 to 2013 following a seasonal trend. In that population, prevention efforts according to gender specific risk behaviour, as well as follow-up programmes both for evaluation of metastatic spreading and for early diagnosis of additional skin melanomas, are crucial due to gender specific differences and to the occurrence of multiple melanomas. PMID:26834525

  12. Psychoeducational intervention for patients with cutaneous malignant melanoma

    DEFF Research Database (Denmark)

    Boesen, Ellen H; Ross, Lone; Frederiksen, Kirsten

    2005-01-01

    PURPOSE: In 1993, a randomized intervention study among patients with malignant melanoma showed a significant decrease in psychological distress and increased coping capacity 6 months after the intervention and enhanced survival 6 years later. We applied a similar intervention with a few modifica......PURPOSE: In 1993, a randomized intervention study among patients with malignant melanoma showed a significant decrease in psychological distress and increased coping capacity 6 months after the intervention and enhanced survival 6 years later. We applied a similar intervention with a few...... modifications in a randomized controlled trial among Danish patients with malignant melanoma and evaluated results on immediate and long-term effects on psychological distress and coping capacity. PATIENTS AND METHODS: A total of 262 patients with primary cutaneous malignant melanoma were randomly assigned...... significantly more active-behavioral and active-cognitive coping than the patients in the control group. The improvements were only significant at first follow-up. CONCLUSION: The findings of this study support the results of an earlier intervention study among patients with malignant melanoma and indicate...

  13. [Update on surgical treatment of primary and metastatic cutaneous melanoma].

    Science.gov (United States)

    Zuluaga-Sepúlveda, María Alejandra; Arellano-Mendoza, Ivonne; Ocampo-Candiani, Jorge

    2016-01-01

    Melanoma is a common cutaneous tumour. It is of great importance due to its increasing incidence and aggressive behaviour, with metastasis to lymph nodes and internal organs. When suspecting melanoma, excisional biopsy should be performed to obtain complete histological information in order to determine the adverse factors such as ulceration, mitosis rate, and Breslow depth, which influence preoperative staging and provide data for sentinel lymph biopsy decision making. The indicated management for melanoma is wide local excision, observing recommended and well-established excision margins, depending on Breslow depth and anatomical location of the tumour. Therapeutic lymphadenectomy is recommended for patients with clinically or radiologically positive lymph nodes. This article reviews surgical treatment of melanoma, adverse histological factors, sentinel lymph node biopsy, and radical lymphadenectomy. Details are presented on special situations in which management of melanoma is different due to the anatomical location (plantar, subungual, lentigo maligna), or pregnancy. Copyright © 2015 Academia Mexicana de Cirugía A.C. Published by Masson Doyma México S.A. All rights reserved.

  14. Treatment of cutaneous melanoma: current approaches and future prospects

    Directory of Open Access Journals (Sweden)

    Alain P Algazi

    2010-08-01

    Full Text Available Alain P Algazi1, Christopher W Soon2, Adil I Daud11Department of Medicine, Division of Hematology and Oncology, 2Department of Dermatology, University of California, San Francisco San Francisco, CA, USAAbstract: Melanoma is the most aggressive and deadly type of skin cancer. Surgical resection with or without lymph node sampling is the standard of care for primary cutaneous melanoma. Adjuvant therapy decisions may be informed by careful consideration of prognostic factors. High-dose adjuvant interferon alpha-2b increases disease-free survival and may modestly improve overall survival. Less toxic alternatives for adjuvant therapy are currently under study. External beam radiation therapy is an option for nodal beds where the risk of local recurrence is very high. In-transit melanoma metastases may be treated locally with surgery, immunotherapy, radiation, or heated limb perfusion. For metastatic melanoma, the options include chemotherapy or immunotherapy; targeted anti-BRAF and anti-KIT therapy is under active investigation. Standard chemotherapy yields objective tumor responses in approximately 10%–20% of patients, and sustained remissions are uncommon. Immunotherapy with high-dose interleukin-2 yields objective tumor responses in a minority of patients; however, some of these responses may be durable. Identification of activating mutations of BRAF, NRAS, c-KIT, and GNAQ in distinct clinical subtypes of melanoma suggest that these are molecularly distinct. Emerging data from clinical trials suggest that substantial improvements in the standard of care for melanoma may be possible.Keywords: melanoma, resection, immune modulation, small molecule kinase inhibitors, chemotherapy, clinical trials

  15. Biomarker utility of circulating tumor cells in metastatic cutaneous melanoma.

    Science.gov (United States)

    Khoja, Leila; Lorigan, Paul; Zhou, Cong; Lancashire, Matthew; Booth, Jessica; Cummings, Jeff; Califano, Raffaele; Clack, Glen; Hughes, Andrew; Dive, Caroline

    2013-06-01

    The incidence of melanoma is increasing worldwide. Advances in targeted agents and immunotherapy have improved outcomes in metastatic disease, but biomarkers are required to optimize treatment. We determined the prevalence of circulating tumor cells (CTCs) and explored their utility as prognostic and pharmacodynamic biomarkers. A total of 101 patients with metastatic cutaneous melanoma were recruited prospectively. CTC number was determined using the CellSearch platform and melanoma kits in samples taken at baseline and serially during treatment. CTC numbers ranged between 0 and 36 per 7.5 ml blood; 26% of patients had ≥ 2 CTCs. Baseline CTC number was prognostic for median overall survival (OS) in univariate analysis (2.6 vs. 7.2 months (P<0.011) for patients with ≥ 2 CTCs vs. <2 CTCs, respectively). In multivariate analysis, CTC number was an independent prognostic biomarker of OS (hazard ratio (HR) 2.403, 95% confidence interval (CI) 1.303-4.430, P=0.005). Patients receiving treatment in whom CTC number remained ≥ 2 CTCs during treatment had shorter median OS than those who maintained <2 CTCs (7 vs. 10 months, HR 0.34, 95% CI 0.14-0.81, log-rank test P=0.015). In conclusion, CTC number in metastatic cutaneous melanoma patients is prognostic for OS with a cutoff of 2 CTCs per 7.5 ml blood. CTC number measured before and throughout treatment provided additional prognostic information. Larger studies are warranted to confirm CTC biomarker utility in melanoma patients.

  16. The risk of cutaneous melanoma in melanocytic nevi Risco de melanoma cutâneo nos nevos melanocíticos

    Directory of Open Access Journals (Sweden)

    Nurimar Conceição Fernandes

    2013-04-01

    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.

  17. Immunomodulatory Monoclonal Antibodies in Combined Immunotherapy Trials for Cutaneous Melanoma

    Directory of Open Access Journals (Sweden)

    Mariana Aris

    2017-08-01

    Full Text Available In the last few years, there has been a twist in cancer treatment toward immunotherapy thanks to the impressive results seen in advanced patients from several tumor pathologies. Cutaneous melanoma is a highly mutated and immunogenic tumor that has been a test field for the development of immunotherapy. However, there is still a way on the road to achieving complete and long-lasting responses in most patients. It is desirable that immunotherapeutic strategies induce diverse immune reactivity specific to tumor antigens, including the so-called neoantigens, as well as the blockade of immunosuppressive mechanisms. In this review, we will go through the role of promising monoclonal antibodies in cancer immunotherapy with immunomodulatory function, especially blocking of the inhibitory immune checkpoints CTLA-4 and PD-1, in combination with different immunotherapeutic strategies such as vaccines. We will discuss the rational basis for these combinatorial approaches as well as different schemes currently under study for cutaneous melanoma in the clinical trials arena. In this way, the combination of “push and release” immunomodulatory therapies can contribute to achieving a more robust and durable antitumor immune response in patients.

  18. Metastatic Tumor Dormancy in Cutaneous Melanoma: Does Surgery Induce Escape?

    Energy Technology Data Exchange (ETDEWEB)

    Tseng, William W. [Department of Surgery, University of California at San Francisco, 513 Parnassus Avenue, Room S-321, San Francisco, CA 94143 (United States); Fadaki, Niloofar; Leong, Stanley P., E-mail: leongsx@cpmcri.org [Department of Surgery and Center for Melanoma Research and Treatment, California Pacific Medical Center and Research Institute, 2340 Clay Street, 2nd floor, San Francisco, CA 94115 (United States)

    2011-02-21

    According to the concept of tumor dormancy, tumor cells may exist as single cells or microscopic clusters of cells that are clinically undetectable, but remain viable and have the potential for malignant outgrowth. At metastatic sites, escape from tumor dormancy under more favorable local microenvironmental conditions or through other, yet undefined stimuli, may account for distant recurrence after supposed “cure” following surgical treatment of the primary tumor. The vast majority of evidence to date in support of the concept of tumor dormancy originates from animal studies; however, extensive epidemiologic data from breast cancer strongly suggests that this process does occur in human disease. In this review, we aim to demonstrate that metastatic tumor dormancy does exist in cutaneous melanoma based on evidence from mouse models and clinical observations of late recurrence and occult transmission by organ transplantation. Experimental data underscores the critical role of impaired angiogenesis and immune regulation as major mechanisms for maintenance of tumor dormancy. Finally, we examine evidence for the role of surgery in promoting escape from tumor dormancy at metastatic sites in cutaneous melanoma.

  19. Metastatic Tumor Dormancy in Cutaneous Melanoma: Does Surgery Induce Escape?

    Directory of Open Access Journals (Sweden)

    William W. Tseng

    2011-02-01

    Full Text Available According to the concept of tumor dormancy, tumor cells may exist as single cells or microscopic clusters of cells that are clinically undetectable, but remain viable and have the potential for malignant outgrowth. At metastatic sites, escape from tumor dormancy under more favorable local microenvironmental conditions or through other, yet undefined stimuli, may account for distant recurrence after supposed “cure” following surgical treatment of the primary tumor. The vast majority of evidence to date in support of the concept of tumor dormancy originates from animal studies; however, extensive epidemiologic data from breast cancer strongly suggests that this process does occur in human disease. In this review, we aim to demonstrate that metastatic tumor dormancy does exist in cutaneous melanoma based on evidence from mouse models and clinical observations of late recurrence and occult transmission by organ transplantation. Experimental data underscores the critical role of impaired angiogenesis and immune regulation as major mechanisms for maintenance of tumor dormancy. Finally, we examine evidence for the role of surgery in promoting escape from tumor dormancy at metastatic sites in cutaneous melanoma.

  20. Collagenase-3 (MMP-13) expression in cutaneous malignant melanoma.

    Science.gov (United States)

    Corte, M D; Gonzalez, L O; Corte, M G; Quintela, I; Pidal, I; Bongera, M; Vizoso, F

    2005-01-01

    Matrix metalloproteases (MMPs), enzymes with the ability to degrade the extracellular matrix, play an important role in tissue invasion by cutaneous malignant melanoma (CMM). One specific MMP, collagenase-3 (MMP-13), is thought to have a key function in the activation of MMP. To evaluate the expression of MMP-13 in CMM and assess its possible relationship to clinical and pathological parameters. MMP-13 expression was analyzed in 51 paraffin-embedded tumor samples from patients with invasive CMM, ten samples from in situ melanomas, and in eight samples from benign lesions (three dermal melanocytic nevi, three compound melanocytic nevi and two atypical melanocytic nevi) using immunohistochemical techniques. The median follow-up period in patients with invasive CMM was 50 months. Benign lesions were consistently negative for MMP-13, whereas three of the ten in situ melanomas (30%) and 23 of the 51 invasive CMMs (45%) showed positive immunostaining for MMP-13. The percentage of MMP-13-positive tumors correlated significantly and positively with the mitotic index (p=0.002) in invasive CMM. However, our results did not show any significant association between tumoral MMP-13 expression and relapse-free survival in patients with invasive CMM. MMP-13 appears to be a factor associated with tumor aggressiveness in CMM. It seems to eliminate an important barrier not only against tumoral invasion but also against proliferation.

  1. Established and Emerging Biomarkers in Cutaneous Malignant Melanoma

    Directory of Open Access Journals (Sweden)

    Stamatina Verykiou

    2014-01-01

    Full Text Available In an era of personalized medicine, disease specific biomarkers play an increasing role in the stratification of high-risk patient groups. Cutaneous malignant melanoma is the most deadly form of skin cancer with an ever-increasing global incidence, especially in patients under 35-years of age. Despite the excellent prognosis for patients diagnosed with early stage disease, metastatic disease still carries significant overall mortality. Biomarkers aim not only to identify high-risk patients, but also to provide potential therapeutic targets for differing patient subgroups. Furthermore, accessibility to tissue samples from a range of disease stages in malignant melanoma, unlike most other solid tissue tumours, provides the unique opportunity to explore the biology of tumour progression that may be relevant in the biology of cancer as a whole. Over the past decade, there have been major advances in targeted therapies, providing new avenues and hope to patients with this devastating disease. This review will focus on most up to date histological, serological and molecular biomarkers in malignant melanoma.

  2. Prognostic factors and epidemiological characteristics of cutaneous and mucosal head and neck melanoma.

    Science.gov (United States)

    Berzina, Anna; Azarjana, Kristine; Cema, Ingrida; Pjanova, Dace; Rivosh, Alexander

    2011-01-01

    OBJECTIVE. To describe the prognostic factors and epidemiological characteristics of cutaneous and mucosal head and neck melanoma and to identify the variables associated with mortality from this disease. MATERIAL AND METHODS. Patients treated for head and neck melanoma in the Oncology Centre of Latvia, Riga during a 10-year period were identified. Records from 124 cases were analyzed in a descriptive, retrospective study. For each patient, information regarding age, sex, tumor anatomic site, as well as ulceration, histological tumor subtypes, Breslow thickness and Clark invasion level was viewed. Disease specific survival rates were calculated. The frequencies of all study variables and their 95% confidence intervals were determined. Kaplan-Meier survival curves were produced to illustrate the survival differences for each variable. RESULTS. The patients' mean age was 67.36 years. The study included 81 females (65.32%) and 43 males (34.67%). The prevalent anatomical site for cutaneous head and neck melanoma was the cheek - 49% (n=55) and the intraocular site for mucosal melanoma (61.5%). A high percentage of thick cutaneous melanoma was detected. In 53 cases (47.3%) out of 112 cutaneous melanoma the tumor ulceration was found. Nodular melanoma subtype was predominating (38%). The incidence of cutaneous melanoma has increased unequally whereas mucosal melanoma of the head and neck is an uncommon cancer and the incidence rates in Latvia during a ten year period are decreasing. CONCLUSION. Female sex, advanced age, facial skin, tumor thickness, nodular subtype and ulceration carried a relevant risk of poor prognosis.

  3. Socio-economic class, rurality and risk of cutaneous melanoma by site and gender in Sweden

    Directory of Open Access Journals (Sweden)

    Gustavsson Per

    2008-01-01

    Full Text Available Abstract Background Cutaneous melanoma (CM is a cancer usually associated with high socio-economic level in the literature. Few studies have, however, assessed this relationship by gender and site or the association between CM and rurality. Methods A major-sized historical occupational Swedish cohort comprising 2,992,166 workers was used to estimate relative risk of cutaneous melanoma, broken down by gender and anatomical site, for occupational sectors (as a proxy of socio-economic class and rurality. To this end, Poisson models were fitted for each site in men and women, including occupational sector and town size, with adjustment for age, period of diagnosis and geographical area as possible confounding factors. Results White collar workers presented a marked increased of risk in men in all melanoma cases, as well as in trunk, upper and lower limbs. This pattern was less clear for women, in which some heterogeneity appeared, as low risks in lower socioeconomic sectors in trunk, or risk excesses in white collar workers in lower limbs did not achieve statistical significance. Males also showed significant differences in risk by rural/urban distribution, but in women this association was limited to CM of lower limb. Risk of CM of head/neck did not vary by occupational sector or town size, thus depicting a specific epidemiological profile, which proved common to both sexes. Conclusion While differences in risk between men and women could suggest greater homogeneity in UV-exposure behaviour among women, the uniform risk pattern in head and neck melanoma, present in both sexes, might support the coexistence of different aetiological pathways, related to anatomical site.

  4. Socioeconomic status and cutaneous malignant melanoma in Northern Europe

    DEFF Research Database (Denmark)

    Idorn, L W; Wulf, H C

    2014-01-01

    Socioeconomic status (SES) is associated with cutaneous malignant melanoma (CMM), also in Northern Europe despite equal access to health care. SES per se is not responsible for this association which must be ascribed to important risk factors for CMM such as intermittent UVR exposure, and screening....... There is evidence that high SES is associated with sun holidays, whereas low SES is associated with use of sunbeds. Findings suggest that high SES is associated with use of physicians and dermatologists for marks and moles, possibly due to more knowledge and better understanding of CMM. We conclude that there has...... been a true increase in CMM incidence among high SES individuals in Northern Europe probably due to past intense intermittent UVR exposure, especially in connection with sun holidays. However, the increased risk of CMM and a better outcome of CMM in high SES individuals may also be conditioned...

  5. [Current diagnosis of cutaneous lupus erythematosus].

    Science.gov (United States)

    Haust, M; Bonsmann, G; Kuhn, A

    2006-07-14

    Cutaneous lupus erythematosus (CLE) is a disease with different subtypes and the new classification system includes acute CLE (ACLE), subacute CLE (SCLE), chronic CLE (CCLE), and intermittent CLE (ICLE). The broad spectrum of skin involvement and the possibility of systemic organ manifestations at the beginning and during the course of CLE require specific diagnostic procedures. Clinical assessment of the cutaneous manifestations is necessary along with a detailed patient's history. The diagnosis of CLE is confirmed by histopathology and immunofluorescence microscopy. Selective laboratory screening and additional diagnostic procedures depending on clinical symptoms are recommended. Photoprovocation tests can be performed to assess photosensitivity in patients with CLE and to support the diagnosis. Recently, a scoring system for the activity of the cutaneous manifestations in CLE has been developed and is now evaluated in several clinical studies. In this review, the classification and the characteristic clinical criteria of the different CLE subtypes as well as the current diagnostic possibilities are emphasized.

  6. Accuracy of Diagnostic Biopsy for Cutaneous Melanoma: Implications for Surgical Oncologists

    OpenAIRE

    Hieken, Tina J.; Roberto Hernández-Irizarry; Boll, Julia M.; Jones Coleman, Jamie E.

    2013-01-01

    Background and Objectives. While excisional biopsy is recommended to diagnose cutaneous melanoma, various biopsy techniques are used in practice. We undertook this study to identify how frequently final tumor stage and treatment recommendations changed from diagnostic biopsy to final histopathology after wide local excision (WLE). Methods. We compared the histopathology of the dermatopathologist-reviewed diagnostic biopsy and final WLE in 332 cutaneous melanoma patients. Results. Tumor sites ...

  7. Primary cutaneous melanoma of the scalp: Patterns of recurrence.

    Science.gov (United States)

    Sparks, David S; Read, Tavis; Lonne, Michael; Barbour, Andrew P; Wagels, Michael; Bayley, Gerard J; Smithers, B Mark

    2017-03-01

    Patients with primary melanoma of the scalp have been reported to have worse disease-related outcomes compared with other anatomical regions. There are few studies in the literature specifically addressing recurrence patterns and treatment outcomes for primary scalp melanoma as a discrete anatomical sub-region. We sought to identify key features adversely influencing disease control and survival and to clarify the role of resection plane, margin, and method of reconstruction in the management of this disease process. A retrospective clinical study of medical records was performed evaluating all patients with primary melanoma of the scalp treated at two hospitals in southeast Queensland between 2004 and 2014. A total of 107 patients were eligible for analysis. There were 46 recurrences in 38 patients in the cohort accounting for a recurrence rate of 35.5%. The local recurrence rate was 15.9% with 12 in-transit metastases after diagnosis. Regional and distant recurrence rates were 12.1% and 15%, respectively. At a median follow up of 30.5 months, disease-free survival was 47% and overall survival was also 47%. On multi-variate analysis, the deeper resection plane (sub-galeal) had a lower disease-free survival rate compared with the supra-galeal resection plane (P = 0.032). Our results support the hypothesis that primary scalp melanoma represents a unique aggressive subcategory with high rates of in-transit disease and poor disease-related and survival outcomes. There is a need for robust prospective comparative studies to address the significance of resection plane in the management of patients with scalp melanoma. © 2016 Wiley Periodicals, Inc.

  8. [Cutaneous melanoma - "black death" of modern times? Traces in contemporary literature].

    Science.gov (United States)

    Bahmer, F A; Bahmer, J A

    2013-11-01

    Cutaneous melanoma, sometimes labeled as "black skin cancer", is increasing in frequency and becoming a more common literary motive. In US literature, Sylvia Plath and Charles Bukowski depicted melanoma more than 50 years ago, later Stephen King and Thomas C. Boyle. In German literature, Charlotte Roche shortly mentioned this tumor. Jörg Pönnighaus, both poet and dermatologist, intensively deals in his poems with the effects melanoma has on patients and doctors alike. Melanoma definitely is not the "Black Death" of modern times. However, the perception of this tumor as extremely malignant and as life-threatening makes melanoma a metaphor of the deadly danger of cancer.

  9. Molecular characterisation of cutaneous melanoma: creating a framework for targeted and immune therapies

    Science.gov (United States)

    Rajkumar, Shivshankari; Watson, Ian R

    2016-01-01

    Large-scale genomic analyses of cutaneous melanoma have revealed insights into the aetiology and heterogeneity of this disease, as well as opportunities to further personalise treatment for patients with targeted and immune therapies. Herein, we review the proposed genomic classification of cutaneous melanoma from large-scale next-generation sequencing studies, including the largest integrative analysis of melanoma from The Cancer Genome Atlas (TCGA) Network. We examine studies that have identified molecular features of melanomas linked to immune checkpoint inhibitor response. In addition, we draw attention to low-frequency actionable mutations and highlight frequent non-coding mutations in melanoma where little is known about their biological function that may provide novel avenues for the development of treatment strategies for melanoma patients. PMID:27336610

  10. Molecular characterisation of cutaneous melanoma: creating a framework for targeted and immune therapies.

    Science.gov (United States)

    Rajkumar, Shivshankari; Watson, Ian R

    2016-07-12

    Large-scale genomic analyses of cutaneous melanoma have revealed insights into the aetiology and heterogeneity of this disease, as well as opportunities to further personalise treatment for patients with targeted and immune therapies. Herein, we review the proposed genomic classification of cutaneous melanoma from large-scale next-generation sequencing studies, including the largest integrative analysis of melanoma from The Cancer Genome Atlas (TCGA) Network. We examine studies that have identified molecular features of melanomas linked to immune checkpoint inhibitor response. In addition, we draw attention to low-frequency actionable mutations and highlight frequent non-coding mutations in melanoma where little is known about their biological function that may provide novel avenues for the development of treatment strategies for melanoma patients.

  11. BRAF mutations distinguish anorectal from cutaneous melanoma at the molecular level

    DEFF Research Database (Denmark)

    Helmke, Burkhard M; Mollenhauer, Jan; Herold-Mende, Christel

    2004-01-01

    BACKGROUND & AIMS: Anorectal melanoma (AM) is a rare but highly malignant tumor, displaying histologic and immunohistochemical features very similar to cutaneous melanoma (CM). Because BRAF mutations were recently identified in the majority of CM and nevi, we investigated AM for BRAF mutations an...

  12. A multicentre epidemiological study on sunbed use and cutaneous melanoma in Europe

    NARCIS (Netherlands)

    V. Bataille (Veronique); M. Boniol; E.G.E. de Vries (Elisabeth); G. Severi (Gianluca); Y. Brandberg (Yvonne); P. Sasieni (Peter); J. Cuzick (Jack); A.M.M. Eggermont (Alexander); U. Ringborg; A.-R. Grivegnée (André-Robert); J.W.W. Coebergh (Jan Willem); M.C. Chignol (Marie Christine); J.F. Doré; P.J.M. Autier (Philippe)

    2005-01-01

    textabstractA large European case-control study investigated the association between sunbed use and cutaneous melanoma in an adult population aged between 18 and 49 years. Between 1999 and 2001 sun and sunbed exposure was recorded in 597 newly diagnosed melanoma cases and 622 controls in Belgium, Fr

  13. Thin and thick primary cutaneous melanomas reveal distinct patterns of somatic copy number alterations.

    Science.gov (United States)

    Montagnani, Valentina; Benelli, Matteo; Apollo, Alessandro; Pescucci, Chiara; Licastro, Danilo; Urso, Carmelo; Gerlini, Gianni; Borgognoni, Lorenzo; Luzzatto, Lucio; Stecca, Barbara

    2016-05-24

    Cutaneous melanoma is one of the most aggressive type of skin tumor. Early stage melanoma can be often cured by surgery; therefore current management guidelines dictate a different approach for thin (thick (>4mm) melanomas. We have carried out whole-exome sequencing in 5 thin and 5 thick fresh-frozen primary cutaneous melanomas. Unsupervised hierarchical clustering analysis of somatic copy number alterations (SCNAs) identified two groups corresponding to thin and thick melanomas. The most striking difference between them was the much greater abundance of SCNAs in thick melanomas, whereas mutation frequency did not significantly change between the two groups. We found novel mutations and focal SCNAs in genes that are embryonic regulators of axon guidance, predominantly in thick melanomas. Analysis of publicly available microarray datasets provided further support for a potential role of Ephrin receptors in melanoma progression. In addition, we have identified a set of SCNAs, including amplification of BRAF and ofthe epigenetic modifier EZH2, that are specific for the group of thick melanomas that developed metastasis during the follow-up. Our data suggest that mutations occur early during melanoma development, whereas SCNAs might be involved in melanoma progression.

  14. Diagnosis of Cutaneous Leishmaniasis by Multiplex PCR

    Directory of Open Access Journals (Sweden)

    M Heiat

    2010-07-01

    Full Text Available Introduction: Annually, more than 14 million people are reported to be infected with Leishmaniasis all over the world. In Iran, this disease is seen in the form of cutaneous and visceral leishmaniasis, of which the cutaneous form is more wide spread. In recent years, cutaneous leishmaniaisis is diagnosed by PCR utilizing specific primers in order to amplify different parasite genes including ribosomal RNA genes, kinetoplast DNA or tandem repeating sequences. The aim of this research was to detect early stage cutaneous leishmaniasis using Multiplex-PCR technique. Methods: In this study, 67 samples were prepared from patients with cutaneous leishmaniasis. DNA was extracted with phenolchloroform. Each specimen was analyzed using two different pairs of PCR primers. The sensitivity of each PCR was optimized on pure Leishmania DNA prior to use for diagnosis. Two standard parasites L. major and L. tropica were used as positive control. Results: DNA amplification fragments were two 115 bp and 683 bp for AB and UL primers, respectively. The sensitivity of two primers was not equal for detection of L. major and L. tropica. The sensivity of PCR with AB primer was 35 cells, while that for UL primer was 40 cells. Conclusion: The results of this study indicate that PCR is a sensitive diagnostic assay for cutaneous leishmaniasis and could be employed as the new standard for routine diagnosis when species identification is not required. However, the ability to identify species is especially important in prognosis of the disease and in deciding appropriate therapy, especially in regions where more than one type of species and disease are seen by clinicians.

  15. Evaluation of the Melanocytic Pathology Assessment Tool and Hierarchy for Diagnosis (MPATH-Dx) classification scheme for diagnosis of cutaneous melanocytic neoplasms: Results from the International Melanoma Pathology Study Group.

    Science.gov (United States)

    Lott, Jason P; Elmore, Joann G; Zhao, Ge A; Knezevich, Stevan R; Frederick, Paul D; Reisch, Lisa M; Chu, Emily Y; Cook, Martin G; Duncan, Lyn M; Elenitsas, Rosalie; Gerami, Pedram; Landman, Gilles; Lowe, Lori; Messina, Jane L; Mihm, Martin C; van den Oord, Joost J; Rabkin, Michael S; Schmidt, Birgitta; Shea, Christopher R; Yun, Sook Jung; Xu, George X; Piepkorn, Michael W; Elder, David E; Barnhill, Raymond L

    2016-08-01

    Pathologists use diverse terminology when interpreting melanocytic neoplasms, potentially compromising quality of care. We sought to evaluate the Melanocytic Pathology Assessment Tool and Hierarchy for Diagnosis (MPATH-Dx) scheme, a 5-category classification system for melanocytic lesions. Participants (n = 16) of the 2013 International Melanoma Pathology Study Group Workshop provided independent case-level diagnoses and treatment suggestions for 48 melanocytic lesions. Individual diagnoses (including, when necessary, least and most severe diagnoses) were mapped to corresponding MPATH-Dx classes. Interrater agreement and correlation between MPATH-Dx categorization and treatment suggestions were evaluated. Most participants were board-certified dermatopathologists (n = 15), age 50 years or older (n = 12), male (n = 9), based in the United States (n = 11), and primary academic faculty (n = 14). Overall, participants generated 634 case-level diagnoses with treatment suggestions. Mean weighted kappa coefficients for diagnostic agreement after MPATH-Dx mapping (assuming least and most severe diagnoses, when necessary) were 0.70 (95% confidence interval 0.68-0.71) and 0.72 (95% confidence interval 0.71-0.73), respectively, whereas correlation between MPATH-Dx categorization and treatment suggestions was 0.91. This was a small sample size of experienced pathologists in a testing situation. Varying diagnostic nomenclature can be classified into a concise hierarchy using the MPATH-Dx scheme. Further research is needed to determine whether this classification system can facilitate diagnostic concordance in general pathology practice and improve patient care. Copyright © 2016 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  16. Patients highly value routine follow-up of skin cancer and cutaneous melanoma

    DEFF Research Database (Denmark)

    Themstrup, Lotte; Jemec, Gregor E; Lock-Andersen, Jørgen

    2013-01-01

    INTRODUCTION: Skin cancer follow-up is a substantial burden to outpatient clinics. Few studies have investigated patients' views on skin cancer follow-up and cutaneous melanoma. The objective was to investigate patients' perceived benefits and the impact of follow-up. MATERIAL AND METHODS......: This study included an open sample of patients attending routine follow-up at the outpatient Departments of Plastic Surgery and Dermatology, Roskilde Hospital. A total of 218 follow-up patients diagnosed with cutaneous malignant melanoma (MM), non-melanoma skin cancer (NMSC) or actinic keratosis (AK...

  17. Diagnosis and treatment of in-transit melanoma metastases.

    Science.gov (United States)

    Testori, A; Ribero, S; Bataille, V

    2017-03-01

    In transit metastases (ITM) from extremity or trunk melanomas are subcutaneous or cutaneous lymphatic deposits of melanoma cells, distant from the primary site but not reaching the draining nodal basin. Superficial ITM metastases develop in 5-10% of melanoma patients and are thought to be caused by cells spreading along lymphatics; ITM appear biologically different from distant cutaneous metastases, these probably due to a haematogenous dissemination. The diagnosis is usually clinical and by patients, but patients need to be adequately educated in the recognition of this clinical situation. Ultrasound or more sophisticated instrumental devices may be required if the disease develops more deeply in the soft tissues. According to AJCC 2009 staging classification, ITM are included in stages IIIb and IIIc, which are considered local advanced disease with quite poor 5-year survival rates and outcomes of 24-54% at 5 years.(2) Loco-regional recurrence is in fact an important risk factor for distant metastatic disease, either synchronous or metachronous. Therapy for this pattern of recurrence is less standardised then in most other clinical situations and options vary based on the volume and site of the disease. Definitive surgical resection remains the preferred therapeutic approach. However, when surgery cannot be performed with a reasonable cosmetic and functional outcome, other options must be utilized.(3-6) Treatment options are classified as local, regional or systemic. The choice of therapy depends on the number of lesions, their anatomic location, whether or not these are dermal or subcutaneous, the size and the presence or absence of extra-regional disease.

  18. Stereological estimation of nuclear volume in benign melanocytic lesions and cutaneous malignant melanomas

    DEFF Research Database (Denmark)

    Sørensen, Flemming Brandt

    1989-01-01

    V in melanocytic cutaneous tumors and to compare these with estimates of nuclear volume fraction and with traditional two-dimensional morphometric estimates of nuclear profile area, nuclear density, and mitotic index. Routinely processed, paraffin embedded tissue specimens from 47 malignant melanomas and 76...... noninvasive melanocytic cutaneous tumors were investigated retrospectively. vV clearly distinguished between noninvasive (average vV = 122 microns 3) and invasive lesions (average vV = 246 microns 3). Most of the patients with malignant melanomas showing an overlap of nuclear vV with benign lesions had...... estimator for distinguishing between melanocytic cutaneous tumors showing different biological behavior, well-suited for objective malignancy grading....

  19. Primary tumor sites in relation to ultraviolet radiation exposure and skin visibility correlate with survival in cutaneous melanoma.

    Science.gov (United States)

    Gordon, Daniela; Hansson, Johan; Eloranta, Sandra; Gordon, Max; Gillgren, Peter; Smedby, Karin E

    2017-10-01

    The prognostic value of detailed anatomic site and ultraviolet radiation (UVR) exposure patterns has not been fully determined in cutaneous melanoma. Thus, we reviewed medical records for detailed site in a population-based retrospective Swedish patient cohort diagnosed with primary invasive melanoma 1976-2003 (n = 5,973). We followed the patients from date of diagnosis until death, emigration or December 31(st) 2013, and evaluated melanoma-specific survival by subsite in a multivariable regression model adjusting for established prognostic factors. We found that melanoma on chronic UVR exposure sites (face, dorsum of hands; adjusted HR 0.6; CI 0.4-0.7) and moderately intermittent UVR sites (lateral arms, lower legs, dorsum of feet; HR 0.7; CI 0.6-0.8) were associated with a favorable prognosis compared with highly intermittent sites (chest, back, neck, shoulders and thighs). Further, melanoma on poorly visible skin sites upon self-examination (scalp, retroauricular area, back, posterior upper arms and thighs, buttocks, pubic area; HR 1.3; CI 1.1-1.5) had a worse prognosis than those on easily visible sites (face, chest, abdomen, anterior upper arms and thighs, lower arms and legs, dorsum of hands and feet, palms). In conclusion, highly intermittent UVR exposure sites and poor skin visibility presumably correlate with reduced melanoma survival, independent of established tumor characteristics. A limitation of the study was the lack of information on actual individual UVR exposure. © 2017 UICC.

  20. TERT promoter mutation status as an independent prognostic factor in cutaneous melanoma.

    Science.gov (United States)

    Griewank, Klaus G; Murali, Rajmohan; Puig-Butille, Joan Anton; Schilling, Bastian; Livingstone, Elisabeth; Potrony, Miriam; Carrera, Cristina; Schimming, Tobias; Möller, Inga; Schwamborn, Marion; Sucker, Antje; Hillen, Uwe; Badenas, Celia; Malvehy, Josep; Zimmer, Lisa; Scherag, André; Puig, Susana; Schadendorf, Dirk

    2014-09-01

    Recently, TERT promoter mutations were identified at high frequencies in cutaneous melanoma tumor samples and cell lines. The mutations were found to have a UV-signature and to lead to increased TERT gene expression. We analyzed a large cohort of melanoma patients for the presence and distribution of TERT promoter mutations and their association with clinico-pathological characteristics. 410 melanoma tumor samples were analyzed by Sanger sequencing for the presence of TERT promoter mutations. An analysis of associations between mutation status and various clinical and pathologic variables was performed. TERT promoter mutations were identified in 154 (43%) of 362 successfully sequenced melanomas. Mutation frequencies varied between melanoma subtype, being most frequent in melanomas arising in nonacral skin (48%) and melanomas with occult primary (50%), and less frequent in mucosal (23%), and acral (19%) melanomas. Mutations carried a UV signature (C>T or CC>TT). The presence of TERT promoter mutations was associated with factors such as BRAF or NRAS mutation (P promoter mutation was independently associated with poorer overall survival in patients with nonacral cutaneous melanomas (median survival 80 months vs 291 months for wild-type; hazard ratio corrected for other covariates 2.47; 95% confidence interval [CI] = 1.29 to 4.74; P = .006). UV-induced TERT promoter mutations are one of the most frequent genetic alterations in melanoma, with frequencies varying depending on melanoma subtype. In nonacral cutaneous melanomas, presence of TERT promoter mutations is independently associated with poor prognosis. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  1. Effect of proteasome inhibitors on proliferation and apoptosis of human cutaneous melanoma-derived cell lines.

    Science.gov (United States)

    Sorolla, A; Yeramian, A; Dolcet, X; Pérez de Santos, A M; Llobet, D; Schoenenberger, J A; Casanova, J M; Soria, X; Egido, R; Llombart, A; Vilella, R; Matias-Guiu, X; Marti, R M

    2008-03-01

    Cutaneous malignant melanoma is an aggressive type of skin cancer which causes disproportionate mortality in young and middle-aged adults. Once disseminated, melanoma can be considered an incurable disease, highly resistant to standard antineoplastic treatment, such as chemotherapy or radiation therapy. The proteasome represents a novel target for cancer therapy that can potentially be used in melanoma. To assess the effect of four structurally different proteasome inhibitors on human cutaneous melanoma-derived cell lines. Sixteen human cutaneous melanoma-derived cell lines which are original were obtained from patients who were treated by two of the authors. Cells were cultured, exposed to proteasome inhibitors (bortezomib, ALLN, MG-132 and epoxomicin) and then assayed for cell cycle and cell death analyses. Proteasome inhibitors inhibited the in vitro growth of melanoma cells, and this effect was due to a reduction in cell proliferation rate and an induction of both caspase-dependent and caspase-independent cell death. Moreover, release of apoptosis-inducing factor was observed in the presence of the broad-specificity caspase inhibitor BAF (Boc-D-fmk). In addition, the four different proteasome inhibitors induced caspase 2 processing. This study provides information regarding the in vitro effects of proteasome inhibitors on melanoma cell lines, and the molecular mechanisms involved. It also gives support to the future use of such inhibitors in the treatment of patients with melanoma, either administered alone or in combination with other drugs.

  2. Increased NY-ESO-1 Expression and Reduced Infiltrating CD3+ T Cells in Cutaneous Melanoma

    OpenAIRE

    Mara Giavina-Bianchi; Pedro Giavina-Bianchi; Mirian Nacagami Sotto; Alona Muzikansky; Jorge Kalil; Cyro Festa-Neto; Duncan, Lyn M.

    2015-01-01

    NY-ESO-1 is a cancer-testis antigen aberrantly expressed in melanomas, which may serve as a robust and specific target in immunotherapy. NY-ESO-1 antigen expression, tumor features, and the immune profile of tumor infiltrating lymphocytes were assessed in primary cutaneous melanoma. NY-ESO-1 protein was detected in 20% of invasive melanomas (16/79), rarely in in situ melanoma (1/10) and not in benign nevi (0/20). Marked intratumoral heterogeneity of NY-ESO-1 protein expression was observed. N...

  3. Downregulation of miR-125b in metastatic cutaneous malignant melanoma

    DEFF Research Database (Denmark)

    Glud, Martin; Rossing, Maria; Hother, Christoffer

    2010-01-01

    This study aimed to identify microRNA species involved in the earliest metastatic event in cutaneous malignant melanoma (MM). Samples from 28 patients with MM [stage T2 (tumor), M0 (distant metastasis)] were grouped by the presence of micrometastasis in the sentinel lymph nodes (N0/N1). Melanoma...... melanomas that produced early metastases (T2, N1, M0) compared with the sentinel lymph node-negative (T2, N0, M0) melanomas. MiR-125b has earlier been found to be downregulated in other tumor types and in atypic naevi compared with the common acquired naevi. In conclusion, miR-125b may be involved...

  4. A 3-Year Follow-up of Sun Behavior in Patients With Cutaneous Malignant Melanoma

    DEFF Research Database (Denmark)

    Idorn, Luise Winkel; Datta, Pameli; Heydenreich, Jakob

    2014-01-01

    IMPORTANCE UV radiation (UVR) exposure is the primary environmental risk factor for developing cutaneous malignant melanoma (CMM). OBJECTIVE To measure changes in sun behavior from the first until the third summer after the diagnosis of CMM using matched controls as a reference. DESIGN, SETTING...... that measured time-related UVR in standard erythema dose (SED) and corresponding sun diaries (mean, 74 days per participant each participation year). RESULTS Patients' daily UVR dose and UVR dose in connection with various behaviors increased during follow-up (quantified as an increase in daily UVR dose each...... suggest that patients with CMM do not maintain a cautious sun behavior in connection with an increase in UVR exposure, especially on days with body exposure, when abroad, and on holidays....

  5. Prognosis of sentinel node staged patients with primary cutaneous melanoma.

    Directory of Open Access Journals (Sweden)

    Otmar Elsaesser

    Full Text Available BACKGROUND: This study investigated survival probabilities and prognostic factors in sentinel lymph node biopsy (SLNB staged patients with cutaneous melanoma (CM with the aim of defining subgroups of patients who are at higher risk for recurrences and who should be considered for adjuvant clinical trials. METHODS: Patients with primary CM who underwent SLNB in the Department of Dermatology, University of Tuebingen, Germany, between 1996 and 2009 were included into this study. Survival probabilities and prognostic factors were evaluated by Kaplan-Meier and multivariate Cox proportional hazard models. RESULTS: 1909 SLNB staged patients were evaluated. Median follow-up time was 44 months. Median tumor thickness was 1.8 mm, ulceration was present in 31.8% of cases. The 5-year Overall Survival (OS was 90.3% in SLNB negative patients (IB 96.2%, IIA 87.0%, IIB 78.1%, IIC 72.6%. Patients with micrometastases (stage IIIA/B had a 5-year OS rate of 70.9% which was clearly less favorable than for stages I-II. Multivariate analysis revealed tumor thickness, ulceration, body site, histopathologic subtype and SLNB status as independent significant prognostic factors. CONCLUSION: Survival rates of patients with primary CM in stages I-II were shown to be much more favorable than previously reported from non sentinel node staged collectives. For future clinical trials, sample size calculations should be adapted using survival probabilities based on sentinel node staging.

  6. Cutaneous melanoma in Latin America: a population-based descriptive study.

    Science.gov (United States)

    Sortino-Rachou, Ana Maria; Curado, Maria Paula; Cancela, Marianna de Camargo

    2011-03-01

    Cutaneous melanoma incidences vary between geographic regions and are a health concern for Caucasians and for all ethnic populations. In Latin America, data from population-based cancer registries of cutaneous melanoma incidence rates have rarely been reported. We searched the Cancer Incidence in Five Continents volume IX (CI5-IX) database for cutaneous melanoma and select cases by topography (C43) from 11 population-based cancer registries in Latin America. Between 1998 and 2002, a total of 4,465 cutaneous melanoma cases were reported in Latin America. The average age-standardized incidence rates (per 100,000 persons-year) was 4.6 (male) and 4.3 (female). This study presents an overview of cutaneous melanoma incidence in Latin America, highlighting the need to enhance coverage of population-based cancer registries in Latin America, to allow for a better understanding of this neoplasm in the region. Thus it can help in implementing primary prevention programs for the whole Latino population. At this point in time, early detection messages should target young women and older men in Latin America.

  7. Study of the histopathological types of cutaneous melanoma in Palmas-TO from 2001 to 2011.

    Science.gov (United States)

    Costa, Nilo Fernandes da; Fernandes, Nurimar Conceição; Borges, Myrlena Regina Machado Mescouto

    2015-01-01

    Cutaneous melanoma (CM) is considered serious for causing frequent metastasis, presenting high mortality, resistance to available therapies and incidences in laboring activity. To study the histopathological types of cutaneous melanoma in Palmas-TO from 2001 to 2011, according to risk factors, location of lesions, Clark levels and Breslow thickness. A descriptive, retrospective and quantitative research in reports of the Serviços de Anatomia Patológica in Palmas (SAPP) and Registro de Câncer de Base Populacional de Palmas (RCBPP). The years of highest incidences were: 2004 (8 cases/17.8%), 2008 and 2011 (7 cases each/15.6%) and 2010 (6 cases/13.3%). Among the 45 cases studied, there were predominance in patients between 41 and 60 years old, women, caucasians, farmers, located in trunk, in situ type, superficial extensive and metastatic cutaneous, Clark levels I (20%) and IV (17.7%), Breslow thickness ≤1 mm (35.5%) and 2.01 to 4 mm (24.4%). The most common histopathological types were: cutaneous melanoma in situ, superficial extensive and metastatic, followed by nodular cutaneous melanoma, and finally, by other forms. In this study, Clark levels and Breslow thickness pointed to greater importance of thin melanomas and sun exposure without appropriate protection in farmers.

  8. Correlations between cutaneous malignant melanoma and other cancers: An ecological study in forty European countries

    Directory of Open Access Journals (Sweden)

    Pablo Fernandez-Crehuet Serrano

    2016-01-01

    Full Text Available Background: The presence of noncutaneous neoplasms does not seem to increase the risk of cutaneous malignant melanoma; however, it seems to be associated with the development of other hematological, brain, breast, uterine, and prostatic neoplasms. An ecological transversal study was conducted to study the geographic association between cutaneous malignant melanoma and 24 localizations of cancer in forty European countries. Methods: Cancer incidence rates were extracted from GLOBOCAN database of the International Agency for Research on Cancer. We analyzed the age-adjusted and gender-stratified incidence rates for different localizations of cancer in forty European countries and calculated their correlation using Pearson′s correlation test. Results: In males, significant correlations were found between cutaneous malignant melanoma with testicular cancer (r = 0.83 [95% confidence interval (CI: 0.68-0.89], myeloma (r = 0.68 [95% CI: 0.46-0.81], prostatic carcinoma (r = 0.66 [95% CI: 0.43-0.80], and non-Hodgkin lymphoma (NHL (r = 0.63 [95% CI: 0.39-0.78]. In females, significant correlations were found between cutaneous malignant melanoma with breast cancer (r = 0.80 [95% CI: 0.64-0.88], colorectal cancer (r = 0.72 [95% CI: 0.52-0.83], and NHL (r = 0.71 [95% CI: 0.50-0.83]. Conclusions: These correlations call to conduct new studies about the epidemiology of cancer in general and cutaneous malignant melanoma risk factors in particular.

  9. GNA11 Mutation in a Patient With Cutaneous Origin Melanoma: A Case Report.

    Science.gov (United States)

    Patel, Sapna P; Kim, Dae Won; Lacey, Carol L; Hwu, Patrick

    2016-01-01

    The rapid advances in the molecular biology and genetics have improved the understanding of molecular pathogenesis of v-Raf murine sarcoma viral oncogene homolog B (BRAF), feline sarcoma viral oncogene v-kit (KIT), and neuroblastoma v-Ras oncogene homolog (NRAS) mutant melanomas with the subsequent development of targeted therapeutic agents. However, only limited data are available for melanoma harboring other somatic than BRAF, KIT, and NRAS mutations. Mutations in guanine nucleotide-binding protein Q polypeptide (GNAQ) and guanine nucleotide-binding protein alpha-11 (GNA11), alpha subunits of heterotrimeric G proteins, constitutively activate mitogen-activated protein kinase (MAPK) pathway in uveal melanoma. However, there are no reports of GNA11 mutations in cutaneous melanomas. A 48-year-old woman was diagnosed with cutaneous nodular melanoma on the left scalp. Mutation analysis of the tumor revealed a GNA11 Q209L mutation. There was no evidence of uveal melanoma or malignant blue nevus in ophthalmologic exam, imaging studies, and pathology review. To our knowledge, this is the first case report to demonstrate cutaneous origin melanoma harboring a GNA11 Q209L mutation.

  10. Clinical significance of serum laminin and type-IV collagen levels in cutaneous melanoma patients.

    Science.gov (United States)

    Tas, Faruk; Bilgin, Elif; Karabulut, Senem; Duranyildiz, Derya

    2016-07-01

    Laminin and type-IV collagen constitute a significant portion of the extracellular matrix. The objective of the present study was to evaluate whether the serum concentrations of laminin and type-IV collagen may serve as biomarkers for cutaneous melanoma. Sixty pathologically confirmed melanoma patients were enrolled in the study. Serum laminin and type-IV collagen levels were assessed using an ELISA. Thirty healthy controls were also examined. No significant differences in the baseline serum levels of laminin were identified between melanoma patients and healthy controls (P=0.45). However, the baseline serum levels of type-IV collagen were significantly elevated in melanoma patients compared with those in the control group (PIV collagen (P>0.05). Furthermore, the serum levels of laminin and type-IV collagen had no prognostic value regarding the outcome for melanoma patients (P=0.36 and P=0.26, respectively). While laminin levels showed no diagnostic value, the serum concentrations of type-IV collagen were indicated to serve as a diagnostic marker in patients with cutaneous melanoma. In conclusion, type-IV collagen levels may be used as a diagnostic marker for cutaneous melanoma, while being void of any prognostic value.

  11. Interval Sentinel Lymph Nodes: An Unusual Localization in Patients with Cutaneous Melanoma

    Directory of Open Access Journals (Sweden)

    A. M. Manganoni

    2011-01-01

    Full Text Available Background. Recent studies have demonstrated that there exists a great variation in the lymphatic drainage in patients with malignant melanoma. Some patients have drainage to lymph nodes outside of conventional nodal basins. The lymph nodes that exist between a primary melanoma and its regional nodal basin are defined “interval nodes”. Interval node occurs in a small minority of patients with forearm melanoma. We report our experience of the Melanoma Unit of University Hospital Spedali Civili Brescia, Italy. Methods. Lymphatic mapping using cutaneous lymphoscintigraphy (LS has become a standard preoperative diagnostic procedure to locate the sentinel lymph nodes (SLNs in cutaneous melanoma. We used LS to identify sentinel lymph nodes biopsy (SLNB in 480 patients. Results. From over 2100 patients affected by cutaneous melanoma, we identified 2 interval nodes in 480 patients with SLNB . The melanomas were both located in the left forearm. The interval nodes were also both located in the left arm. Conclusion. The combination of preoperative LS and intraoperative hand-held gamma detecting probe plays a remarkable role in identifying these uncommon lymph node locations. Knowledge of the unusual drainage patterns will help to ensure the accuracy and the completeness of sentinel nodes identification.

  12. Multiple primary cutaneous melanomas in patients with FAMMM syndrome and sporadic atypical mole syndrome (AMS): what's worse?

    Science.gov (United States)

    Tchernev, Georgi; Ananiev, Julian; Cardoso, José-Carlos; Chokoeva, Anastasiya Atanasova; Philipov, Stanislav; Penev, Plamen Kolev; Lotti, Torello; Wollina, Uwe

    2014-08-01

    Atypical Mole Syndrome is the most important phenotypic risk factor for cutaneous melanoma, a malignancy that accounts for about 80% of deaths from skin cancer. Since early diagnosis of melanoma is of great prognostic relevance, the identification of Atypical Mole Syndrome carriers (sporadic and familial) is essential, as well as the recommendation of preventative measures that must be undertaken by these patients.We report two rare cases concerning patients with multiple primary skin melanomas in the setting of a familial and a sporadic syndrome of dysplastic nevi: the first patient is a 67-year-old patient with a history of multiple superficial spreading melanomas localized on his back. The second patient presented with multiple primary melanomas in advanced stage in the context of the so-called sporadic form of the syndrome of dysplastic nevi-AMS (atypical mole syndrome). In the first case, excision of the melanomas was carried out with an uneventful post-operative period. In the second case, disseminated metastases were detected, involving the right fibula, the abdominal cavity as well as multiple lesions in the brain. The patient declined BRAF mutation tests as well as chemotherapy or targeted therapies, and suffered a rapid deterioration in his general condition leading to death. We classified the second case as a sporadic form of the atypical mole syndrome, associated with one nodular and two superficial spreading melanomas.There are no data in the literature to allow us to understand if, in patients with multiple primary melanomas, there is any difference in terms of prognosis between those with and without a family history of a similar phenotype. To answer this and other questions related to these rare cases, further studies with a significant number of patients should be carried out.

  13. Clinicopathologic findings and BRAF mutation in cutaneous melanoma in young adults.

    Science.gov (United States)

    Estrozi, Bruna; Machado, Juliana; Rodriguez, Rubens; Bacchi, Carlos E

    2014-01-01

    Cutaneous melanoma in young patients is rare with increasing incidence. It is not clear whether the etiology and clinical outcome are similar to cutaneous melanoma in the elderly. Mutations in BRAF gene in patients with cutaneous melanoma, in general, range in frequency from 20% to 80%; however, the status and clinical significance of BRAF mutations in the young population have not been evaluated. We investigated 132 cases of primary cutaneous melanoma in patients aged between 18 and 30 years with emphasis on clinical characteristics, pathologic features, and molecular evaluation of mutation in the BRAF gene (BRAF(V600E)). It was predominantly seen in female individuals (61.4%), trunk was the most common site of involvement (40.4%), and superficially spreading melanoma was the predominant histologic type (79.5%). Mutation in BRAF(V600E) was analyzed successfully in 93 cases using an RT-PCR. The BRAF(V600E) mutation was identified in 38.7% (36/93) and was associated with vertical growth phase (P=0.01) and mild inflammatory infiltrate (P=0.02). No case of melanoma with regression phenomenon presented with BRAF(V600E) mutation (P<0.05). There was no significant association between BRAF(V600E) mutation and sex, histologic type, the Clark level, the Breslow index, solar elastosis, angiolymphatic and perineural invasion, satellitosis, and coexisting nevus. As in melanomas in older patients, these results probably indicate that BRAF mutation may not be the only key factor in melanoma tumorigenesis, and that there should be multiple alternative genetic pathways related to melanoma.

  14. Epidemiología del melanoma cutáneo Epidemiology of cutaneous melanoma

    Directory of Open Access Journals (Sweden)

    R M C Leitner

    2006-06-01

    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.

  15. BRAF, KIT, NRAS, GNAQ and GNA11 mutation analysis in cutaneous melanomas in Turkish population

    OpenAIRE

    Ismail Yilmaz; Mehmet Gamsizkan; Zafer Kucukodaci; Ufuk Berber; Dilaver Demirel; Aptullah Haholu; Gizem Narli

    2015-01-01

    Background: KIT and mitogen-activated protein kinase cascade are important for melanomagenesis. In the present study, we analyzed the frequency of BRAF, NRAS, KIT, GNAQ and GNA11 gene mutations and investigated their association with clinicopathological features of melanomas in Turkish population. Materials and Methods: Forty-seven primary cutaneous melanomas were included in our study. Sanger sequencing method was used for mutation analysis in all cases. Results: Mean age was 62.1 (29-101) y...

  16. Downregulation of miR-125b in metastatic cutaneous malignant melanoma

    DEFF Research Database (Denmark)

    Glud, Martin; Rossing, Maria; Hother, Christoffer;

    2010-01-01

    cells were harvested from primary, cutaneous MM tumors by laser-capture microdissection, and microRNA expression profiles were obtained by the microarray technique. Results were validated by quantitative reverse transcription PCR. We found that miR-125b was downregulated in the primary cutaneous...... melanomas that produced early metastases (T2, N1, M0) compared with the sentinel lymph node-negative (T2, N0, M0) melanomas. MiR-125b has earlier been found to be downregulated in other tumor types and in atypic naevi compared with the common acquired naevi. In conclusion, miR-125b may be involved...

  17. BRAF, KIT, NRAS, GNAQ and GNA11 mutation analysis in cutaneous melanomas in Turkish population

    Directory of Open Access Journals (Sweden)

    Ismail Yilmaz

    2015-01-01

    Full Text Available Background: KIT and mitogen-activated protein kinase cascade are important for melanomagenesis. In the present study, we analyzed the frequency of BRAF, NRAS, KIT, GNAQ and GNA11 gene mutations and investigated their association with clinicopathological features of melanomas in Turkish population. Materials and Methods: Forty-seven primary cutaneous melanomas were included in our study. Sanger sequencing method was used for mutation analysis in all cases. Results: Mean age was 62.1 (29-101 years. Female:male ratio was 17:30. Among 47 melanomas, 14 (29.8% BRAF, 10 (21.3% NRAS, 4 (8.5% KIT and 1(2.1% GNAQ gene mutations were detected. Two of the KIT mutations were found in acral lentiginous melanoma (ALM. In the head and neck region, mutation frequency was significantly lower than in other locations (P = 0.035. The only GNAQ gene mutation (p.Q209L was detected in a melanoma arising from blue nevus located on the scalp. None of the melanomas harbored NRAS exon 2, KIT exon 13/17/18, GNAQ exon 4 and GNA11 exon 4/5 mutations. Overall mutation frequency did not show significant difference between metastatic (8/14, 57.1% and nonmetastatic (18/33, 54.5% patients. We did not observe any significant association between mutation status and gender or age of various patients. Conclusions: Our results support that BRAF and NRAS gene mutations are common in cutaneous melanomas. The activating mutations of KIT gene are rare and especially seen in ALM. GNAQ and GNA11 mutations are infrequent in cutaneous melanomas and may be associated only with melanomas arising from blue nevus.

  18. A Qualitative Study of Quality of Life Concerns following a Melanoma Diagnosis

    Directory of Open Access Journals (Sweden)

    Rachel I. Vogel

    2017-01-01

    Full Text Available The goal of this study was to identify a relevant and inclusive list of quality of life issues among long-term survivors of melanoma. Individuals diagnosed with stage I-III cutaneous melanoma and had survived 1-5 years, ages 18-65 years at diagnosis, were recruited. Five focus groups were conducted with 33 participants in total. Discussions centered on participants’ experiences at diagnosis, as well as ongoing physical, emotional, and social concerns, and behavioral changes since diagnosis. The majority of participants reported shock, fear, and feeling overwhelmed at the time of diagnosis. Some reported lingering physical concerns, including pain, numbness, and lymphedema, while a few reported no lasting issues. Emotional concerns were common, with most reporting anxiety. Several also noted feeling lonely and isolated. Social concerns included alteration of activities to avoid sun exposure, issues with family communication, and frustration with the lack of appreciation of the seriousness of melanoma by others. Finally, while many participants reported changes to their sun exposure and UV-protection behaviors, some reported little to no change. The shared experiences among participants in this study confirm the unique nature of melanoma and the need for interventions designed to improve the health and quality of life of melanoma survivors.

  19. The role of interleukin-8 produced by tumor induced fibroblasts in the development of cutaneous melanoma

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    Objective To determine the role of interleukin-8(IL-8)produced by tumor induced fibroblasts in the development of cutaneous melanoma.Methods B16 melanoma cells induced L929 fibroblasts phenotype was transdifferentiated to myofibroblasts(MF)by co-culture in vitro.MF was monitored by morphology and immunophenotype for a-SMA.The level of IL-8 was detected by ELISA.The effect on B16 cell proliferation rate was estimated using MTT method in vitro.Melanoma implanting model was constructed in C57 mice.Results L929...

  20. Surgery and radiotherapy in the treatment of cutaneous melanoma

    DEFF Research Database (Denmark)

    Testori, A; Rutkowski, P; Marsden, J;

    2009-01-01

    Adequate surgical management of primary melanoma and regional lymph node metastasis, and rarely distant metastasis, is the only established curative treatment. Surgical management of primary melanomas consists of excisions with 1-2 cm margins and primary closure. The recommended method of biopsy...... on individual circumstances. Radiotherapy is indicated as a treatment option in select patients with lentigo maligna melanoma and as an adjuvant in select patients with regional metastatic disease. Radiotherapy is also indicated for palliation, especially in bone and brain metastases....

  1. Serum Fatty Acids and Risk of Cutaneous Melanoma: A Population-Based Case-Control Study

    Directory of Open Access Journals (Sweden)

    Marco Vinceti

    2013-01-01

    Full Text Available Background. Some observational studies have suggested that excess dietary intake of polyunsaturated fatty acids such as linoleic acid increases cutaneous melanoma risk. We aimed at examining the association between serum fatty acids and melanoma risk by conducting a population-based case-control study in a northern Italy community. Methods. The percentage composition of 12 fatty acids was determined in 51 newly diagnosed melanoma patients and 51 age- and sex-matched population controls by extracting total lipids from serum samples using thin layer and gas chromatography. Conditional logistic regression was used to estimate the relative risk of melanoma associated with tertiles of percentage composition of each fatty acid as well as groupings including saturated, monounsaturated, and polyunsaturated fatty acids. Results. We found a slightly increased melanoma risk for stearic and arachidic acids proportion, with and without adjustment for potential confounders. For an n-3 polyunsaturated fatty acid, docosapentaenoic acid, we found a male-specific direct association with melanoma risk. No other associations emerged for the other saturated, monounsaturated, and polyunsaturated fatty acids, individually or grouped by type. Conclusions. These findings do not suggest a major role of fatty acids, including linoleic acid, on risk of cutaneous melanoma, though their evaluation is limited by the small sample size.

  2. Mortality due to cutaneous melanoma in south region of Brazil: a spatial approach*

    Science.gov (United States)

    Ferreira, Flávia Regina; Nascimento, Luiz Fernando Costa

    2016-01-01

    Background Cutaneous melanoma is a skin cancer with low incidence but high mortality rates. The South region of Brazil has the highest death rates by melanoma per 100,000 inhabitants of the country. Little is known about the spatial distribution of this malignancy in southern Brazil. Objectives Identify the spatial patterns of deaths from cutaneous melanoma in South region of Brazil, using geoprocessing tools. Methods This is an ecological and exploratory study of death information by cutaneous melanoma obtained from portal Datasus, for Brazil's southern region, from January 2008 to December 2012. Deaths were separated by gender and rates per 100,000 inhabitants were calculated and used to compile thematic maps, Moran maps and Kernel maps, using TerraView software. It was adopted an alpha = 5%. Results There were data on 2378 deaths from cutaneous melanoma in the study period. High rates were identified in the northern and littoral regions of Rio Grande do Sul; the northeast of Santa Catarina; and west of Paraná - for the total population, with minor differences detected and indicated regarding gender. The global Moran index presented p-values of 0.03, 0.04 and 0.03, respectively, for male, female and overall deaths. All the micro-regions that showed high priority for intervention were detected in the Rio Grande do Sul. Conclusion Spatial clusters of micro-regions with high death rates from cutaneous melanoma in South region of Brazil were identified, serving as an important tool for health managers. PMID:27579737

  3. Prognosis of thin cutaneous head and neck melanoma (

    DEFF Research Database (Denmark)

    Andersson, A P; Dahlstrøm, Karin Kjærgaard; Drzewiecki, K T

    1996-01-01

    Thin malignant melanomas, i.e. tumours less than 1 mm, are generally considered to have a good prognosis. The records of 148 patients with thin invasive melanomas located to the head and neck region were reviewed. All patients were followed for the excision of the primary tumour until death...... of these 16 patients (75%) died of disseminated melanoma. We conclude that thin head and neck melanomas do not necessarily carry an excellent prognosis. Prognosis is not dependent upon tumour thickness when less than 1.00 mm....

  4. Prognosis of thin cutaneous head and neck melanoma (

    DEFF Research Database (Denmark)

    Andersson, A P; Dahlstrøm, Karin Kjærgaard; Drzewiecki, K T

    1996-01-01

    Thin malignant melanomas, i.e. tumours less than 1 mm, are generally considered to have a good prognosis. The records of 148 patients with thin invasive melanomas located to the head and neck region were reviewed. All patients were followed for the excision of the primary tumour until death...... of these 16 patients (75%) died of disseminated melanoma. We conclude that thin head and neck melanomas do not necessarily carry an excellent prognosis. Prognosis is not dependent upon tumour thickness when less than 1.00 mm....

  5. Prognosis and determinants of outcome following locoregional or distant recurrence in patients with cutaneous melanoma

    NARCIS (Netherlands)

    Francken, Anne Brecht; Accortt, Neil A.; Shaw, Helen M.; Wiener, Martin; Soong, Seng-jaw; Hoekstra, Harald J.; Thompson, John F.

    Objective: Information on prognosis for patients with cutaneous melanoma after locoregional or distant recurrence is sparse and controversial. The aim of this study was to analyze factors influencing outcome after the development of a first relapse. Methods: Information was extracted from the Sydney

  6. ASIP and TYR pigmentation variants associate with cutaneous melanoma and basal cell carcinoma.

    NARCIS (Netherlands)

    Gudbjartsson, D.F.; Sulem, P.; Stacey, S.N.; Goldstein, A.M.; Rafnar, T.; Sigurgeirsson, B.; Benediktsdottir, K.R.; Thorisdottir, K.; Ragnarsson, R.; Sveinsdottir, S.G.; Magnusson, V.; Lindblom, A.; Kostulas, K.; Botella-Estrada, R.; Soriano, V.; Juberias, P.; Grasa, M.; Saez, B.; Andres, R.; Scherer, D.; Rudnai, P.; Gurzau, E.; Koppova, K.; Kiemeney, L.A.L.M.; Jakobsdottir, M.; Steinberg, S.; Helgason, A.; Gretarsdottir, S.; Tucker, M.A.; Mayordomo, J.I.; Nagore, E.; Kumar, R.; Hansson, J.; Olafsson, J.H.; Gulcher, J.; Kong, A.; Thorsteinsdottir, U.; Stefansson, K.

    2008-01-01

    Fair color increases risk of cutaneous melanoma (CM) and basal cell carcinoma (BCC). Recent genome-wide association studies have identified variants affecting hair, eye and skin pigmentation in Europeans. Here, we assess the effect of these variants on risk of CM and BCC in European populations

  7. Prognosis and determinants of outcome following locoregional or distant recurrence in patients with cutaneous melanoma

    NARCIS (Netherlands)

    Francken, Anne Brecht; Accortt, Neil A.; Shaw, Helen M.; Wiener, Martin; Soong, Seng-jaw; Hoekstra, Harald J.; Thompson, John F.

    2008-01-01

    Objective: Information on prognosis for patients with cutaneous melanoma after locoregional or distant recurrence is sparse and controversial. The aim of this study was to analyze factors influencing outcome after the development of a first relapse. Methods: Information was extracted from the Sydney

  8. Photodynamic therapy in treatment of cutaneous and choroidal melanoma.

    Science.gov (United States)

    Kawczyk-Krupka, Aleksandra; Bugaj, Andrzej M; Latos, Wojciech; Zaremba, Katarzyna; Sieroń, Aleksander

    2013-12-01

    Melanoma is a malignant, the most aggressive and dreaded skin cancer. This form of cancer arises from melanocytes and may grow rapidly and metastasize. Melanoma predominantly occurs in skin, but could also be found in the mouth, iris and retina of the eye. Melanoma is the most dangerous form of skin cancer, with a steeply rising incidence and a poor prognosis in its advanced stages. It is highly resistant to traditional chemotherapy and radiotherapy, although modern biological therapies are showing some promise. Photodynamic therapy (PDT), as a novel effective modality of the treatment of skin cancers, opens up new possibilities in melanoma treatment also. Many experimental photodynamic therapy studies were performed. The results of many experiments indicate that that photodynamic therapy may be a promising tool for adjuvant treatment in advanced melanoma. Copyright © 2013 Elsevier B.V. All rights reserved.

  9. Analysis of trends and seasonal variation in primary cutaneous melanoma: an Irish study.

    LENUS (Irish Health Repository)

    Downes, M R

    2010-11-10

    A seasonal variation in the presentation of cutaneous melanoma has been documented in several studies. We performed a retrospective review of primary cutaneous melanomas (n = 263) from our institution to examine whether the seasonal patterns of presentation noted in the literature would be similar in Ireland, a climate with low ambient sunshine. A summer : winter ratio was determined for age, gender, subtype, location and Breslow thickness. We found an increase in total numbers of melanomas, particularly in men. The summer : winter ratio was 2.39 for all patients (95% CI 1.60-3.57, P < 0.001), with seasonal variations noted for location, thickness and subtype (excluding lentigo). Melanomas presenting over the summer tended towards a greater Breslow thickness than did those presenting in winter. This subclassification of primary cutaneous melanoma with summer : winter ratios based on patient and tumour characteristics gave remarkably similar results to previously published reports, notwithstanding the low levels of annual ambient sunshine in Ireland.

  10. Diagnosis and management of cutaneous vasculitis in children.

    Science.gov (United States)

    Ting, Tracy V

    2014-04-01

    Cutaneous vasculitis in children is rare. Causes of cutaneous vasculitis are varied and are typically differentiated by the affected vessel size. A skin biopsy remains the gold standard for diagnosis but other causes for vasculitis, including systemic conditions, should be considered. This article discusses the childhood conditions commonly presenting with cutaneous vasculitis (leukocytoclastic vasculitis, cutaneous polyarteritis nodosa), biopsy recommendations and findings, and management and potential differential diagnoses, and includes a brief summary of other diseases that may include cutaneous symptoms as a constellation of other systemic findings.

  11. Patients highly value routine follow-up of skin cancer and cutaneous melanoma

    DEFF Research Database (Denmark)

    Themstrup, Lotte; Jemec, Gregor E; Lock-Andersen, Jørgen

    2013-01-01

    : This study included an open sample of patients attending routine follow-up at the outpatient Departments of Plastic Surgery and Dermatology, Roskilde Hospital. A total of 218 follow-up patients diagnosed with cutaneous malignant melanoma (MM), non-melanoma skin cancer (NMSC) or actinic keratosis (AK......INTRODUCTION: Skin cancer follow-up is a substantial burden to outpatient clinics. Few studies have investigated patients' views on skin cancer follow-up and cutaneous melanoma. The objective was to investigate patients' perceived benefits and the impact of follow-up. MATERIAL AND METHODS......) completed a structured interview. RESULTS: A total of 97% patients found follow-up useful. Continuity and consistency were important. One third of patients felt some degree of pre follow-up anxiety. The number of anxious MM patients was significantly greater than that of NMSC patients. No significant...

  12. Optimizing the management of cutaneous melanoma in the elderly.

    Science.gov (United States)

    Tragos, Christina; Hieken, Tina J

    2011-10-01

    The incidence of melanoma in patients aged ≥ 65 years is increasing. Melanoma characteristics appear to be different in the elderly, and outcomes worse. We undertook this study to characterize our experience with melanoma in the elderly and identify factors associated with outcome. We studied 244 elderly consecutive melanoma patients with clinically localized disease. Mean follow-up was 73 ± 3.7 months. One-hundred thirty-two patients (54%) were male. The most common site was extremity (44%), histology superficial spreading (51%), mean thickness 1.91 mm, 16% ulcerated. T stage included 36% T1, 14% T2, 14% T3, 9% T4 tumors. Undertreatment of the primary tumor occurred in 22%, overtreatment in 6%, and inadequate lymph node staging/treatment in 22%. 23% of patients recurred, 21% died of unrelated causes, and 12% died of melanoma. Sex, tumor thickness, mitotic index, ulceration, and lymph node status were significant factors affecting disease-free survival, while tumor thickness, mitotic index, and lymph node status were significant predictors of overall survival. The features of melanoma in elderly patients were different from younger patients, but prognostic factors were similar. Most patients received appropriate treatment and survived >5 years. Strategies to improve early detection to facilitate optimal treatment of melanoma in the elderly are warranted. Copyright © 2011 Mosby, Inc. All rights reserved.

  13. Time trends and latitude dependence of uveal and cutaneous malignant melanoma induced by solar radiation

    Energy Technology Data Exchange (ETDEWEB)

    Moan, J.; Setlow, R.; Cicarma, E.; Porojnicu, A. C.; Grant, W. B.; Juzeniene, A.

    2010-01-01

    In order to evaluate the role of solar radiation in uveal melanoma etiology, the time and latitude dependency of the incidence rates of this melanoma type were studied in comparison with those of cutaneous malignant melanoma (CMM). Norway and several other countries with Caucasian populations were included. There is a marked north - south gradient of the incidence rates of CMM in Norway, with three times higher rates in the south than in the north. No such gradient is found for uveal melanoma. Similar findings have been published for CMM in other Caucasian populations, with the exception of Europe as a whole. In most populations the ratios of uveal melanoma incidence rates to those of CMM tend to decrease with increasing CMM rates. This is also true for Europe, in spite of the fact that in this region there is an inverse latitude gradient of CMM, with higher rates in the north than in the south. In Norway the incidence rates of CMM have increased until about 1990 but have been constant, or even decreased (for young people) after that time, indicating constant or decreasing sun exposure. The uveal melanoma rates have been increasing after 1990. In most other populations the incidence rates of CMM have been increasing until recently while those of uveal melanoma have been decreasing. These data generally support the assumption that uveal melanomas are not generated by ultraviolet (UV) radiation and that solar UV, via its role in vitamin D photosynthesis, may have a protective effect.

  14. The role of interleukin-8 produced by tumor induced fibroblasts in the development of cutaneous melanoma

    Institute of Scientific and Technical Information of China (English)

    Cui Rong; Feng Jie; Cao Haozhe; Zhou Xi; Zhang Xin; Yan Xiaoning

    2008-01-01

    Objective To determine the role of interleukin-8 (IL-8) produced by tumor induced fibroblasts in the development of cutaneous melanoma. Methods B16 melanoma cells induced L929 fibroblasts phenotype was transdifferentiated to myofibroblasts (MF) by co-culture in vitro. MF was monitored by morphology and immunophenotype for a-SMA. The level of IL-8 was detected by ELISA. The effect on B16 cell proliferation rate was estimated using MIT method in vitro. Melanoma implanting model was constructed in C57 mice. Results L929 MF phenotype could be modulated by B16 melanoma cells-derived transforming growth factor-β1 (TGF-β1) and elevated the levels of IL-8. L929 MF did not influence the B16 melanoma cells viability in vitro, but shortened the time of tumor formation and increased the incidence rates of tumors in C57 implanting model mice. Conclusion Fibroblasts can be activated by tumor cells and produce IL-8, which acts as an inflammatory cytokine promoting the development of cutaneous melanoma.

  15. Pathogenesis, diagnosis and management of primary melanoma of the colon

    Directory of Open Access Journals (Sweden)

    Imam Ayesha

    2011-02-01

    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

  16. Unravelling molecular mechanisms underlying therapy resistance in cutaneous melanoma

    OpenAIRE

    Azimi, Alireza

    2016-01-01

    For many years the standard treatment of advanced metastatic melanoma with chemotherapeutic agents, including temozolomide (TMZ) and dacarbazine (DTIC), has been unsuccessful. The paradigm shift in melanoma treatment occurred with the identification of mutations in the BRAF gene that leads to a constitutively active BRAF V600E protein. This resulted in the development of BRAF mutant targeted therapies with small molecule inhibitors and showed favorable response in patient...

  17. Update and Review on the Surgical Management of Primary Cutaneous Melanoma

    Directory of Open Access Journals (Sweden)

    Solmaz Niknam Leilabadi

    2014-06-01

    Full Text Available The surgical management of malignant melanoma historically called for wide excision of skin and subcutaneous tissue for any given lesion, but has evolved to be rationally-based on pathological staging. Breslow and Clark independently described level and thickness as determinant in prognosis and margin of excision. The American Joint Committee of Cancer (AJCC in 1988 combined features from each of these histologic classifications, generating a new system, which is continuously updated and improved. The National Comprehensive Cancer Network (NCCN has also combined several large randomized prospective trials to generate current guidelines for melanoma excision as well. In this article, we reviewed: (1 Breslow and Clark classifications, AJCC and NCCN guidelines, the World Health Organization’s 1988 study, and the Intergroup Melanoma Surgical Trial; (2 Experimental use of Mohs surgery for in situ melanoma; and (3 Surgical margins and utility and indications for sentinel lymph node biopsy (SLNB and lymphadenectomy. Current guidelines for the surgical management of a primary melanoma of the skin is based on Breslow microstaging and call for cutaneous margins of resection of 0.5 cm for MIS, 1.0 cm for melanomas ≤1.0 mm thick, 1–2 cm for melanoma thickness of 1.01–2 mm, 2 cm margins for melanoma thickness of 2.01–4 mm, and 2 cm margins for melanomas >4 mm thick. Although the role of SLNB, CLND, and TLND continue to be studied, current recommendations include SLNB for Stage IB (includes T1b lesions ≤1.0 with the adverse features of ulceration or ≥1 mitoses/mm2 and Stage II melanomas. CLND is recommended when sentinel nodes contain metastatic deposits.

  18. Update and Review on the Surgical Management of Primary Cutaneous Melanoma

    Science.gov (United States)

    Niknam Leilabadi, Solmaz; Chen, Amie; Tsai, Stacy; Soundararajan, Vinaya; Silberman, Howard; Wong, Alex K.

    2014-01-01

    The surgical management of malignant melanoma historically called for wide excision of skin and subcutaneous tissue for any given lesion, but has evolved to be rationally-based on pathological staging. Breslow and Clark independently described level and thickness as determinant in prognosis and margin of excision. The American Joint Committee of Cancer (AJCC) in 1988 combined features from each of these histologic classifications, generating a new system, which is continuously updated and improved. The National Comprehensive Cancer Network (NCCN) has also combined several large randomized prospective trials to generate current guidelines for melanoma excision as well. In this article, we reviewed: (1) Breslow and Clark classifications, AJCC and NCCN guidelines, the World Health Organization’s 1988 study, and the Intergroup Melanoma Surgical Trial; (2) Experimental use of Mohs surgery for in situ melanoma; and (3) Surgical margins and utility and indications for sentinel lymph node biopsy (SLNB) and lymphadenectomy. Current guidelines for the surgical management of a primary melanoma of the skin is based on Breslow microstaging and call for cutaneous margins of resection of 0.5 cm for MIS, 1.0 cm for melanomas ≤1.0 mm thick, 1–2 cm for melanoma thickness of 1.01–2 mm, 2 cm margins for melanoma thickness of 2.01–4 mm, and 2 cm margins for melanomas >4 mm thick. Although the role of SLNB, CLND, and TLND continue to be studied, current recommendations include SLNB for Stage IB (includes T1b lesions ≤1.0 with the adverse features of ulceration or ≥1 mitoses/mm2) and Stage II melanomas. CLND is recommended when sentinel nodes contain metastatic deposits. PMID:27429273

  19. Update and Review on the Surgical Management of Primary Cutaneous Melanoma.

    Science.gov (United States)

    Leilabadi, Solmaz Niknam; Chen, Amie; Tsai, Stacy; Soundararajan, Vinaya; Silberman, Howard; Wong, Alex K

    2014-06-10

    The surgical management of malignant melanoma historically called for wide excision of skin and subcutaneous tissue for any given lesion, but has evolved to be rationally-based on pathological staging. Breslow and Clark independently described level and thickness as determinant in prognosis and margin of excision. The American Joint Committee of Cancer (AJCC) in 1988 combined features from each of these histologic classifications, generating a new system, which is continuously updated and improved. The National Comprehensive Cancer Network (NCCN) has also combined several large randomized prospective trials to generate current guidelines for melanoma excision as well. In this article, we reviewed: (1) Breslow and Clark classifications, AJCC and NCCN guidelines, the World Health Organization's 1988 study, and the Intergroup Melanoma Surgical Trial; (2) Experimental use of Mohs surgery for in situ melanoma; and (3) Surgical margins and utility and indications for sentinel lymph node biopsy (SLNB) and lymphadenectomy. Current guidelines for the surgical management of a primary melanoma of the skin is based on Breslow microstaging and call for cutaneous margins of resection of 0.5 cm for MIS, 1.0 cm for melanomas ≤1.0 mm thick, 1-2 cm for melanoma thickness of 1.01-2 mm, 2 cm margins for melanoma thickness of 2.01-4 mm, and 2 cm margins for melanomas >4 mm thick. Although the role of SLNB, CLND, and TLND continue to be studied, current recommendations include SLNB for Stage IB (includes T1b lesions ≤1.0 with the adverse features of ulceration or ≥1 mitoses/mm²) and Stage II melanomas. CLND is recommended when sentinel nodes contain metastatic deposits.

  20. Ancestry reported by white adults with cutaneous melanoma and control subjects in central Alabama

    Directory of Open Access Journals (Sweden)

    Hollowell William W

    2004-08-01

    Full Text Available Abstract Background We sought to evaluate the hypothesis that the high incidence of cutaneous melanoma in white persons in central Alabama is associated with a predominance of Irish and Scots descent. Methods Frequencies of country of ancestry reports were tabulated. The reports were also converted to scores that reflect proportional countries of ancestry in individuals. Using the scores, we computed aggregate country of ancestry indices as estimates of group ancestry composition. HLA-DRB1*04 allele frequencies and relationships to countries of ancestry were compared in probands and controls. Results were compared to those of European populations with HLA-DRB1*04 frequencies. Results Ninety evaluable adult white cutaneous melanoma probands and 324 adult white controls reported countries of ancestry of their grandparents. The respective frequencies of Ireland, and Scotland and "British Isles" reported countries of ancestry were significantly greater in probands than in controls. The respective frequencies of Wales, France, Italy and Poland were significantly greater in controls. 16.7% of melanoma probands and 23.8% of controls reported "Native American" ancestry; the corresponding "Native American" country of ancestry index was not significantly different in probands and controls. The frequency of HLA-DRB1*04 was significantly greater in probands, but was not significantly associated with individual or aggregate countries of ancestry. The frequency of DRB1*04 observed in Alabama was compared to DRB1*04 frequencies reported from England, Wales, Ireland, Orkney Island, France, Germany, and Australia. Conclusion White adults with cutaneous melanoma in central Alabama have a predominance of Irish, Scots, and "British Isles" ancestry and HLA-DRB1*04 that likely contributes to their high incidence of cutaneous melanoma.

  1. What's new in the treatment of cutaneous melanoma?

    Science.gov (United States)

    Olhoffer, I H; Bolognia, J L

    1998-06-01

    As surveyors of the skin, it is important for dermatologists to be aware of recent developments in the management of melanoma. Revised recommendations for surgical margins will be reviewed as will the use of Mohs micrographic surgery for the excision of melanoma, in particular lentigo maligna. An explanation of the technique of sentinel node biopsy is followed by a discussion of the results of recent clinical trials. Adjuvant immunotherapy in the form of vaccines and high-dose alpha-interferon is outlined as is the concept of biochemotherapy for more advanced disease.

  2. Clear cell sarcoma: A case mimicking primary cutaneous malignant melanoma

    Directory of Open Access Journals (Sweden)

    Rodriguez-Martin M

    2009-01-01

    Full Text Available Clear cell sarcoma (CCS is a recently described variant of sarcoma characterized by prominent clear cells showing features similar to clear cell melanoma. This neoplasm was first described by Dr. Franz M. Erzinger. Primary CCS usually arises in deeper soft tissues, in association with fascia, tendons, or aponeuroses. Characteristic translocation t(12;22 (q13;q12 has been considered pathognomonic for CCS. Prognosis is related to tumor size. An early recognition and initial radical surgery is the key to a favourable outcome. We present a patient with an unusual neoplasm that resembled malignant melanoma.

  3. Sentinel lymph node biopsy for cutaneous melanoma: A 6 years study

    Directory of Open Access Journals (Sweden)

    Jaime Lima Sánchez

    2013-01-01

    Full Text Available Background: The aim of this study was to evaluate the results of sentinel lymph node biopsy (SLNB in cutaneous melanoma at our institution. Materials and Methods: 128 patients with primary cutaneous melanoma who underwent SLNB between April, 2004, and August, 2010 were studied. Univariate and multivariate analysis was performed to explore the effect of variables on mortality and sentinel node status. Survival analysis was performed using the Kaplan-Meier approach. Results: Positive SLNB were detected in 35 (27.3% of 128 cases. Mean Breslow depths were 3.7 mm for SLNB positive patients and 1.99 mm for SLNB negative patients. False negative rate was 1%. The recurrence rate was 40% for positive patients and 6.5% for negative patients (odds ratio 9.7 [confidence interval 95 % 3.3-28.1]. 33 patients (29% had an ulcerated melanoma, 12 (10.5% in the positive group and 21 (18.5% in the negative group. The disease recurred in a 48.5% of patients with ulcerated melanoma, but only in a 2.5% of patients with non-ulcerated melanoma. Upon multivariate analysis, only Breslow thickness (P = 0.005 demonstrate statistically significance for SLNB status. Multivariate analysis for clinicopathologic predictors of death demonstrate statistically significance for Breslow thickness (P = 0.020, ulceration (P = 0.030 and sentinel node status (P = 0.020. Conclusions: This study confirms that the status of the sentinel node is a strong independent prognostic factor with a higher risk of death and lower survival. Patients with ulcerated melanoma are more likely to develop recurrence, and also higher risk of death than patients with non-ulcerated melanoma.

  4. Uveal melanoma: From diagnosis to treatment and the science in between.

    Science.gov (United States)

    Chattopadhyay, Chandrani; Kim, Dae Won; Gombos, Dan S; Oba, Junna; Qin, Yong; Williams, Michelle D; Esmaeli, Bita; Grimm, Elizabeth A; Wargo, Jennifer A; Woodman, Scott E; Patel, Sapna P

    2016-08-01

    Melanomas of the choroid, ciliary body, and iris of the eye are collectively known as uveal melanomas. These cancers represent 5% of all melanoma diagnoses in the United States, and their age-adjusted risk is 5 per 1 million population. These less frequent melanomas are dissimilar to their more common cutaneous melanoma relative, with differing risk factors, primary treatment, anatomic spread, molecular changes, and responses to systemic therapy. Once uveal melanoma becomes metastatic, therapy options are limited and are often extrapolated from cutaneous melanoma therapies despite the routine exclusion of patients with uveal melanoma from clinical trials. Clinical trials directed at uveal melanoma have been completed or are in progress, and data from these well designed investigations will help guide future directions in this orphan disease. Cancer 2016;122:2299-2312. © 2016 American Cancer Society. © 2016 American Cancer Society.

  5. Pterygia are indicators of an increased risk of developing cutaneous melanomas.

    Science.gov (United States)

    Crewe, Julie M; Threlfall, Tim; Clark, Antony; Sanfilippo, Paul G; Mackey, David A

    2017-08-26

    To investigate whether pterygium is an indicator of an increased risk of cutaneous melanoma (CM). A matched-cohort study, using linked health administrative data sets to identify all hospital-treated pterygium in Western Australia (WA) between 1979 and 2014. We identified pterygium cases from hospital diagnosis and/or procedure International Classification of Diseases 9th revision (ICD-9) and 10th revision (ICD-10) codes and matched cases by age, sex and residential postcode to WA Electoral Roll controls with no known history of pterygium. Both cohorts were linked to the WA Cancer Registry and the WA Deaths Registry. 23 625 people had pterygium treatment (64% male) in WA hospitals. The median age for pterygium diagnosis and/or treatment was 49 years (range 14-96). There were significantly more CM cases in the pterygium cohort compared with the control cohort (1083 vs 874; p<0.001). In a logistic regression analysis, there was a 24% increase in the odds of developing a CM in the pterygium cohort, compared with controls, after controlling for other predictors (OR 1.24, 95% CI 1.1 to 1.4). The incident rate ratio (IRR) of a malignant CM diagnosis was 20% greater in people who had treatment for a pterygium compared with controls (IRR 1.2, 95% CI 1.0 to 1.4). The presence of a pterygium indicates a significantly increased risk of developing a CM. Eye care providers who see patients with developing pterygia should advise these patients of this increased risk and recommend regular skin surveillance. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  6. Liquid Biopsy Utility for the Surveillance of Cutaneous Malignant Melanoma Patients

    Science.gov (United States)

    Huang, Sharon K.; Hoon, Dave S.B.

    2017-01-01

    Cutaneous melanoma is one of the highest incident-rate cancers with increasing prevalence in Western societies. Despite the advent of new approved therapeutics, the 5-year overall survival rate of stage IV melanoma patients remains below 15%. Current treatments for late-stage disease have shown higher efficacy when treated at a lower disease burden. Thus, blood-based biomarkers capable of detecting melanoma prior to clinically evident distant metastasis, will improve the treatment and outcomes for melanoma patients. To that end, effective treatment of melanoma necessitates identification of patients at risk for developing distant metastases. Furthermore, employing blood biomarkers that monitor cancer progression over the course of treatment, is a promising solution to post-treatment drug resistance often developed in melanoma patients. Non-invasive blood biomarker assays allow for regular dynamic monitoring of disease. “Liquid Biopsy” of blood, which exploits circulating tumor cells (CTCs), cell-free circulating tumor DNA (ctDNA) and cell-free circulating microRNA (cmiRNA), has been shown to detect prognostic factors for relapse in AJCC stage III and stage IV melanoma patients. Moreover, molecular characterization of CTC and analysis of various forms of ctDNA present promising potential in development of individualized therapy for melanoma patients. New approaches such as massive parallel sequencing (MPS) provide a comprehensive view of the disease progression, allowing for the selection of therapeutic options for individual patients. With advancements of improving molecular assays, liquid biopsy analysis as a powerful, routine clinical assay for melanoma patients, is highly promising prospective. PMID:26778792

  7. Increased NY-ESO-1 Expression and Reduced Infiltrating CD3+ T Cells in Cutaneous Melanoma

    Directory of Open Access Journals (Sweden)

    Mara Giavina-Bianchi

    2015-01-01

    Full Text Available NY-ESO-1 is a cancer-testis antigen aberrantly expressed in melanomas, which may serve as a robust and specific target in immunotherapy. NY-ESO-1 antigen expression, tumor features, and the immune profile of tumor infiltrating lymphocytes were assessed in primary cutaneous melanoma. NY-ESO-1 protein was detected in 20% of invasive melanomas (16/79, rarely in in situ melanoma (1/10 and not in benign nevi (0/20. Marked intratumoral heterogeneity of NY-ESO-1 protein expression was observed. NY-ESO-1 expression was associated with increased primary tumor thickness (P=0.007 and inversely correlated with superficial spreading melanoma (P<0.02. NY-ESO-1 expression was also associated with reduced numbers and density of CD3+ tumor infiltrating lymphocytes (P=0.017. When NY-ESO-1 protein was expressed, CD3+ T cells were less diffusely infiltrating the tumor and were more often arranged in small clusters (P=0.010 or as isolated cells (P=0.002 than in large clusters of more than five lymphocytes. No correlation of NY-ESO-1 expression with gender, age, tumor site, ulceration, lymph node sentinel status, or survival was observed. NY-ESO-1 expression in melanoma was associated with tumor progression, including increased tumor thickness, and with reduced tumor infiltrating lymphocytes.

  8. Increased NY-ESO-1 expression and reduced infiltrating CD3+ T cells in cutaneous melanoma.

    Science.gov (United States)

    Giavina-Bianchi, Mara; Giavina-Bianchi, Pedro; Sotto, Mirian Nacagami; Muzikansky, Alona; Kalil, Jorge; Festa-Neto, Cyro; Duncan, Lyn M

    2015-01-01

    NY-ESO-1 is a cancer-testis antigen aberrantly expressed in melanomas, which may serve as a robust and specific target in immunotherapy. NY-ESO-1 antigen expression, tumor features, and the immune profile of tumor infiltrating lymphocytes were assessed in primary cutaneous melanoma. NY-ESO-1 protein was detected in 20% of invasive melanomas (16/79), rarely in in situ melanoma (1/10) and not in benign nevi (0/20). Marked intratumoral heterogeneity of NY-ESO-1 protein expression was observed. NY-ESO-1 expression was associated with increased primary tumor thickness (P = 0.007) and inversely correlated with superficial spreading melanoma (P ESO-1 expression was also associated with reduced numbers and density of CD3+ tumor infiltrating lymphocytes (P = 0.017). When NY-ESO-1 protein was expressed, CD3+ T cells were less diffusely infiltrating the tumor and were more often arranged in small clusters (P = 0.010) or as isolated cells (P = 0.002) than in large clusters of more than five lymphocytes. No correlation of NY-ESO-1 expression with gender, age, tumor site, ulceration, lymph node sentinel status, or survival was observed. NY-ESO-1 expression in melanoma was associated with tumor progression, including increased tumor thickness, and with reduced tumor infiltrating lymphocytes.

  9. Coffee consumption and the risk of cutaneous melanoma: a meta-analysis.

    Science.gov (United States)

    Wang, Jia; Li, Xutong; Zhang, Dongfeng

    2016-06-01

    Results from epidemiologic studies on coffee consumption and the risk of cutaneous melanoma are inconsistent. We conducted a meta-analysis to assess the associations between the consumption of total coffee, caffeinated coffee and decaffeinated coffee and the risk of cutaneous melanoma, respectively. A literature search was performed in PubMed, Web of Science and EMBASE for relevant articles published up to August 2015. Pooled relative risks (RRs) with 95 % confidence intervals (CIs) were calculated with a random-effects model. Dose-response relationship was assessed by restricted cubic spline. Twelve studies involving 832,956 participants for total coffee consumption, 5 studies involving 717,151 participants for caffeinated coffee consumption and 6 studies involving 718,231 participants for decaffeinated coffee consumption were included in this meta-analysis. Compared with the lowest level of consumption, the pooled RRs were 0.80 (95 % CI 0.69-0.93, I (2) = 53.5 %), 0.85 (95 % CI 0.71-1.01, I (2) = 65.0 %) and 0.92 (95 % CI 0.81-1.05, I (2) = 0.0 %) for the consumption of total coffee, caffeinated coffee and decaffeinated coffee, respectively. In subgroup analysis by study design, the pooled RRs in cohort studies and case-control studies were 0.83 (95 % CI 0.72-0.97) and 0.74 (95 % CI 0.51-1.07) for total coffee consumption, respectively. Dose-response analysis suggested cutaneous melanoma risk decreased by 3 % [0.97 (0.93-1.00)] and 4 % [0.96 (0.92-1.01)] for 1 cup/day increment of total coffee and caffeinated coffee consumption, respectively. This meta-analysis suggests that coffee consumption may reduce the risk of cutaneous melanoma.

  10. Tumor-infiltrating CD8+ lymphocytes effect on clinical outcome of muco-cutaneous melanoma

    Directory of Open Access Journals (Sweden)

    Mahtab Rahbar

    2015-01-01

    Full Text Available Background: Recent data have changed our views of prognostic factors in cutaneous melanoma, while some newer methods have yielded better prognostic information. Tumor-infiltrating lymphocytes are believed to represent the immune reaction/response to melanoma cells which is often found in melanocytic cancer. Aim and Objective: We carried out an analysis, aiming to establish pooled estimates for clinical outcomes based on the presence of CD8+ T cell in melanocytic cancer. Materials and Methods: We have included 42 patients with primary cutaneous melanocytic cancer without preoperative treatments in our study. We next analyzed the proliferative activity of CD8+ T cells that infiltrated in tumor cell nests. The intratumoral and adjacent to invasive margin of tumor CD+ T-cell infiltration were analyzed which could also reflect antitumor immunity. Results: The total number of CD8+ cells especially adjacent to invasive margin of tumor was positively correlated with anatomical tumor thickness (P < .001 and not correlated with patient′s age and sex. The stage of tumor which is related to vascular-neural invasion, regional lymph nodes involvement and tumor thickness shows positive correlation with CD8+ infiltration in tumor (P < .004, P < .005, P < .001, respectively. Acral melanoma shows more CD8 lymphocytes infiltration and also recurrence rate of tumor (P < .005. Conclusion: We believe that CD8+ T-cell infiltration in primary cutaneous melanocytic cancer represents the immune reaction/response to melanoma which could be an important new therapy for melanoma although more research is needed on this treatment modality.

  11. A practical method for clinical diagnosis of oral mucosal melanomas.

    Science.gov (United States)

    Delgado Azañero, Wilson A; Mosqueda Taylor, Adalberto

    2003-01-01

    To present a practical and technically simple method for clinical diagnosis of oral melanomas that allows to differentiate this neoplasm from other pigmented lesions. Thirteen oral pigmented lesions with suspected diagnosis of mucosal melanomas were submitted to a test named "rubbing with a gauze" the surface of the lesion. The test was considered positive when the gauze stained dark brown or black due to the presence of melanin-laden cells on the epithelial surface. In all cases definite diagnosis was confirmed by biopsy. Positive results were obtained in 11 out of 13 cases (84.6%). Our results establish that the test "rubbing with gauze" the surface of oral pigmented lesions demonstrates a high sensitivity to anticipate clinically the diagnosis of mucosal melanomas. However, a negative result does not exclude this neoplasm, since there are some cases in which malignant cells have not invaded the superficial epithelial layers. In every case the final diagnosis must be established by histopathologic or immunohistochemical analysis.

  12. Accuracy of Diagnostic Biopsy for Cutaneous Melanoma: Implications for Surgical Oncologists

    Directory of Open Access Journals (Sweden)

    Tina J. Hieken

    2013-01-01

    Full Text Available Background and Objectives. While excisional biopsy is recommended to diagnose cutaneous melanoma, various biopsy techniques are used in practice. We undertook this study to identify how frequently final tumor stage and treatment recommendations changed from diagnostic biopsy to final histopathology after wide local excision (WLE. Methods. We compared the histopathology of the dermatopathologist-reviewed diagnostic biopsy and final WLE in 332 cutaneous melanoma patients. Results. Tumor sites were extremity (51%, trunk (33%, and head/neck (16%. Initial biopsy types were excisional (56%, punch (21%, shave (18%, and incisional (5%. Most diagnostic biopsies were margin positive regardless of technique, and 36% of patients had residual melanoma on WLE. T-stage changed in 8% of patients, of whom 59% were diagnosed by punch biopsy, 15% by incisional biopsy, 15% by shave biopsy, and 11% by excisional biopsy (P<0.0001. Treatment recommendations changed in 6%: 2% after excisional biopsy, 5% after shave biopsy, 18% after punch biopsy, and 18% after incisional biopsy (P<0.0001. Conclusions. Although most biopsy margins were positive, T-stage and treatment changed for only a minority of melanoma patients. Our data provide valuable information to inform patient discussion regarding the likelihood of a change in prognosis and the need for secondary procedures after WLE. These data support the superiority of dermatopathologist-reviewed excisional biopsy when feasible.

  13. Accuracy of diagnostic biopsy for cutaneous melanoma: implications for surgical oncologists.

    Science.gov (United States)

    Hieken, Tina J; Hernández-Irizarry, Roberto; Boll, Julia M; Jones Coleman, Jamie E

    2013-01-01

    While excisional biopsy is recommended to diagnose cutaneous melanoma, various biopsy techniques are used in practice. We undertook this study to identify how frequently final tumor stage and treatment recommendations changed from diagnostic biopsy to final histopathology after wide local excision (WLE). We compared the histopathology of the dermatopathologist-reviewed diagnostic biopsy and final WLE in 332 cutaneous melanoma patients. Tumor sites were extremity (51%), trunk (33%), and head/neck (16%). Initial biopsy types were excisional (56%), punch (21%), shave (18%), and incisional (5%). Most diagnostic biopsies were margin positive regardless of technique, and 36% of patients had residual melanoma on WLE. T-stage changed in 8% of patients, of whom 59% were diagnosed by punch biopsy, 15% by incisional biopsy, 15% by shave biopsy, and 11% by excisional biopsy (P biopsy, 5% after shave biopsy, 18% after punch biopsy, and 18% after incisional biopsy (P biopsy margins were positive, T-stage and treatment changed for only a minority of melanoma patients. Our data provide valuable information to inform patient discussion regarding the likelihood of a change in prognosis and the need for secondary procedures after WLE. These data support the superiority of dermatopathologist-reviewed excisional biopsy when feasible.

  14. Cutaneous side-effects during therapy of melanoma by vemurafenib

    Directory of Open Access Journals (Sweden)

    Anna Ankudowicz

    2015-06-01

    Full Text Available Introduction. Vemurafenib is a selective inhibitor of serine-threonine kinase BRAF used in the treatment of advanced melanoma with BRAF mutation. Effectiveness of this drug was confirmed in a large clinical trial, which led to the increase of its usage. During treatment with vemurafenib, particular attention should be paid to the numerous side effects, including those concerning the skin. Vemurafenib is highly toxic to the skin. Skin lesions occurring during the treatment of melanoma with this medicament can be divided into: early (observed 3 to 6 weeks after beginning treatment, late (observed 6 weeks after beginning treatment and hypersensitivity reactions to vemurafenib. Objective. Presentation of vemurafenib toxic effects on the skin and side effects that can be caused by this drug. Case report. We present a 58-year-old woman with metastatic melanoma who was treated with vemurafenib. During the course of therapy, numerous adverse reactions, including inflammatory tumors, emergence of a number of melanocytic naevi, skin horns, alopecia, hyperkeratosis of the palms and soles, and palmar erythrodysesthesia were observed. She was treated with anti-inflammatory drugs, an antibiotic, circulation-improving preparations and local moisturizing and keratolytic treatment. The patient remains under the care of oncologists and dermatologists. Conclusions. The new generation anti-cancer drugs bring hope for a cure or prolongation of life, but can also significantly reduce the quality of life by inducing both general and local adverse side effects. Oncological patients should also be taken care of by dermatologists.

  15. Balloon Cell Urethral Melanoma: Differential Diagnosis and Management

    Directory of Open Access Journals (Sweden)

    M. McComiskey

    2015-01-01

    Full Text Available Introduction. Primary malignant melanoma of the urethra is a rare tumour (0.2% of all melanomas that most commonly affects the meatus and distal urethra and is three times more common in women than men. Case. A 76-year-old lady presented with vaginal pain and discharge. On examination, a 4 cm mass was noted in the vagina and biopsy confirmed melanoma of a balloon type. Preoperative CT showed no distant metastases and an MRI scan of the pelvis demonstrated no associated lymphadenopathy. She underwent anterior exenterative surgery and vaginectomy also. Histology confirmed a urethral nodular malignant melanoma. Discussion. First-line treatment of melanoma is often surgical. Adjuvant treatment including chemotherapy, radiotherapy, or immunotherapy has also been reported. Even with aggressive management, malignant melanoma of the urogenital tract generally has a poor prognosis. Recurrence rates are high and the mean period between diagnosis and recurrence is 12.5 months. A 5-year survival rate of less than 20% has been reported in balloon cell melanomas along with nearly 20% developing local recurrence. Conclusion. To the best of our knowledge, this case is the first report of balloon cell melanoma arising in the urethra. The presentation and surgical management has been described and a literature review provided.

  16. Management of primary cutaneous melanoma of the hands and feet: a clinicoprognostic study.

    Science.gov (United States)

    Rex, Jordi; Paradelo, Cristina; Mangas, Cristina; Hilari, Josep Maria; Fernández-Figueras, María Teresa; Ferrándiz, Carlos

    2009-10-01

    Although acral lentiginous melanoma is the most common subtype of malignant melanoma in acral locations, the term acral melanoma (AM) has to be differentiated from the histopathologic description. To characterize the clinical and pathologic features of patients with a primary AM and to elucidate whether the prognosis of patients with AM differs from that of those with melanoma at other sites (nonacral melanoma; NAM). Over a 20-year period, a series of 822 consecutive patients with melanoma were recorded in the database. Clinical and follow-up data were retrieved from the melanoma register and prospectively analyzed. Eighty-nine patients had a malignant melanoma located on the acral sites of extremities. Breslow thickness and Clark level were found to be related to specific and disease-free survival. Breslow thickness greater than 4 mm was associated with greater risk of recurrence, and amelanosis and age of 60 and older were significantly associated with greater risk of death. Comparison of survival of patients with AM with that of those with NAM clearly showed that disease-free survival and overall survival were significantly lower in the former. Survival differences between patients with AM and NAM are due to differences in already known prognostic factors, probably as a consequence of a delay in the diagnosis in these locations.

  17. Melanoma cutáneo asociado a nevo previo Cutaneous melanoma associated with previous nevus

    Directory of Open Access Journals (Sweden)

    María P. Gutiérrez

    2009-10-01

    Full Text Available El melanoma maligno es una neoplasia originada en los melanocitos de la piel y otras localizaciones. No existe información en nuestro país acerca de su incidencia y prevalecencia, sí se sabe cuáles son los factores de riesgo más importantes. El melanoma puede originarse de novo o a partir de lesiones melanocíticas previas. La noción de que un nevo melanocítico pueda servir como lesión precursora es sustentada por evidencias clínicas e histológicas. Realizamos en el Hospital Privado de Córdoba un estudio observacional, retrospectivo y analítico. El objetivo de este trabajo fue conocer cuál es la frecuencia de asociación de melanomas malignos que se desarrollan sobre nevos previos. Fueron analizados un total de 134 melanomas. En 32 pacientes (24%, los melanomas estuvieron histológicamente asociados con nevos, con espesores de Breslow mayores de 1 mm el porcentaje de asociación fue de 16.3%, y con Breslow menores de 1 mm, 38.1%. Al evaluar los melanomas en relación a la clasificación de Breslow y Clark, se objetivó que el grupo de melanomas asociados a nevos presentó un espesor de Breslow y niveles de Clark bajos y en el análisis estadístico fueron predictores significativos en la probabilidad de hallar esta asociación (p The malignant melanoma is a neoplasia originated from the melanocytes located in the skin and other locations. Even though there is not information regarding its incidence and prevalence in our country, its most important risk factors are known. The melanoma can originate de novo or from previous melanocytic lesions. The concept that a melanocytic nevus can serve as a precursor lesion is supported by clinical and histological evidence. An observational, retrospective and analytical study was carried out in the Hospital Privado de Córdoba. The objective was to determine which is the frequency of association of malignant melanomas that develop on previous nevus. A total of 134 melanomas were analyzed. In 32

  18. Ethnicity and cutaneous melanoma in the city of Sao Paulo, Brazil: a case-control study.

    Directory of Open Access Journals (Sweden)

    Olinda C Luiz

    Full Text Available BACKGROUND: Over the last century the incidence of cutaneous melanoma has increased worldwide, a trend that has also been observed in Brazil. The identified risk factors for melanoma include the pattern of sun exposure, family history, and certain phenotypic features. In addition, the incidence of melanoma might be influenced by ethnicity. Like many countries, Brazil has high immigration rates and consequently a heterogeneous population. However, Brazil is unique among such countries in that the ethnic heterogeneity of its population is primarily attributable to admixture. This study aimed to evaluate the contribution of European ethnicity to the risk of cutaneous melanoma in Brazil. METHODOLOGY/PRINCIPAL FINDINGS: We carried out a hospital-based case-control study in the metropolitan area of Sao Paulo, Brazil. We evaluated 424 hospitalized patients (202 melanoma patients and 222 control patients regarding phenotypic features, sun exposure, and number of grandparents born in Europe. Through multivariate logistic regression analysis, we found the following variables to be independently associated with melanoma: grandparents born in Europe-Spain (OR = 3.01, 95% CI: 1.03-8.77, Italy (OR = 3.47, 95% CI: 1.41-8.57, a Germanic/Slavic country (OR = 3.06, 95% CI: 1.05-8.93, or ≥ 2 European countries (OR = 2.82, 95% CI: 1.06-7.47; eye color-light brown (OR = 1.99, 95% CI: 1.14-3.84 and green/blue (OR = 4.62; 95% CI 2.22-9.58; pigmented lesion removal (OR = 3.78; 95% CI: 2.21-6.49; no lifetime sunscreen use (OR = 3.08; 95% CI: 1.03-9.22; and lifetime severe sunburn (OR = 1.81; 95% CI: 1.03-3.19. CONCLUSIONS: Our results indicate that European ancestry is a risk factor for cutaneous melanoma. Such risk appears to be related not only to skin type, eye color, and tanning capacity but also to others specific characteristics of European populations introduced in the New World by European immigrants.

  19. Ethnicity and Cutaneous Melanoma in the City of Sao Paulo, Brazil: A Case-Control Study

    Science.gov (United States)

    Luiz, Olinda C.; Gianini, Reinaldo José; Gonçalves, Fernanda T.; Francisco, Guilherme; Festa-Neto, Cyro; Sanches, José Antonio; Gattas, Gilka J. F.; Chammas, Roger; Eluf-Neto, José

    2012-01-01

    Background Over the last century the incidence of cutaneous melanoma has increased worldwide, a trend that has also been observed in Brazil. The identified risk factors for melanoma include the pattern of sun exposure, family history, and certain phenotypic features. In addition, the incidence of melanoma might be influenced by ethnicity. Like many countries, Brazil has high immigration rates and consequently a heterogenous population. However, Brazil is unique among such countries in that the ethnic heterogeneity of its population is primarily attributable to admixture. This study aimed to evaluate the contribution of European ethnicity to the risk of cutaneous melanoma in Brazil. Methodology/Principal Findings We carried out a hospital-based case-control study in the metropolitan area of Sao Paulo, Brazil. We evaluated 424 hospitalized patients (202 melanoma patients and 222 control patients) regarding phenotypic features, sun exposure, and number of grandparents born in Europe. Through multivariate logistic regression analysis, we found the following variables to be independently associated with melanoma: grandparents born in Europe—Spain (OR = 3.01, 95% CI: 1.03–8.77), Italy (OR = 3.47, 95% CI: 1.41–8.57), a Germanic/Slavic country (OR = 3.06, 95% CI: 1.05–8.93), or ≥2 European countries (OR = 2.82, 95% CI: 1.06–7.47); eye color—light brown (OR = 1.99, 95% CI: 1.14–3.84) and green/blue (OR = 4.62; 95% CI 2.22–9.58); pigmented lesion removal (OR = 3.78; 95% CI: 2.21–6.49); no lifetime sunscreen use (OR = 3.08; 95% CI: 1.03–9.22); and lifetime severe sunburn (OR = 1.81; 95% CI: 1.03–3.19). Conclusions Our results indicate that European ancestry is a risk factor for cutaneous melanoma. Such risk appears to be related not only to skin type, eye color, and tanning capacity but also to others specific characteristics of European populations introduced in the New World by European immigrants. PMID:22558444

  20. Coffee Drinking and Cutaneous Melanoma Risk in the NIH-AARP Diet and Health Study

    Science.gov (United States)

    Freedman, Neal D.; Graubard, Barry I.; Hollenbeck, Albert R.; Shebl, Fatma M.; Mayne, Susan T.; Sinha, Rashmi

    2015-01-01

    Background: Cutaneous melanoma is the fifth most common cancer in the United States. Modifiable risk factors, with the exception of exposure to ultraviolet radiation (UVR), are poorly understood. Coffee contains numerous bioactive compounds and may be associated inversely with melanoma. However, previous epidemiological evidence is limited. Methods: Coffee intake was assessed at baseline with a food frequency questionnaire in the National Institutes of Health–AARP prospective cohort study. Among 447 357 non-Hispanic whites who were cancer-free at baseline, 2904 incident cases of malignant melanoma were identified during 4 329 044 person-years of follow-up, with a median of 10.5 years of follow-up. Multivariable-adjusted Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for coffee intake and subsequent melanoma risk with non–coffee drinkers as the reference group. Statistical tests were two-sided, and P values less than .05 were interpreted as statistically significant. Results: The highest category of coffee intake was inversely associated with malignant melanoma (≥4 cups/day: HR = 0.80, 95% CI = 0.68 to 0.93, P trend = .01). This association was statistically significant for caffeinated (≥4 cups/day: HR = 0.75, 95% CI = 0.64 to 0.89, P trend = .01) but not for decaffeinated coffee (P trend = .55). Conclusions: Higher coffee intake was associated with a modest decrease in risk of melanoma in this large US cohort study. Additional investigations of coffee intake and its constituents, particularly caffeine, with melanoma are warranted. PMID:25604135

  1. Coffee drinking and cutaneous melanoma risk in the NIH-AARP diet and health study.

    Science.gov (United States)

    Loftfield, Erikka; Freedman, Neal D; Graubard, Barry I; Hollenbeck, Albert R; Shebl, Fatma M; Mayne, Susan T; Sinha, Rashmi

    2015-02-01

    Cutaneous melanoma is the fifth most common cancer in the United States. Modifiable risk factors, with the exception of exposure to ultraviolet radiation (UVR), are poorly understood. Coffee contains numerous bioactive compounds and may be associated inversely with melanoma. However, previous epidemiological evidence is limited. Coffee intake was assessed at baseline with a food frequency questionnaire in the National Institutes of Health-AARP prospective cohort study. Among 447 357 non-Hispanic whites who were cancer-free at baseline, 2904 incident cases of malignant melanoma were identified during 4 329 044 person-years of follow-up, with a median of 10.5 years of follow-up. Multivariable-adjusted Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for coffee intake and subsequent melanoma risk with non-coffee drinkers as the reference group. Statistical tests were two-sided, and P values less than .05 were interpreted as statistically significant. The highest category of coffee intake was inversely associated with malignant melanoma (≥4 cups/day: HR = 0.80, 95% CI = 0.68 to 0.93, P trend = .01). This association was statistically significant for caffeinated (≥4 cups/day: HR = 0.75, 95% CI = 0.64 to 0.89, P trend = .01) but not for decaffeinated coffee (P trend = .55). Higher coffee intake was associated with a modest decrease in risk of melanoma in this large US cohort study. Additional investigations of coffee intake and its constituents, particularly caffeine, with melanoma are warranted. Published by Oxford University Press 2015.

  2. Prevalence and heterogeneity of circulating tumour cells in metastatic cutaneous melanoma.

    Science.gov (United States)

    Khoja, Leila; Shenjere, Patrick; Hodgson, Clare; Hodgetts, Jackie; Clack, Glen; Hughes, Andrew; Lorigan, Paul; Dive, Caroline

    2014-02-01

    We previously demonstrated that circulating tumour cells (CTCs) are detectable by the MelCAM and high molecular weight melanoma-associated antigen (HMW-MAA)-dependent CellSearch platform. However, CTCs which do not express these capture and detection markers are not detectable by CellSearch. Consequently, we explored the use of isolation by size of epithelial tumour cells (ISET), a marker independent, filtration-based device to determine the prevalence and heterogeneity of CTCs in metastatic cutaneous melanoma patients. Ninety patients were prospectively recruited and blood samples taken before treatment. Patients' blood was filtered using the ISET platform. CTCs were enumerated using dual immunohistochemistry with positive selection by S100 expression and exclusion of leucocytes and endothelial cells expressing CD45 or CD144, respectively. A panel of markers (Melan-A, MITF, MelCAM, high molecular melanoma-associated antigen, CD271 and MAGEC) was also examined. Fifty-one patients (57%) had CTCs (range 1-44 CTCs/4 ml blood) and 12 patients also had circulating tumour microemboli. Seven patients had S100- CTCs, 11 patients' CTCs were S100+ and 33 patients had S100+ and S100- CTCs. Substantial intrapatient and interpatient heterogeneity was observed for all other melanoma-associated markers. CTCs in metastatic cutaneous melanoma are detectable using the flexible marker-independent ISET platform. CTCs display significant marker expression heterogeneity implying that marker-dependent platforms would not detect all CTCs and multimarker assays are now required to reveal the biological significance of this CTC heterogeneity.

  3. Majority of the most-cited articles on cutaneous malignant melanoma are published in non-dermatology/melanoma specialized journals.

    Science.gov (United States)

    Tas, Faruk

    2016-01-01

    The most-cited articles. (MCAs) are likely those that impressed other researchers and had profound influence on clinical practice or future developments in the related scientific field. This study was conducted to explore a bibliometric approach to assess in where the cutaneous malignant melanoma. (CMM) related MCAs have been published. We identified journals for publications with the word "melanoma" in the title by using the ISI Web of Knowledge Database between 2000 and 2010. The term MCAs arbitrarily defined as equal or more than 100 citations. A total of 425 MCAs were published in 93 journals, led by the Cancer Research. (n = 58) and Journal of Clinical Oncology. (n = 53). Journal categories with the MCAs were the Oncology with 232 articles, followed by the Medicine with 138. articles. The median number of citations was 147. The total numbers of citations were most prominent for the journal Nature and the New England Journal of Medicine. (NEJM) (median 385 and 354, respectively). Total number of citations was the highest for the Science.categorized journals. (median 211). Articles categorized as Dermatology and Melanoma was the least (median 132.5). The median number of citations per year was 14.91. The most valuable cited articles of per year were also published in the journal Nature. (median 59.67) and the NEJM. (median 48.67). The number of citation was the highest for the Science-categorized journals. (median 25.92). Majority of the MCAs on CMM were published in non-dermatology/melanoma specialized journals.

  4. Computer-aided dermoscopy for diagnosis of melanoma

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    Naraghi Zahra S

    2005-07-01

    Full Text Available Abstract Background Computer-aided dermoscopy using artificial neural networks has been reported to be an accurate tool for the evaluation of pigmented skin lesions. We set out to determine the sensitivity and specificity of a computer-aided dermoscopy system for diagnosis of melanoma in Iranian patients. Methods We studied 122 pigmented skin lesions which were referred for diagnostic evaluation or cosmetic reasons. Each lesion was examined by two clinicians with naked eyes and all of their clinical diagnostic considerations were recorded. The lesions were analyzed using a microDERM® dermoscopy unit. The output value of the software for each lesion was a score between 0 and 10. All of the lesions were excised and examined histologically. Results Histopathological examination revealed melanoma in six lesions. Considering only the most likely clinical diagnosis, sensitivity and specificity of clinical examination for diagnosis of melanoma were 83% and 96%, respectively. Considering all clinical diagnostic considerations, the sensitivity and specificity were 100% and 89%. Choosing a cut-off point of 7.88 for dermoscopy score, the sensitivity and specificity of the score for diagnosis of melanoma were 83% and 96%, respectively. Setting the cut-off point at 7.34, the sensitivity and specificity were 100% and 90%. Conclusion The diagnostic accuracy of the dermoscopy system was at the level of clinical examination by dermatologists with naked eyes. This system may represent a useful tool for screening of melanoma, particularly at centers not experienced in the field of pigmented skin lesions.

  5. Diagnosis of Choroidal Melanoma in Dense Asteroid Hyalosis.

    Science.gov (United States)

    Motiani, Meghna V; McCannel, Colin A; Almanzor, Robert; McCannel, Tara A

    2017-01-01

    To demonstrate the utility of Optos ultra-wide field imaging in the diagnosis and management of choroidal melanoma in the setting of asteroid hyalosis. Observational case report. A 52-year-old female was referred for evaluation of floaters, photopsias, and blurry vision in the right eye. Clinical examination revealed dense asteroid hyalosis obscuring the fundus, and a limited view of a pigmented choroidal lesion in the nasal periphery. Optos ultra-wide field fluorescein angiography and ultrasonography facilitated the diagnosis of a choroidal melanoma. The patient underwent Iodine-125 brachytherapy for local tumor control and excellent tumor response was confirmed with serial follow-up Optos imaging and ultrasonography. Ultra-wide field fundus fluorescein angiography facilitated the diagnosis of a choroidal melanoma, which was obscured by dense asteroid hyalosis, allowing for local tumor control with brachytherapy. Optos wide-field imaging may be a valuable tool for detecting potentially life-threatening lesions in the setting of asteroid hyalosis.

  6. Dermatologia comparativa: dermatoscopia em melanoma cutâneo Comparative dermatology: dermatoscopy of cutaneous melanoma

    Directory of Open Access Journals (Sweden)

    Otávio Sérgio Lopes

    2008-10-01

    Full Text Available Os autores apresentam imagens de dermatoscopia em uma fruta (manga-rosa, contaminada pela antracnose, mostrando sua semelhança com o melanoma extensivo superficial.The authors present images from a dermatoscopy performed in a fruit (mango that was contaminated by anthracnosis, showing its similarity to superficial spreading melanona.

  7. CDKN2A and MC1R variants found in Cypriot patients diagnosed with cutaneous melanoma

    Indian Academy of Sciences (India)

    GEORGIA KOULERMOU; CHRISTOS SHAMMAS; ANDREAS VASSILIOU; TASSOS C. KYRIAKIDES; CONSTANTINA COSTI; VASSOS NEOCLEOUS; LEONIDAS A. PHYLACTOU; MARIA PANTELIDOU

    2017-03-01

    The prevalence of genetic variants associated to cutaneous melanoma (CM) has never been determined within Cypriot melanomas. This study evaluates the frequency of variants in cyclin-dependent kinase inhibitor 2A (CDKN2A) andmelanocortin-1 receptor (MC1R) in 32 patients diagnosed with CM. Other characteristics and risk factors were also assessed. CDKN2A p.Ala148Thr was detected in three of 32 patients, while the control group revealed no variationswithin CDKN2A. MC1R screening in 32 patients revealed the following variations: p.Val60Leu in 11 patients, p.Arg142His in four patients, p.Thr314Thr in one patient, p.Arg160Trp in one patient, p.Val92Met/p.Thr314Thr in one patient andp.Val92Met/p.Arg142His/p.Thr314Thr in one patient. The control group revealed only p.Val60Leu (in 10 of 45 individuals), which is frequently found in general populations. Two unrelated patients carried CDKN2A p.Ala148Thr in combination with MC1R p.Arg142His, suggesting digenic inheritance that may provide evidence of different gene variants acting synergistically to contribute for CM development. This study confirms the presence of CDKN2A and MC1R variants among Cypriot melanomas and supports existing evidence of a role for these variants in susceptibility to melanoma.

  8. CD207+/langerin positive dendritic cells in invasive and in situ cutaneous malignant melanoma

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    Grzegorz Dyduch

    2017-05-01

    Full Text Available Introduction : Dendritic cells are crucial for cutaneous immune response. Their role in melanoma progression is however a matter of controversy. Material and methods : The number of dendritic cells within epidermis and in peri- and intratumoral location was analyzed using CD207 immunostain in 17 cases of in situ and 25 case of invasive melanoma. Results : Average peritumoral CD207+ cells count was 22.88 for all cases, 17.94 for in situ lesions and 26.24 for invasive cases. Average epidermal CD207+ cells count was 164.47 for all cases, 183.00 for in situ lesions and 150.78 – for invasive cases. In case of invasive melanomas, peritumoral CD207+ cells count was positively correlated with Breslow stage (R = 0.59 mitotic activity within the tumor (R = 0.62. Invasive cases with regression showed higher intratumoral and epidermal CD207+ cells count than the ones without (275.00 vs. 95.32 and 173.20 vs. 148.35 but lower peritumoral CD207+ cells count (17.60 vs. 27.26. Invasive cases with ulceration showed higher intratumoral and peritumoral CD207+ cells count than the ones without ulceration (220.08 vs. 55.67 and 44.17 vs. 9.69. Conclusions : CD207+ cells play a role in both progression and regression of melanoma but their exact role needs further studies.

  9. Sun behaviour after cutaneous malignant melanoma: a study based on ultraviolet radiation measurements and sun diary data.

    Science.gov (United States)

    Idorn, L W; Datta, P; Heydenreich, J; Philipsen, P A; Wulf, H C

    2013-02-01

    It has been reported that patients with cutaneous malignant melanoma (CMM) can lower their risk of a second primary melanoma by limiting recreational sun exposure. Previous studies based on questionnaires and objective surrogate measurements indicate that before their diagnosis, patients with CMM are exposed to higher ultraviolet radiation (UVR) doses than controls, followed by a reduction after diagnosis. In a prospective, observational case-control study, we aimed to assess sun exposure after diagnosis of CMM by objective measurements to substantiate advice about sun behaviour. The study population consisted of 24 patients recently diagnosed with CMM during the 7 months preceding the start of the study; 51 controls who matched these recently diagnosed patients in age, sex, occupation and constitutive skin type; and 29 patients diagnosed with CMM between 12 months and 6 years before the start of the study. During a summer season participants filled in sun exposure diaries daily and wore personal electronic UVR dosimeters in a wristwatch that continuously measured time-stamped UVR doses in standard erythema dose. The UVR dose of recently diagnosed patients on days with body exposure was one-third lower, and the number of days using sunscreen was double that of matched controls. However, in patients diagnosed more than 12 months earlier, the UVR dose on days with body exposure was one-third higher and the number of days using sunscreen was half that of recently diagnosed patients. Patients with CMM limited their UVR dose on days with body exposure, and by using sunscreen further reduced UVR reaching the skin, although only immediately after diagnosis. © 2012 The Authors. BJD © 2012 British Association of Dermatologists.

  10. BRAF基因突变与皮肤恶性黑素瘤%BRAF gene mutation and cutaneous melanoma

    Institute of Scientific and Technical Information of China (English)

    郑博文; 何黎; 张林; 邹勇莉

    2009-01-01

    BRAF gene, located in chromosome 7q34, encodes a serine/threonine protein kinase of 67-99 kilodalton which plays an important regulating role in the pathway of mitogen-activated protein kinase (MAPK). Recent studies have revealed the relationship between BRAF gene mutation and cutaneous melanoma. Some progress has been made in the research about BRAF gene-targeting therapy. To study BRAF gene and its mutation may benefit the diagnosis, treatment and prognosis evaluation of melanoma.%BRAF基因,位于染色体7q34编码一个67 000~99 000的丝,苏氨酸蛋白激酶,其产物在丝裂原活化蛋白激酶信号途径中起重要调控作用.国内外的研究者先后发现并揭示出BRAF基因变异与皮肤恶性黑素瘤的关系.随着探索的深入,部分学者以BRAF基因作为治疗靶向进行研究,并初步取得成果.对BRAF基因及其突变的研究可能在未来恶性黑素瘤诊断、治疗以及预后等方面产生临床价值,为恶性黑素瘤的治疗开辟新的方向.

  11. Positron emission tomography in the follow-up of cutaneous malignant melanoma patients

    DEFF Research Database (Denmark)

    Danielsen, Maria; Højgaard, Liselotte; Kjær, Andreas

    2014-01-01

    Cutaneous malignant melanoma (CMM) has a high risk of dissemination to regional lymph nodes and visceral organs. Recurrences are most frequently seen within the first 2-3 years after initial treatment, but these patients have a life-long risk of relapse. The prognosis is highly dependent on lymph...... node involvement and distant metastases, accentuating the importance of close surveillance to identify disease progression at an early stage, and thereby detect recurrences amenable to treatment. Positron emission tomography (PET) has already been proven useful in the staging of CMM, but the utility...

  12. Spatial analysis of incidence of cutaneous melanoma in the Friuli Venezia Giulia region in the period 1995-2005

    OpenAIRE

    Lorenzo Cecconi; Anna Busolin; Fabio Barbone; Diego Serraino; Alessandra Chiarugi; Annibale Biggeri; Dolores Catelan

    2016-01-01

    Incidence distribution of cutaneous melanoma depends on phenotypic characteristics of population and geographic location. In Italy, in the period 1999-2003 Friuli Venezia Giulia (FVG) region had the second highest incidence rates for males and the third for females. We analysed melanoma and lip cancer incidence data of the FVG cancer registry for the period 1995-2005. We used Bayesian hierarchical spatial models to describe the spatial pattern by gender. We decomposed the geographical distrib...

  13. 2-cm versus 4-cm surgical excision margins for primary cutaneous melanoma thicker than 2 mm: a randomised, multicentre trial

    DEFF Research Database (Denmark)

    Gillgren, Peter; Drzewiecki, Krzysztof T; Niin, Marianne;

    2011-01-01

    Optimum surgical resection margins for patients with clinical stage IIA-C cutaneous melanoma thicker than 2 mm are controversial. The aim of the study was to test whether survival was different for a wide local excision margin of 2 cm compared with a 4-cm excision margin.......Optimum surgical resection margins for patients with clinical stage IIA-C cutaneous melanoma thicker than 2 mm are controversial. The aim of the study was to test whether survival was different for a wide local excision margin of 2 cm compared with a 4-cm excision margin....

  14. Diagnosis of Malignant Melanoma of Skin Cancer Types

    Directory of Open Access Journals (Sweden)

    Abbas Hassin Alasadi

    2017-08-01

    Full Text Available Malignant melanoma is a kind of skin cancer that begins in melanocytes. It can influence on the skin only, or it may expand to the bones and organs. It is less common, but more serious and aggressive than other types of skin cancer. Malignant Melanoma can happen anywhere on the skin, but it is widespread in certain locations such as the legs in women, the back and chest in men, the face, the neck, mouth, eyes, and genitals. In this paper, a proposed algorithm is designed for diagnosing malignant melanoma types by using digital image processing techniques. The algorithm consists of four steps: preprocessing, separation, features extraction, and diagnosis. A neural network (NN used to diagnosis malignant melanoma types. The total accuracy of the neural network was 100% for training and 93% for testing. The evaluation of the algorithm is done by using sensitivity, specificity, and accuracy. The sensitivity of NN in diagnosing malignant melanoma types was 95.6%, while the specificity was 92.2% and the accuracy was 93.9%. The experimental results are acceptable.

  15. A 3-year follow-up of sun behavior in patients with cutaneous malignant melanoma.

    Science.gov (United States)

    Idorn, Luise Winkel; Datta, Pameli; Heydenreich, Jakob; Philipsen, Peter Alshede; Wulf, Hans Christian

    2014-02-01

    IMPORTANCE UV radiation (UVR) exposure is the primary environmental risk factor for developing cutaneous malignant melanoma (CMM). OBJECTIVE To measure changes in sun behavior from the first until the third summer after the diagnosis of CMM using matched controls as a reference. DESIGN, SETTING, AND PARTICIPANTS Three-year follow-up, observational, case-control study performed from May 7 to September 22, 2009, April 17 to September 15, 2010, and May 6 to July 31, 2011, at a university hospital in Denmark of 21 patients with CMM and 21 controls matched to patients by sex, age, occupation, and constitutive skin type participated in the study. Exposure to UVR was assessed the first and second summers (n=20) and the first and third summers (n=22) after diagnosis. Data from 40 participants were analyzed. MAIN OUTCOMES AND MEASURES Exposure to UVR was assessed by personal electronic UVR dosimeters that measured time-related UVR in standard erythema dose (SED) and corresponding sun diaries (mean, 74 days per participant each participation year). RESULTS Patients' daily UVR dose and UVR dose in connection with various behaviors increased during follow-up (quantified as an increase in daily UVR dose each year; all days: mean, 0.3 SED; 95% CI, 0.05-0.5 SED; days with body exposure: mean, 0.6 SED; 95% CI, 0.07-1.2 SED; holidays: mean, 1.2 SED; 95% CI, 0.3-2.1 SED; days abroad: 1.9 SED; 95% CI, 0.4-3.4 SED; and holidays with body exposure: mean, 2.3 SED; 95% CI, 1.1-3.4 SED). After the second year of follow-up, patients' UVR dose was higher than that of controls, who maintained a stable UVR dose. No difference was found between groups in the number of days with body exposure or the number of days using sunscreen in the second and third years of follow-up. CONCLUSIONS AND RELEVANCE Our findings suggest that patients with CMM do not maintain a cautious sun behavior in connection with an increase in UVR exposure, especially on days with body exposure, when abroad, and on holidays.

  16. Applications of nanotechnology for melanoma treatment, diagnosis, and theranostics

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    Chen J

    2013-07-01

    Full Text Available Jiezhong Chen,1,2 Renfu Shao,3 Xu Dong Zhang,4 Chen Chen1 1School of Biomedical Sciences, University of Queensland, Brisbane, QLD, Australia; 2Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, Australia; 3GeneCology Research Centre, School of Science, Education and Engineering, University of the Sunshine Coast, Maroochydore, QLD, Australia; 4School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia Abstract: Melanoma is the most aggressive type of skin cancer and has very high rates of mortality. An early stage melanoma can be surgically removed, with a survival rate of 99%. However, metastasized melanoma is difficult to cure. The 5-year survival rates for patients with metastasized melanoma are still below 20%. Metastasized melanoma is currently treated by chemotherapy, targeted therapy, immunotherapy and radiotherapy. The outcome of most of the current therapies is far from optimistic. Although melanoma patients with a mutation in the oncogene v-Raf murine sarcoma viral oncogene homolog B1 (BRAF have an initially higher positive response rate to targeted therapy, the majority develop acquired drug resistance after 6 months of the therapy. To increase treatment efficacy, early diagnosis, more potent pharmacological agents, and more effective delivery systems are urgently needed. Nanotechnology has been extensively studied for melanoma treatment and diagnosis, to decrease drug resistance, increase therapeutic efficacy, and reduce side effects. In this review, we summarize the recent progress on the development of various nanoparticles for melanoma treatment and diagnosis. Several common nanoparticles, including liposome, polymersomes, dendrimers, carbon-based nanoparticles, and human albumin, have been used to deliver chemotherapeutic agents, and small interfering ribonucleic acids (siRNAs against signaling molecules have also been tested for the treatment of melanoma. Indeed

  17. Comparing disciplines: outcomes of non melanoma cutaneous malignant lesions in oral and maxillofacial surgery and dermatology.

    Science.gov (United States)

    Thavarajah, M; Szamocki, S; Komath, D; Cascarini, L; Heliotis, M

    2015-01-01

    300 cases of non-melanoma cutaneous lesion procedures carried out by the Oral and Maxillofacial Surgery and Dermatology departments in a North West London hospital over a 6 month period between September 2011 and February 2012 were included in a retrospective case control study. The results from each speciality were compared. The mean age of the OMFS group was 75.8 years compared to 69.9 years in the dermatology group. There was no statistically significant difference in gender between the 2 groups. The OMFS group treated a higher proportion of atypical (17%) and malignant (64.9%) cases compared to the dermatology group (11.3% and 50.5% respectively). This could also account for the fact that the OMFS group carried out a higher number of full excisions compared to dermatology. Both groups had a similar number of false positives (a benign lesion initially diagnosed as malignant) and a similar proportion of false negatives (a malignant lesion initially diagnosed as benign). Overall, the results show that both specialities had similar outcomes when managing non-melanoma cutaneous lesions. Both groups adhere to the guidelines set out by the British Association of Dermatologists and the National Institute of Clinical Excellence when managing such lesions.

  18. BAP1 cancer syndrome: malignant mesothelioma, uveal and cutaneous melanoma, and MBAITs

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    Carbone Michele

    2012-08-01

    Full Text Available Abstract Background BRCA1–associated protein 1 (BAP1 is a tumor suppressor gene located on chromosome 3p21. Germline BAP1 mutations have been recently associated with an increased risk of malignant mesothelioma, atypical melanocytic tumors and other neoplasms. To answer the question if different germline BAP1 mutations may predispose to a single syndrome with a wide phenotypic range or to distinct syndromes, we investigated the presence of melanocytic tumors in two unrelated families (L and W with germline BAP1 mutations and increased risk of malignant mesothelioma. Methods Suspicious cutaneous lesions were clinically and pathologically characterized and compared to those present in other families carrying BAP1 mutations. We then conducted a meta-analysis of all the studies reporting BAP1-mutated families to survey cancer risk related to the germline BAP1 mutation (means were compared using t-test and proportions were compared with Pearson χ2 test or two-tailed Fisher’s exact test. Results Melanocytic tumors: of the five members of the L family studied, four (80% carried a germline BAP1 mutation (p.Gln684* and also presented one or more atypical melanocytic tumors; of the seven members of W family studied, all carried a germline BAP1 mutation (p.Pro147fs*48 and four of them (57% presented one or more atypical melanocytic tumors, that we propose to call “melanocytic BAP1-mutated atypical intradermal tumors” (MBAITs. Meta-analysis: 118 individuals from seven unrelated families were selected and divided into a BAP1-mutated cohort and a BAP1-non-mutated cohort. Malignant mesothelioma, uveal melanoma, cutaneous melanoma, and MBAITs prevalence was significantly higher in the BAP1-mutated cohort (p ≤ 0.001. Conclusions Germline BAP1 mutations are associated with a novel cancer syndrome characterized by malignant mesothelioma, uveal melanoma, cutaneous melanoma and MBAITs, and possibly by other cancers. MBAITs provide physicians with a

  19. FT-Raman spectroscopy for the differentiation between cutaneous melanoma and pigmented nevus Espectroscopia FT-Raman na diferenciação entre melanoma cutâneo e nevo pigmentado

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    Sidney Bandeira Cartaxo

    2010-08-01

    Full Text Available Cutaneous melanoma is the most aggressive type of skin cancer and Ft-Raman spectroscopy has been studied as a potential method that could be a real alternative for early diagnosis of neoplasms. PURPOSE: To qualify the spectral FT-Raman data, in order to differentiate cutaneous melanoma and pigmented nevus. METHODS: For this study, 10 samples of cutaneous melanoma, 9 samples of pigmented nevi, and 10 samples of normal skin were obtained by incisional biopsies performed during plastic surgeries ex vivo, immediately after removing the surgical sample. RESULTS: The FT-Raman spectra of each group presented a high correlation between the elements of the same group, thus favoring the elaboration of spectral averages. When analyzing the spectral standard of each group, the normal skin standard did not show a significant variation between the spectra; the standard of the pigmented nevi group showed significant variation, and the cutaneous melanoma group also showed variation. Through univariate analysis, specific bands were detected for each vibrational mode identified. The discriminatory analysis of the data showed a 75.3% efficiency of the differentiation between the three groups studied. CONCLUSION: The vibrational modes Polysaccharides, Tyrosine and Amide-I differentiated the melanoma from the pigmented nevus.O melanoma cutâneo é o câncer de pele mais agressivo, e a espectroscopia FT-Raman tem sido estudada como um método em potencial que pode ser uma verdadeira alternativa no diagnóstico precoce de neoplasias. OBJETIVO: Qualificar os dados espectrais FT-Raman de modo a diferenciar melanoma cutâneo de nevo pigmentado. MÉTODOS: Foram utilizadas 10 amostras de melanoma cutâneo, obtidas por meio de biopsias incisionais realizadas "ex-vivo"; nove amostras de nevo pigmentado e 10 amostras de pele normal foram coletadas durante cirurgias plásticas. RESULTADOS: Os espectros FT-Raman de cada grupo diagnóstico apresentaram alta correlação entre os

  20. A cascade classifier for diagnosis of melanoma in clinical images.

    Science.gov (United States)

    Sabouri, P; GholamHosseini, H; Larsson, T; Collins, J

    2014-01-01

    Computer aided diagnosis of medical images can help physicians in better detecting and early diagnosis of many symptoms and therefore reducing the mortality rate. Realization of an efficient mobile device for semi-automatic diagnosis of melanoma would greatly enhance the applicability of medical image classification scheme and make it useful in clinical contexts. In this paper, interactive object recognition methodology is adopted for border segmentation of clinical skin lesion images. In addition, performance of five classifiers, KNN, Naïve Bayes, multi-layer perceptron, random forest and SVM are compared based on color and texture features for discriminating melanoma from benign nevus. The results show that a sensitivity of 82.6% and specificity of 83% can be achieved using a single SVM classifier. However, a better classification performance was achieved using a proposed cascade classifier with the sensitivity of 83.06% and specificity of 90.05% when performing ten-fold cross validation.

  1. First application of dynamic infrared imaging in boron neutron capture therapy for cutaneous malignant melanoma

    Energy Technology Data Exchange (ETDEWEB)

    Santa Cruz, G. A.; Gonzalez, S. J.; Bertotti, J.; Marin, J. [Departamento de Instrumentacion y Control, Comision Nacional de Energia Atomica, Avenida del Libertador 8250, 1429 Buenos Aires (Argentina); Departamento de Instrumentacion y Control, Comision Nacional de Energia Atomica, Avenida del Libertador 8250, 1429 Buenos Aires (Argentina) and CONICET, Avenida Rivadavia 1917, 1033 Buenos Aires (Argentina); Universidad Favaloro, Solis 453, 1078 Buenos Aires (Argentina)

    2009-10-15

    Purpose: The purpose of this study is to assess the potential of dynamic infrared imaging (DIRI) as a functional, noninvasive technique for evaluating the skin acute toxicity and tumor control within the framework of the Argentine boron neutron capture therapy (BNCT) program for cutaneous malignant melanoma. Methods: Two patients enrolled in the Argentine phase I/II BNCT clinical trial for cutaneous malignant melanoma were studied with DIRI. An uncooled infrared camera, providing a video output signal, was employed to register the temperature evolution of the normal skin and tumor regions in patients subjected to a mild local cooling (cold stimulus). In order to study the spatial correlation between dose and acute skin reactions, three-dimensional representations of the superficial dose delivered to skin were constructed and cameralike projections of the dose distribution were coregistered with visible and infrared images. Results: The main erythematous reaction was observed clinically between the second and fifth week post-BNCT. Concurrently, with its clinical onset, a reactive increase above the basal skin temperature was observed with DIRI in the third week post-BNCT within regions that received therapeutic doses. Melanoma nodules appeared as highly localized hyperthermic regions. 2 min after stimulus, these regions reached a temperature plateau and increased in size. Temperature differences with respect to normal skin up to 10 deg. C were observed in the larger nodules. Conclusions: Preliminary results suggest that DIRI, enhanced by the application of cold stimuli, may provide useful functional information associated with the metabolism and vasculature of tumors and inflammatory processes related to radiation-induced changes in the skin as well. These capabilities are aimed at complementing the clinical observations and standard imaging techniques, such as CT and Doppler ultrasound.

  2. Predictors of sentinel lymph node status in cutaneous melanoma: a classification and regression tree analysis.

    Science.gov (United States)

    Tejera-Vaquerizo, A; Martín-Cuevas, P; Gallego, E; Herrera-Acosta, E; Traves, V; Herrera-Ceballos, E; Nagore, E

    2015-04-01

    The main aim of this study was to identify predictors of sentinel lymph node (SN) metastasis in cutaneous melanoma. This was a retrospective cohort study of 818 patients in 2 tertiary-level hospitals. The primary outcome variable was SN involvement. Independent predictors were identified using multiple logistic regression and a classification and regression tree (CART) analysis. Ulceration, tumor thickness, and a high mitotic rate (≥6 mitoses/mm(2)) were independently associated with SN metastasis in the multiple regression analysis. The most important predictor in the CART analysis was Breslow thickness. Absence of an inflammatory infiltrate, patient age, and tumor location were predictive of SN metastasis in patients with tumors thicker than 2mm. In the case of thinner melanomas, the predictors were mitotic rate (>6 mitoses/mm(2)), presence of ulceration, and tumor thickness. Patient age, mitotic rate, and tumor thickness and location were predictive of survival. A high mitotic rate predicts a higher risk of SN involvement and worse survival. CART analysis improves the prediction of regional metastasis, resulting in better clinical management of melanoma patients. It may also help select suitable candidates for inclusion in clinical trials. Copyright © 2014 Elsevier España, S.L.U. and AEDV. All rights reserved.

  3. DIFFERENTIAL DIAGNOSIS OF CUTANEOUS LEISHMANIAS IS AND PARACOCCIDIOIDOMYCOSIS: CASE REPORT

    Directory of Open Access Journals (Sweden)

    Thaísa da Silva Vieira

    2017-01-01

    Full Text Available The polymorphism of the clinical presentation of paracoccidioidomycosis allows it to be included in the differential diagnosis of various clinical conditions, including cutaneous leishmaniasis. This study aims to discuss the difficulty of establishing the differential diagnosis between paracoccidioidomycosis and american cutaneous leishmaniasis in the case of patients from rural areas with chronic ulcerative lesion in the oral and nasal mucosa. This is a case report of an adult patient, coming from rural Itagi, Bahia, admitted to the public Hospital Prado Valadares (HGPV, in Jequié-BA. Thus, the case report aims to contribute to the medical and scientific community in the description of the clinical aspects of the lesions for the early diagnosis and prevention of the impacts of disabilities and injuries

  4. 2-cm versus 4-cm surgical excision margins for primary cutaneous melanoma thicker than 2 mm: a randomised, multicentre trial

    DEFF Research Database (Denmark)

    Gillgren, Peter; Drzewiecki, Krzysztof T; Niin, Marianne;

    2011-01-01

    Optimum surgical resection margins for patients with clinical stage IIA-C cutaneous melanoma thicker than 2 mm are controversial. The aim of the study was to test whether survival was different for a wide local excision margin of 2 cm compared with a 4-cm excision margin....

  5. Epidemiology, management and survival outcomes of primary cutaneous melanoma: a ten-year overview.

    Science.gov (United States)

    Aubuchon, M M F; Bolt, L J J; Janssen-Heijnen, M L G; Verleisdonk-Bolhaar, S T H P; van Marion, A; van Berlo, C L H

    2017-02-01

    Malignant melanoma (MM) is the most aggressive type of skin cancer, accounting for 90% of all the skin cancer mortality. The objective of this study was providing an overview of current patient- and tumour characteristics, treatment strategies, complications and survival in patients with MM over the past ten years. Hereby, an up-to-date view of every day clinical practice is obtained. Files of patients treated for primary cutaneous melanoma (n = 686) in the VieCuri Medical Centre in the Netherlands between January 2002 and December 2013 were retrospectively reviewed. Relevant patient features, tumour characteristics, and (surgical) outcomes were evaluated. The majority of all the patients presented thin tumours (59.1% stage 1A/in situ melanoma). Men showed more ulceration (17.7% vs. 8.4%, p < .01) and a significantly higher Breslow thickness than women (1.2 mm vs. 0.9 mm, p < .01). 14.6% (40/273) underwent sentinel lymph node biopsy (SLNB); 10/40 (25%) showed nodal metastasis, 50 patients (7.3%) developed distant metastases (M: 10.6%, F: 5%, p < .01). One-, 5- and 10- year disease specific survival rates were 96%, 86% and 84%, respectively. Median survival for stage 4 MM was 3 months. Extensive surgery was uncommon (n = 3). Patients generally presented with thin melanomas. Lymph node disease and distant metastases remained infrequently observed during following years, and general 1- and 5-year overall disease-specific survival rates exceeded 85%. Small numbers of rescue surgery and palliative medical treatment warrant further centralisation and investigation.

  6. Cutaneous Leiomyoma: Novel Histologic Findings for Classification and Diagnosis

    Directory of Open Access Journals (Sweden)

    Kambiz Kamyab Hesari

    2013-01-01

    Full Text Available Smooth muscle tumors rather benign or malignant can arise wherever the muscular tissue presents but cutaneous leiomyoma is one of the rare benign tumors of the which even the diagnostic criteria from the malignant type of the tumor is still in doubt. This study was aimed to compare the subtypes of cutaneous leiomyoma from different histologic aspects in order to find unique criteria for better classification and diagnosis. The six year data base of our center was reviewed and 25 patients with cutaneous leiomyoma were included in this study. Of 25 patients, 5 were female and 20 were male. 5 patients had angioleiomyoma (ALM and 20 had pilar leiomyoma (PLM. ALM had following characteristics: dilated vascular canals intermingled with compact smooth muscle bundles; well circumscribe counter and myxoid and hyaline changes through the tumor. In contrast, PLMs had following histologic features: poor defined outline, entrapped hair follicles and eccrine glands, acanthosis and elongated rete ridges with hyperpigmentation and smooth muscle bundles which are interdigitated with elongated rete ridges. Here we introduced some distinct histological features for each subtype of the cutaneous leiomyoma which can lead to create novel criteria for classification and diagnosis of the lesion.

  7. Evaluation of laboratory diagnosis for cutaneous tuberculosis

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    Ilhan Afsar

    2016-01-01

    Full Text Available Background and Aim: Cutaneous tuberculosis (CTB is still difficult to diagnose due to its varied clinical presentation and limitations of diagnostic methods. The aim of this study was to evaluate the results of diagnostic laboratory tests available for CTB. Materials and Methods: Twenty-six skin biopsy specimens belonging to clinically suspected cases of CTB were studied retrospectively. The specimens were divided into two portions, one part processed for histopathological evaluation and the other was used for microscopy and inoculation for the isolation of mycobacteria. Polymerase chain reaction (PCR technique was applied to 14 of 26 specimens to detect Mycobacterium tuberculosis complex (MTBC DNA. Results: Of the 26 biopsy specimens, 11 were confirmed as CTB by identification of MTBC in culture and/or histopathologic affirmation. Of these, four were lupus vulgaris, four were TB verrucosa cutis, one was scrofuloderma, one was primary inoculation TB, and one was periorifical CTB. Culture for mycobacteria was positive for five (45.45% specimens, while histopathologic affirmation was obtained in ten (90.90% specimens. Acid-fast Bacilli were not demonstrated in any of the specimens on microscopic examination. The PCR was found to be applied to six of the 11 specimens diagnosed as CTB and was positive in two specimens (33.3%, which were positive for growth in culture and histopathological correlation. Conclusion: The recovery rate of MTBC from biopsy specimens was found to be satisfactory for CTB with histopathological correlation, but the combination of culture with a rapid method, PCR, may improve the diagnostic rate.

  8. Investigation of the relationship between dermoscopic features and histopathological prognostic indicators in patients with cutaneous melanoma

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    Özlem Özbağçıvan

    2015-09-01

    Full Text Available Background and Design: Dermoscopy has an important role in the diagnosis of melanoma nowadays. Dermoscopic findings of melanoma had been associated with Breslow thickness and invasion status in previous studies but the relationship between dermatoscopic findings and other histopathological prognostic indicators has not been investigated until today. In this study, our aim is to investigate the relationship between dermatoscopic findings and histopathologic prognostic indicators such as Breslow thickness, invasion status, mitotic rate, lymphovascular invasion (LVI, ulceration and regression in patients who had been diagnosed with melanoma due to their clinical, dermatoscopic and histopatological findings. Materials and Methods: Dermoscopic and histopathological findings of 47 cases of melanoma who applied to our clinic between the years 2000 and 2014 were evaluated. The relationship between the dermoscopic findings which had been reported to be observed in melanomas in previous research and the histopathologic prognostic indicators such as Breslow thickness, invasion status, mitotic rate, lymphovascular invasion, ulceration and regression were investigated. Results: Irregular dots/globules, atypical pigment network, multifocal hypopigmentation, radial streaks and moth-eaten borders have been associated with good prognostic indicators whereas comedo like openings, regular blotch, exophytic papillary structures, dotted, glomerular, lineer irregular vessels, pink/red and blue/gray colors were associated with poor prognostic indicators. Additionally some dermatoscopic findings which are more observed in benign lesions such as multiple milia-like cysts, comedo like openings, moth-eaten borders, regular blotch, exophytic papillary structures and finger print areas have been observed in melanomas in our study. Conclusion: Many dermoscopic findings have demonstrated statistically significant association with the histopathological prognostic indicators

  9. Meta-analysis of the performance of {sup 18}F-FDG PET in cutaneous melanoma

    Energy Technology Data Exchange (ETDEWEB)

    Jimenez-Requena, Felisa; Perez-Vazquez, Jose M. [Hospital General Universitario Gregorio Maranon, Nuclear Medicine Department, Madrid (Spain); Delgado-Bolton, Roberto C.; Carreras-Delgado, Jose L. [Hospital Clinico San Carlos, Nuclear Medicine Department, Madrid (Spain); Fernandez-Perez, Cristina [Hospital Clinico San Carlos, Research Unit, Madrid (Spain); Gambhir, Sanjiv S. [Stanford University School of Medicine, Department of Radiology, James H. Clark Center, Stanford, CA (United States); Schwimmer, Judy [David Geffen School of Medicine at UCLA, Department of Molecular and Medical Pharmacology, Los Angeles, CA (United States)

    2010-02-15

    The aim of this study was to perform a systematic review of the literature to evaluate the accuracy of FDG-PET in staging and restaging of cutaneous melanoma. Systematic methods were used to identify, select, and evaluate the methodologic quality of the studies as well as to summarize the overall findings of sensitivity and specificity. The search strategy consisted of identifying studies published between 2000 and 2006. Inclusion criteria were studies that evaluated the diagnostic performance of FDG-PET in staging/restaging of cutaneous melanoma. The results were compared and pooled with a meta-analysis published previously that included studies published until 1999. The meta-analysis included 95% confidence intervals (CI) of sensitivity, specificity, likelihood-ratio (LR), and diagnostic-odds-ratio (DOR). The quantitative meta-analysis included 24 studies that were analysed in two groups: eight studies were included only in the regional staging analysis (group I), 13 studies were included only in the detection of distant metastases analysis (group II), and three studies were included in both analyses. Compliance with the methodologic-quality criteria was acceptable. We analysed the results of data presented in patients, lesions, basins, lymph-nodes, areas, and scans. Regarding the performance of FDG-PET in the detection of metastases, the pooled studies presented homogeneity for the negative-LR (0.15; 95% CI, 0.10-0.22) when analyzing lesions. When analyzing scans, there was global homogeneity for specificity (0.86; 95% CI, 0.77-0.92), positive-LR (5.86; 95% CI, 3.64-9.43), and DOR (37.89; 95% CI, 15.80-90.86). The pooled studies presented heterogeneity for the other items analysed. Regarding the detection of regional metastases, when analyzing lymph-nodes there was global homogeneity for specificity (0.99; 95% CI, 0.97-0.99; P = 0.101). The meta-regression evidenced that the variable that most influenced the DOR of the different studies and that can explain the

  10. [Cutaneous melanomas, a spectrum of emerging cancers in women of Wallonia. Outlook by the Mosan Study Group of Pigmented Neoplasms].

    Science.gov (United States)

    Piérard-Franchimont, C; Arrese, J E; Cornil, F; Damseaux, M; Darcis, J M; Deleixhe-Mauhin, F; Delvoye, P; Fraiture, A L; Gerardy-Goffin, F; Giet-Lesuisse, M; Goffin, V; Henry, F; Hermanne-Wolff, P; Hermanns, J F; Hermanns-Lê, T; Heymans, O; Letawe, C; Nikkels, A; Nikkels-Tassoudji, N; d'Hauterive-Willemaers, V P; Rakic, L; Soyeur-Broux, M; Sproten, G; Uhoda, I; Piérard, G E

    1999-05-01

    The Mosan Study Group of Pigmented Neoplasms was founded about 15 years ago. It has collected more than 20,000 cutaneous malignancies including melanomas and basal and squamous cell carcinomas. The incidence of these cancers is on the rise in Wallonia. In particular, malignant melanomas represent a spectrum of emerging cancers characterized by a proteiform biological outcome. They mostly affect young women. The major risk factor appears to be iterative and unwise ultraviolet exposures. The prevention of melanomas is basically founded on such a dogma and accordingly relies on sunscreens. However, controversies about their beneficial effects are rife and fueled by axiomas and contradictory sophisms. At the exception of surgery, the therapeutic options for the diverse types of melanomas do not yet fulfill the scope of evidence-based medicine.

  11. Melanoma

    Science.gov (United States)

    Melanoma is the most serious type of skin cancer. Often the first sign of melanoma is a change in the size, shape, color, or feel of a mole. Most melanomas have a black or black-blue area. Melanoma ...

  12. Ocular Melanoma

    Science.gov (United States)

    ... Español Eye Health / Eye Health A-Z Ocular Melanoma Sections What is Ocular Melanoma? Ocular Melanoma Causes ... Melanoma Diagnosis Ocular Melanoma Treatment What is Ocular Melanoma? Leer en Español: ¿Qué Es el Melanoma Ocular? ...

  13. Progression in cutaneous malignant melanoma is associated with distinct expression profiles: a tissue microarray-based study.

    Science.gov (United States)

    Alonso, Soledad R; Ortiz, Pablo; Pollán, Marina; Pérez-Gómez, Beatriz; Sánchez, Lydia; Acuña, Ma Jesús; Pajares, Raquel; Martínez-Tello, Francisco J; Hortelano, Carlos M; Piris, Miguel A; Rodríguez-Peralto, José L

    2004-01-01

    Cutaneous malignant melanoma remains the leading cause of skin cancer death in industrialized countries. Clinical and histological variables that predict survival, such as Breslow's index, tumor size, ulceration, or vascular invasion have been identified in malignant melanoma. Nevertheless, the potential relevance of biological variables still awaits an in-depth exploration. Using tissue microarrays (TMAs), we retrospectively analyzed 165 malignant melanoma samples from 88 patients corresponding to distinct histological progression phases, radial, vertical, and metastases. A panel of 39 different antibodies for cell cycle, apoptosis, melanoma antigens, transcription factors, DNA mismatch repair, and other proteins was used. Integrating the information, the study has identified expression profiles distinguishing specific melanoma progression stages. Most of the detected alterations were linked to the control of cell cycle G1/S transition; cyclin D1 was expressed in radial cases 48% (12 of 25) with significant lost of expression in vertical cases 14% (9 of 65), P = 0.002; whereas p16(INK4a) (89% in vertical versus 71% in metastatic cases, P = 0.009) and p27(KIP1) (76% in radial versus 45% in vertical cases, P = 0.010) were diminished in advanced stages. The study also defines a combination of biological markers associated with shorter overall survival in patients with vertical growth phase melanoma, that provided a predictor model with four antibodies (Ki67, p16(INK4a), p21(CIP1), and Bcl-6). This predictor model was validated using an independent series of 72 vertical growth phase melanoma patients.

  14. Laser and light-based therapy for cutaneous and soft-tissue metastases of malignant melanoma: a systematic review.

    Science.gov (United States)

    Austin, Evan; Mamalis, Andrew; Ho, Derek; Jagdeo, Jared

    2017-05-01

    Invasive cutaneous melanoma is a growing health concern. Although surgical excision can effectively treat in situ tumors, use for metastatic melanoma is limited. Laser and light-based therapies may be a valuable palliative treatment option for patients with stage III and stage IV cutaneous metastatic melanoma. Our goal is to review the published literature and provide evidence-based recommendations on laser and light-based palliative therapies for metastatic melanoma. A search of the databases Pubmed, EMBASE, Web of Science, and CINAHL was performed on March 10, 2016. Key search terms were related to melanoma, laser, and light-based modalities. Our search initially identified 13,923 articles and 27 original articles met inclusion criteria for our review. Grade of recommendation: C for non-fractionated carbon dioxide laser, Grade of recommendation: D for fractionated carbon dioxide laser, ruby laser, neodymium laser, near-infrared diode laser, and photodynamic therapy. Non-fractionated carbon dioxide laser had the best palliative efficacy of the reviewed laser and light-based therapies, while other treatment modalities may have potential as adjunctive therapy to standard of care.

  15. Effect of biopsy type on outcomes in the treatment of primary cutaneous melanoma.

    Science.gov (United States)

    Mills, Jane K; White, Ian; Diggs, Brian; Fortino, Jeanine; Vetto, John T

    2013-05-01

    Surgical excision remains the primary and only potentially curative treatment for melanoma. Although current guidelines recommend excisional biopsy as the technique of choice for evaluating lesions suspected of being primary melanomas, other biopsy types are commonly used. We sought to determine the impact of biopsy type (excisional, shave, or punch) on outcomes in melanoma. A prospectively collected, institutional review board-approved database of primary clinically node-negative melanomas (stages cT1-4N0) was reviewed to determine the impact of biopsy type on T-staging accuracy, wide local excision (WLE) area (cm(2)), sentinel lymph node biopsy (SLNB) identification rates and results, tumor recurrence, and patient survival. Seven hundred nine patients were diagnosed by punch biopsy (23%), shave biopsy (34%), and excisional biopsy (43%). Shave biopsy results showed significantly more positive deep margins (P biopsy results showed more positive peripheral margins (P biopsy. Punch biopsy resulted in a larger mean WLE area compared with shave and excisional biopsies (P = .030), and this result was sustained on multivariate analysis. SLNB accuracy was 98.5% and was not affected by biopsy type. Similarly, biopsy type did not confer survival advantage or impact tumor recurrence; the finding of residual tumor in the WLE impacted survival on univariate but not multivariate analysis. Both shave and punch biopsies demonstrated a significant risk of finding residual tumor in the WLE, with pathologic upstaging of the WLE. Punch biopsy also led to a larger mean WLE area compared with other biopsy types. However, biopsy type did not impact SLNB accuracy or results, tumor recurrence, or disease-specific survival (DSS). Punch and shave biopsies, when used appropriately, should not be discouraged for the diagnosis of melanoma. Copyright © 2013 Elsevier Inc. All rights reserved.

  16. Cutaneous amelanotic signet-ring cell malignant melanoma with interspersed myofibroblastic differentiation in a young cat.

    Science.gov (United States)

    Hirz, Manuela; Herden, Christiane

    2016-07-01

    The diagnosis of malignant melanoma can be difficult because these tumors can be amelanotic and may contain diverse variants and divergent differentiations, of which the signet-ring cell subtype is very rare and has only been described in humans, dogs, cats, and a hamster. We describe herein histopathologic and immunohistochemical approaches taken to diagnose a case of signet-ring cell malignant melanoma with myofibroblastic differentiation in a cat. A tumor within the abdominal skin of a 2-year-old cat was composed of signet-ring cells and irregularly interwoven streams of spindle cells. Both neoplastic cell types were periodic-acid-Schiff, Fontana, and Sudan black B negative. Signet-ring cells strongly expressed vimentin and S100 protein. Spindle cells strongly expressed vimentin and smooth muscle actin; some cells expressed S100, moderately neuron-specific enolase, and others variably actin and desmin. A few round cells expressed melan A, and a few plump spindle cells expressed melan A and PNL2, confirming the diagnosis of amelanotic signet-ring cell malignant melanoma with myofibroblastic differentiation in a cat. Differential diagnoses were excluded, including signet-ring cell forms of adenocarcinomas, lymphomas, liposarcomas, leiomyosarcomas, squamous cell carcinomas, basal cell carcinomas, and adnexal tumors.

  17. Cutaneous melanoma in childhood and adolescence shows frequent loss of INK4A and gain of KIT.

    Science.gov (United States)

    Daniotti, Maria; Ferrari, Andrea; Frigerio, Simona; Casieri, Paola; Miselli, Francesca; Zucca, Elisa; Collini, Paola; Della Torre, Gabriella; Manoukian, Siranoush; Peissel, Bernard; Bono, Aldo; Santinami, Mario; Parmiani, Giorgio; Rivoltini, Licia; Pilotti, Silvana; Rodolfo, Monica

    2009-07-01

    Childhood cutaneous melanoma is a rare disease with increasing incidence. It is not clear whether it differs from adult melanoma in etiology and clinical evolution. To genetically characterize childhood melanoma, 21 pediatric patients were studied by germ-line analysis of CDKN2A, CDK4, and MC1R genes. In addition, alterations in CDKN2A, c-Kit, BRAF, and NRAS genes were evaluated at the somatic level by direct gene sequencing, fluorescence in situ hybridization analysis, and immunohistochemistry. As a control group of susceptible patients, we studied patients from 23 melanoma-prone families. At the germ-line level, CDKN2A and MC1R gene variants were detected in 2/21 and 12/21 pediatric patients and in 9/23 and 19/22 in familial patients. At the somatic level, most lesions (9/14) from pediatric patients showed CDKN2A locus homozygous deletions and a null p16 immunophenotype, whereas most lesions (5/8) from familial patients were disomic and immunoreactive. A c-Kit low-polysomy profile seems to parallel CDKN2A homozygous deletions in pediatric melanoma whereas the single activating mutation observed segregates with familial patients. Loss of KIT protein expression was frequent (7/14) in pediatric melanomas, where metastatic cases were prevalent. BRAF(V600E) mutation occurred at a similar rate (approximately 50%) in lesions from pediatric and familial patients, whereas no NRAS mutations were detected.

  18. Angiogenic and Metastatic Determinants of Malignant Melanoma

    NARCIS (Netherlands)

    A. Mooppilmadham Das (Asha)

    2015-01-01

    markdownabstractCutaneous melanoma or malignant melanoma of the skin is a highly metastatic disease, with an increasing rate of incidence, poor prognosis and high resistance to therapeutic intervention. Although early diagnosis and surgical resection of the primary lesion could significantly improve

  19. Angiogenic and Metastatic Determinants of Malignant Melanoma

    NARCIS (Netherlands)

    A. Mooppilmadham Das (Asha)

    2015-01-01

    markdownabstractCutaneous melanoma or malignant melanoma of the skin is a highly metastatic disease, with an increasing rate of incidence, poor prognosis and high resistance to therapeutic intervention. Although early diagnosis and surgical resection of the primary lesion could significantly improve

  20. Clinicopathological features and clinical outcomes associated with TP53 and BRAF(N)(on-)(V)(600) mutations in cutaneous melanoma patients.

    Science.gov (United States)

    Kim, Dae Won; Haydu, Lauren E; Joon, Aron Y; Bassett, Roland L; Siroy, Alan E; Tetzlaff, Michael T; Routbort, Mark J; Amaria, Rodabe N; Wargo, Jennifer A; McQuade, Jennifer L; Kemnade, Jan; Hwu, Patrick; Woodman, Scott E; Roszik, Jason; Kim, Kevin B; Gershenwald, Jeffrey E; Lazar, Alexander J; Davies, Michael A

    2017-04-15

    BRAF(V600) , NRAS, TP53, and BRAF(Non-V600) are among the most common mutations detected in non-acral cutaneous melanoma patients. Although several studies have identified clinical and pathological features associated with BRAF(V600) and NRAS mutations, limited data are available regarding the correlates and significance of TP53 and BRAF(Non-V600) mutations. This study analyzed the patient demographics, primary tumor features, and clinical outcomes of a large cohort of non-acral cutaneous melanoma patients who had undergone clinically indicated molecular testing (n = 926). The prevalence of BRAF(V600) , NRAS, TP53, and BRAF(Non-V600) mutations was 43%, 21%, 19%, and 7%, respectively. The presence of a TP53 mutation was associated with older age (P = .019), a head and neck primary tumor site (P = .0001), and longer overall survival (OS) from the diagnosis of stage IV disease in univariate (P = .039) and multivariate analyses (P = .015). BRAF(Non-V600) mutations were associated with older age (P = .005) but not with primary tumor features or OS from stage IV. Neither TP53 nor BRAF(Non-V600) mutations correlated significantly with OS with frontline ipilimumab treatment, and the TP53 status was not significantly associated with outcomes with frontline BRAF inhibitor therapy. Eleven patients with BRAF(Non-V600) mutations were treated with a BRAF inhibitor. Three patients were not evaluable for a response because of treatment cessation for toxicities; the remaining patients had disease progression as the best response to therapy. These results add to the understanding of the clinical features associated with TP53 and BRAF(Non-V600) mutations in advanced cutaneous melanoma patients, and they support the rationale for evaluating the prognostic significance of TP53 in other cohorts of melanoma patients. Cancer 2017;123:1372-1381. © 2016 American Cancer Society. © 2016 American Cancer Society.

  1. Inoculation site from a cutaneous melanoma patient treated with an allogeneic therapeutic vaccine: a case report

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    Mariana eAris

    2015-03-01

    Full Text Available We have developed a therapeutic vaccine consisting of a mixture of lethally-irradiated allogeneic cutaneous melanoma cell lines with BCG and GM-CSF as adjuvants. The CSF-470 vaccine is currently being assayed in a Phase II-III trial against medium-dose IFN-a2b. All vaccinated patients immunized intradermally developed large edematous erythema reactions, which then transformed into subcutaneous nodules active for several months. However, vaccine injection sites were not routinely biopsied. We describe the case of a female patient, previously classified as stage III, but who, due to the simultaneous discovery of bone metastases, only received one vaccination, was withdrawn from the study and continued her treatment elsewhere. Patient #1 developed a post-vaccination nodule which was surgically removed 7 weeks later, and allowed to analyze the reactivity and immune profiling of the inoculation site. An inflammatory reaction with zones of fibrosis, high irrigation and brisk lymphoid infiltration, primarily composed of CD8+ and CD20+ lymphocytes, was observed. There were no remaining BCG bacilli, and scarce CD4+ and Foxp3+ T cells were observed. MART-1 Ag was found throughout the vaccination site. CD11c+ Ag presenting cells were either dispersed or forming dense nests. Some CD11c+ cells proliferated; most of them contained intracellular MART-1 Ag, and some interacted with CD8+ lymphocytes. These observations suggest a potent, long-lasting local inflammatory response with recruitment of Ag-presenting cells that incorporate melanoma Ags, probably leading to Ag presentation to naïve T cells.

  2. The case of diagnosis of imported cutaneous leishmaniasis in Zaporozhye

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    V. G. Savelyev

    2014-08-01

    infectious diseases doctor with suspected cutaneous leishmaniasis (Mexican?. The patient was admitted to the department number 1 in Zaporizhzhya Regional Infectious Hospital. From the epidemiological history it was known that in December 2012 the patient was in Mexico, in its southeastern part. Tours visited the waterfall, located in the jungle. By the waterfall he was in a bathing suit and does not exclude the bites of mosquitoes. Objective status on admission: no complains. Local Status: In a field of ulcerative blade element 2 cm in diameter, covered with dry serous crust with a raised edge. Ulcerative element palpation painless. On the periphery of the ulcer there were inflammatory small roller, moderately thick, smooth. Perifocal inflammation of about 0,5 cm in removing the crusts revealed crater hole, the bottom close-grained, ulcer edges are rough, eroded occurred granulation. Discharge from the ulcers were scarce, sero-purulent character turned into a drying brownish crust. To confirm the diagnosis of leishmaniasis patient passed tests. The prepared area for scraping was anesthetize, then the end of the scalpel scrape small pieces of tissue, while scraping with sanious liquid is transferred to a glass slide, fixed and stained by the Romanovsky- Himze. So after taking clarify technical characteristics of the material for this specific study was conducted repeated studies that included biopsies of ulcerative item. Ultimately, the only element of ulcer biopsy taken on the periphery of the ulcer site with regional infiltration at the site of fresh granulation, gave a positive result. In preparation pathogen was detected - Leishmania sp., Amastihotna form. Conclusion: The clinical observation demonstrates the case of importation to Ukraine rather exotic disease - cutaneous leishmaniasis. This case should alert healthcare workers about the possibility of re-importation of cases of this disease in our country, which requires mandatory specific confirmation of the diagnosis

  3. Metastatic Malignant Melanoma Presenting as an Appendiceal Mucocele

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    A. A. Alduaij

    2011-01-01

    Full Text Available Melanoma metastatic to the appendix is extremely rare. Here we describe a case of a 31-year-old female from Bolivia with a remote history of metastatic malignant melanoma first diagnosed as a cutaneous malignant melanoma ten years prior to this presentation. The patient was being followed for a mucocele which on resection was found to be metastatic melanoma. “Mucocele” is a generic diagnosis that warrants further characterization and treatment.

  4. Allosteric MEK1/2 inhibitors including cobimetanib and trametinib in the treatment of cutaneous melanomas.

    Science.gov (United States)

    Roskoski, Robert

    2017-03-01

    The Ras-Raf-MEK-ERK (Map kinase) cellular pathway is a highly conserved eukaryotic signaling module that transduces extracellular signals from growth factors and cytokines into intracellular regulatory events that are involved in cell growth and proliferation or the contrary pathway of cell differentiation. Dysregulation of this pathway occurs in more than one-third of all malignancies, a process that has fostered the development of targeted Map kinase pathway inhibitors. Cutaneous melanomas, which arise from skin melanocytes, are the most aggressive form of skin cancer. Mutations that activate the Map kinase pathway occur in more than 90% of these melanomas. This has led to the development of the combination of dabrafenib and trametinib or vemurafenib and cobimetanib for the treatment of BRAF V600E mutant melanomas. Dabrafenib and vemurafenib target V600E/K BRAF mutants while trametinib and cobimetanib target MEK1/2. The latter two agents bind to MEK1/2 at a site that is adjacent to, but separate from, the ATP-binding site and are therefore classified as type III allosteric protein kinase inhibitors. These agents form a hydrogen bond with a conserved β3-lysine and they make numerous hydrophobic contacts with residues within the αC-helix, the β5 strand, and within the activation segment, regions of the protein kinase domain that exhibit greater diversity than those found within the ATP-binding site. One advantage of such allosteric inhibitors is that they do not have to compete with millimolar concentrations of cellular ATP, which most FDA-approved small molecule competitive inhibitors such as imatinib must do. Owing to the wide spread activation of this pathway in numerous neoplasms, trametinib and cobimetinib are being studied in combination with other targeted and cytotoxic drugs in a variety of clinical situations. Except for BRAF and NRAS mutations, there are no other biomarkers correlated with treatment responses following MEK1/2 inhibition and the

  5. Telomere length and the risk of cutaneous malignant melanoma in melanoma-prone families with and without CDKN2A mutations.

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    Laura S Burke

    Full Text Available INTRODUCTION: Recent evidence suggests a link between constitutional telomere length (TL and cancer risk. Previous studies have suggested that longer telomeres were associated with an increased risk of melanoma and larger size and number of nevi. The goal of this study was to examine whether TL modified the risk of melanoma in melanoma-prone families with and without CDKN2A germline mutations. MATERIALS AND METHODS: We measured TL in blood DNA in 119 cutaneous malignant melanoma (CMM cases and 208 unaffected individuals. We also genotyped 13 tagging SNPs in TERT. RESULTS: We found that longer telomeres were associated with an increased risk of CMM (adjusted OR = 2.81, 95% CI = 1.02-7.72, P = 0.04. The association of longer TL with CMM risk was seen in CDKN2A- cases but not in CDKN2A+ cases. Among CMM cases, the presence of solar injury was associated with shorter telomeres (P = 0.002. One SNP in TERT, rs2735940, was significantly associated with TL (P = 0.002 after Bonferroni correction. DISCUSSION: Our findings suggest that TL regulation could be variable by CDKN2A mutation status, sun exposure, and pigmentation phenotype. Therefore, TL measurement alone may not be a good marker for predicting CMM risk.

  6. Interpretation on Expert Consensus for Diagnosis and Treatment of Melanoma in China

    Institute of Scientific and Technical Information of China (English)

    DU Fu-rong; WU Yin-ping; YANG Xue; YU Li-fang; YE Zhen-hua

    2016-01-01

    In recent years, melanoma has become a tumor with the fastest increase of morbidity in all malignant tumors, and its annual increase is 3%-5%. Both morbidity and mortality of melanoma are low in China, but they are showing an increasing tendency in recent years. However, the morbidity of melanoma is increasing in most European and American countries, but the mortality keeps stable and is not in an increasing tendency along with the increasing morbidity, demonstrating that there are great differences between China and Western countries in the diagnosis and treatment of melanoma. At present, melanoma has become one of the diseases that severely threaten human health. Compared with other common malignant tumors, there are signiifcant differences in the clinical diagnosis and specific treatment of melanoma. To better adapt the rapid development of treatment for melanoma, and to make the clinical practice of melanoma more specific and internationalized in China, Expert Committee on Melanoma, Chinese Society of Clinical Oncology, has updated the Guidelines for Diagnosis and Treatment of Melanoma in China. Therefore, the editorial board of this journal interpreted this guideline in details, aiming to provide the lastest and most practical evidence-based evidence for clinical oncologists in China.

  7. Whole Body Microwave Irradiation for Improved Dacarbazine Therapeutical Action in Cutaneous Melanoma Mouse Model

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    Monica Neagu

    2013-01-01

    Full Text Available A cutaneous melanoma mouse model was used to test the efficacy of a new therapeutical approach that uses low doses of cytostatics in conjunction with mild whole body microwave exposure of 2.45 GHz in order to enhance cytostatics antitumoral effect. Materials and Methods. A microwave exposure system for C57BL/6 mouse whole body microwave irradiation was designed; groups of 40 mice (males and females bearing experimental tumours were subjected to a combined therapy comprising low doses of dacarbazine in combination with mild whole body irradiation. Clinical parameters and serum cytokine testing using xMAP technology were performed. Results. The group that was subjected to combined therapy, microwave and cytostatic, had the best clinical evolution in terms of overall survival, tumour volume, and metastatic potential. At day 14 the untreated group had 100% mortality, while in the combined therapy group 40% of mice were surviving. Quantifying serum IL-1β, IL-6, IL-10, IL-12 (p70, IFN-γ, GM-CSF, TNF-α, MIP-1α, MCP-1, and KC during tumorigenesis and therapy found that the combined experimental therapy decreases all the inflammatory cytokines, except chemokine MCP-1 that was found increased, suggesting an increase of the anti-tumoral immune response triggered by the combined therapy. The overall metastatic process is decreased in the combined therapy group.

  8. Diagnosis and treatment of melanoma. European consensus-based interdisciplinary guideline - Update 2016.

    Science.gov (United States)

    Garbe, Claus; Peris, Ketty; Hauschild, Axel; Saiag, Philippe; Middleton, Mark; Bastholt, Lars; Grob, Jean-Jacques; Malvehy, Josep; Newton-Bishop, Julia; Stratigos, Alexander J; Pehamberger, Hubert; Eggermont, Alexander M

    2016-08-01

    Cutaneous melanoma (CM) is potentially the most dangerous form of skin tumour and causes 90% of skin cancer mortality. A unique collaboration of multi-disciplinary experts from the European Dermatology Forum, the European Association of Dermato-Oncology and the European Organisation of Research and Treatment of Cancer was formed to make recommendations on CM diagnosis and treatment, based on systematic literature reviews and the experts' experience. Diagnosis is made clinically using dermoscopy and staging is based upon the AJCC system. CMs are excised with 1-2 cm safety margins. Sentinel lymph node dissection is routinely offered as a staging procedure in patients with tumours >1 mm in thickness, although there is as yet no clear survival benefit for this approach. Interferon-α treatment may be offered to patients with stage II and III melanoma as an adjuvant therapy, as this treatment increases at least the disease-free survival and less clear the overall survival (OS) time. The treatment is however associated with significant toxicity. In distant metastasis, all options of surgical therapy have to be considered thoroughly. In the absence of surgical options, systemic treatment is indicated. For first-line treatment particularly in BRAF wild-type patients, immunotherapy with PD-1 antibodies alone or in combination with CTLA-4 antibodies should be considered. BRAF inhibitors like dabrafenib and vemurafenib in combination with the MEK inhibitors trametinib and cobimetinib for BRAF mutated patients should be offered as first or second line treatment. Therapeutic decisions in stage IV patients should be primarily made by an interdisciplinary oncology team ('Tumour Board'). Copyright © 2016 Elsevier Ltd. All rights reserved.

  9. Antitumor effects of the investigational selective MEK inhibitor TAK733 against cutaneous and uveal melanoma cell lines

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    von Euw Erika

    2012-04-01

    Full Text Available Abstract Background TAK733 is a novel allosteric, non-ATP-binding, inhibitor of the BRAF substrates MEK-1/2. Methods The growth inhibitory effects of TAK733 were assessed in a panel of 27 cutaneous and five uveal melanoma cell lines genotyped for driver oncogenic mutations. Flow cytometry, Western blots and metabolic tracer uptake assays were used to characterize the changes induced by exposure to TAK733. Results Fourteen cutaneous melanoma cell lines with different driver mutations were sensitive to the antiproliferative effects of TAK733, with a higher proportion of BRAFV600E mutant cell lines being highly sensitive with IC50s below 1 nM. The five uveal melanoma cell lines had GNAQ or GNA11 mutations and were either moderately or highly sensitive to TAK733. The tested cell lines wild type for NRAS, BRAF, GNAQ and GNA11 driver mutations were moderately to highly resistant to TAK733. TAK733 led to a decrease in pERK and G1 arrest in most of these melanoma cell lines regardless of their origin, driver oncogenic mutations and in vitro sensitivity to TAK733. MEK inhibition resulted in increase in pMEK more prominently in NRASQ61L mutant and GNAQ mutant cell lines than in BRAFV600E mutant cell lines. Uptake of the metabolic tracers FDG and FLT was inhibited by TAK733 in a manner that closely paralleled the in vitro sensitivity assays. Conclusions The MEK inhibitor TAK733 has antitumor properties in melanoma cell lines with different oncogenic mutations and these effects could be detectable by differential metabolic tracer uptake.

  10. Coexistence of TERT promoter and BRAF mutations in cutaneous melanoma is associated with more clinicopathological features of aggressiveness.

    Science.gov (United States)

    Macerola, Elisabetta; Loggini, Barbara; Giannini, Riccardo; Garavello, Giulia; Giordano, Mirella; Proietti, Agnese; Niccoli, Cristina; Basolo, Fulvio; Fontanini, Gabriella

    2015-08-01

    The recently described telomerase reverse transcriptase (TERT) promoter mutations are recurrent in cutaneous melanoma. Several authors have described an association between these molecular alterations, some histological parameters, and patient survival. BRAF mutations are very frequent in melanoma, but their actual role in the evolution of the disease is still unclear. Here, we investigated the relationship of TERT promoter mutations and BRAF mutations with the most relevant clinicopathological parameters, individually and coexisting, in order to evaluate their role as independent prognostic markers and to determine the effect of their coexistence. A TERT promoter alteration was found in 20 of 53 cases (38 %), significantly associated with histological type, increasing tumor thickness and mitotic rate, more advanced pathologic tumor (pT) stage, and absence of regression. A BRAF mutation was found in 21 of 53 cases (40 %), significantly associated with tumor thickness and presence of metastases in the sentinel lymph node. Coexistence of a TERT promoter and BRAF mutation was detected in 11 of 53 cases (21 %). This was associated with increasing thickness, high mitotic rate, lymph node metastasis, presence of ulceration, and absence of regression. Coexistence of a mutation in the TERT promoter and in the BRAF gene correlated with more prognostically relevant factors than either mutation alone. Our data lead us to hypothesize that TERT promoter and BRAF mutations cooperate in cutaneous melanoma. Further studies in larger cohorts of patients are needed to investigate how this synergistic effect is involved in the evolution of the disease.

  11. Spatial analysis of incidence of cutaneous melanoma in the Friuli Venezia Giulia region in the period 1995-2005.

    Science.gov (United States)

    Cecconi, Lorenzo; Busolin, Anna; Barbone, Fabio; Serraino, Diego; Chiarugi, Alessandra; Biggeri, Annibale; Catelan, Dolores

    2016-04-18

    Incidence distribution of cutaneous melanoma depends on phenotypic characteristics of population and geographic location. In Italy, in the period 1999-2003 Friuli Venezia Giulia (FVG) region had the second highest incidence rates for males and the third for females. We analysed melanoma and lip cancer incidence data of the FVG cancer registry for the period 1995-2005. We used Bayesian hierarchical spatial models to describe the spatial pattern by gender. We decomposed the geographical distribution of the risk in two parts: a component linked to chronic exposure and a component related to intermittent exposure. In order to model the chronic component we considered the geographical distribution of incidence cases of lip cancer, for which chronic occupational solar radiation exposure is a documented risk factor. We also analysed the distribution by site and we calculated standardised rates for body surface area. This study documents a significant gradient in the incidence of cutaneous melanoma in FVG. High-standardized incidence rates are present in the area of Trieste and in the coastal area. The descriptive analysis by age group and by site, showed risks associated with intermittent exposures in both genders. For the coastal area the risk is especially high for sites traditionally linked to high cumulative exposures (face and neck), especially among men. The results suggest diagnostic preventive interventions in the populations living in the area of Trieste, given the high rates observed in the young age groups.

  12. Spatial analysis of incidence of cutaneous melanoma in the Friuli Venezia Giulia region in the period 1995-2005

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    Lorenzo Cecconi

    2016-04-01

    Full Text Available Incidence distribution of cutaneous melanoma depends on phenotypic characteristics of population and geographic location. In Italy, in the period 1999-2003 Friuli Venezia Giulia (FVG region had the second highest incidence rates for males and the third for females. We analysed melanoma and lip cancer incidence data of the FVG cancer registry for the period 1995-2005. We used Bayesian hierarchical spatial models to describe the spatial pattern by gender. We decomposed the geographical distribution of the risk in two parts: a component linked to chronic exposure and a component related to intermittent exposure. In order to model the chronic component we considered the geographical distribution of incidence cases of lip cancer, for which chronic occupational solar radiation exposure is a documented risk factor. We also analysed the distribution by site and we calculated standardised rates for body surface area. This study documents a significant gradient in the incidence of cutaneous melanoma in FVG. Highstandardisedincidence rates are present in the area of Trieste and in the coastal area. The descriptive analysis by age group and by site, showed risks associated with intermittent exposures in both genders. For the coastal area the risk is especially high for sites traditionally linked to high cumulative exposures (face and neck, especially among men. The results suggest diagnostic preventive interventions in the populations living in the area of Trieste, given the high rates observed in the young age groups.

  13. Cutaneous syncytial myoepithelioma:: Clinico-pathological features and differential diagnosis.

    Science.gov (United States)

    Pizzi, Marco; Facchin, Federico; Kohlscheen, Eva; Sartore, Leonardo; Salmaso, Roberto; Bassetto, Franco

    2016-10-01

    Cutaneous syncytial myoepithelioma (CSM) is a very rare tumor belonging to the spectrum of skin myoepithelial lesions. CSM usually affects the upper extremities of young to middle aged patients and is characterized by peculiar morphological and immunohistochemical features. Unlike classic myoepithelioma, CSM is composed by a densely packed proliferation of spindled to histiocytoid cells, which are variably positive for EMA, S100, SMA, and frequently negative for cytokeratins and GFAP. The peculiar histopathology and the extreme rarity of such lesion (less than 40 cases reported in the literature) can make the diagnosis of CSM a true challenge. In the present case, we report the clinico-pathological features of a primary CSM occurring in a 38 year-old Caucasian man. The differential diagnoses of such lesion are also briefly discussed.

  14. Familial malignant melanoma

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    Kopf, A.W.; Hellman, L.J.; Rogers, G.S.; Gross, D.F.; Rigel, D.S.; Friedman, R.J.; Levenstein, M.; Brown, J.; Golomb, F.M.; Roses, D.F.; Gumport, S.L.

    1986-10-10

    Characteristics associated with familial compared with nonfamilial malignant melanoma were assessed. These data were obtained from consecutive prospectively completed questionnaires on 1169 cases of cutaneous malignant melanoma. Of these, 69 patients indicated a positive family history for this cancer. Among the various clinical and histological variables compared, those that significantly correlated with the familial occurrence of malignant melanoma include younger age at first diagnosis, smaller diameter of the lesion, lower Clark level, decreased frequency of nonmelanoma skin cancer, and reduced prevalence of noncutaneous cancer. Increased awareness of malignant melanoma among family members could account for some of these observations. Identification of the familial variety of malignant melanoma has practical implications concerning early detection and prompt intervention.

  15. Sunny holidays before and after melanoma diagnosis are respectively associated with lower breslow thickness and lower relapse rates in Italy

    NARCIS (Netherlands)

    S. Gandini (Sara); E. de Vries (Esther); A. Tosti (Antonella); E. Botteri (Edoardo); G. Spadola (Giuseppe); P. Maisonneuve (Patrick); C. Martinoli (Carlo); A. Joosse (Arjen); P.F. Ferrucci (Pier Francesco); F. Baldini (Federica); E. Cocorocchio (Emilia); E. Pennacchioli (E.); F. Cataldo (Francesco); B. Bazolli (Barbara); A. Clerici (Alessandra); M. Barberis (Massimo); V. Bataille (Veronique); A. Testori (Alessandro)

    2013-01-01

    textabstractBackground: Previous studies have reported an association between sun exposure and improved cutaneous melanoma (CM) survival. We analysed the association of UV exposure with prognostic factors and outcome in a large melanoma cohort. Methods: A questionnaire was given to 289 (42%) CM pati

  16. Respuesta completa tras tratamiento con bioquimioterapia en un caso de melanoma cutáneo diseminado Complete response in a patient with a metastatic cutaneous melanoma

    Directory of Open Access Journals (Sweden)

    M.J. Bermejo-Pérez

    2011-08-01

    Full Text Available Fundamento. El pronóstico del melanoma diseminado es muy sombrío. Actualmente no hay consenso sobre el tratamiento estándar en primera línea para el melanoma metastático. Se presenta un caso por su comportamiento excepcional. Resultados. Varón de 43 años diagnosticado en 1999 de melanoma maligno estadio IIA. En mayo de 2000 se objetivaron metástasis hepáticas y esplénicas. Recibió 6 ciclos de bioquimioterapia (cisplatino y DTIC junto con interleukina-2 e interferón-α cada 21 días y otros 6 ciclos con inmunoterapia sola (interleukina-2 e interferón-α. Actualmente el paciente sigue vivo y sin evidencia de enfermedad. Conclusión. El melanoma cutáneo metastático, en ocasiones, presenta una inusual evolución favorable. Es de esperar que los métodos de detección de marcadores moleculares logren determinar factores implicados en este tipo de respuesta y que los nuevos tratamientos dirigidos consigan mantener esta tendencia positiva.Background. The management of patients with disseminated disease is a difficult problem. There is currently no consensus on the standard first-line treatment for metastatic melanoma. We present a case because of his exceptional evolution. Results. A 43 year old male diagnosed in 1999 with malignant melanoma stage IIA. In May 2000, hepatic and splenic metastases were detected. He received 6 cycles of biochemotherapy (cisplatin and DTIC, plus interleukin-2 and interferon-α and another 6 cycles with single immunotherapy (interleukin-2 and interferon-α. Today, the patient is still alive and without evidence of disease. Conclusion. Metastatic cutaneous melanoma, sometimes, presents and unusual and favourable evolution. In the near future, the methods of detection of molecular markers are expected to identify factors involved in this type of response. Furthermore, new targeted therapies may become essential to maintain this positive trend.

  17. Breslow thickness and (18)F-FDG PET-CT result in initial staging of cutaneous melanoma: Can a cut-off point be established?

    Science.gov (United States)

    Ortega-Candil, A; Rodríguez-Rey, C; Cano-Carrizal, R; Cala-Zuluaga, E; González Larriba, J L; Jiménez-Ballvé, A; Fuentes-Ferrer, M E; Cabrera-Martín, M N; Pérez-Castejón, M J; García García-Esquinas, M; Lapeña-Gutierrez, L; Carreras-Delgado, J L

    2016-01-01

    To establish a Breslow Thickness (BT) cut-off point for indication of PET-CT of cutaneous melanoma in early stages and evaluate its prognostic value. Retrospective analysis of 347 PET-CT studies with diagnosis of melanoma, of which 108 were performed for initial staging. Thirty-one patients were excluded, and a final sample of 77 patients remained. A ROC curve analysis was performed to establish an optimal cut-off point. A survival analysis was performed, considering death assignable to melanoma as the main event, for the evaluation of its prognostic value. Forty-seven (61.04%) of all 77 patients selected were men, and 11 (14.29%) had a positive PET-CT result. Mean age was 65.17±15.00 years. The median BT in patients with a negative PET-CT result was 2.75 mm (IQR 1.83-4.50) and in the positive group 6.25 mm (IQR 5.40-7.50) (P=.0013). In the ROC curve analysis (AUC 0.804, SE 0.054), an optimal value of 5 mm BT with the following values was obtained: sensitivity 90.91%, specificity 78.79%, negative predictive value (NPV) 98.1%, positive predictive value (PPV) 41.7%, diagnostic OR 37.1, and accuracy 80.52%. Mean follow-up was 18.66±14,35 months, detecting 2/53 (3.77%) deaths in the BT<5 mm group, and 7/24 (29.17%) in the BT≥5 mm group. Survival curves between both groups were significantly different (P=.0013). A 5 mm cut-off point correctly distinguishes those patients with positive PET-CT from those with negative results in the early stages of cutaneous melanoma; therefore it could be included in initial staging of this subgroup of patients. Copyright © 2015 Elsevier España, S.L.U. and SEMNIM. All rights reserved.

  18. Immunolabeling for p16, WT1, and Fli-1 in the assignment of growth phase for cutaneous melanomas.

    Science.gov (United States)

    Strickler, Allen G; Schaefer, Jochen T; Slingluff, Craig L; Wick, Mark R

    2014-09-01

    Distinction between radial growth phase (RGP) and vertical growth phase (VGP) in cutaneous melanomas is prognostically significant. Despite established morphological criteria, molecular markers to separate RGP and VGP have not been well established. The goal of this study was to investigate associations of p16, WT1, and Fli-1 with RGP-to-VGP progression, by immunohistochemistry. The p16 is a tumor suppressor, whereas WT1 and Fli-1 are transcriptional activators. The authors hypothesized that entry into VGP would be associated with decreased p16 and increased WT1 and Fli-1. Paraffin sections from 18 RGP and 15 VGP melanomas were immunostained with well-characterized antibodies to p16, WT1, and Fli-1. Melanoma growth phases were determined using precodified morphological attributes. In RGP melanomas, p16 was expressed in 15 of 18 (83%), WT1 in 17 of 17 (100%), and Fli-1 at least focally in 6 of 18 (33%). The deep dermal component of VGP melanomas stained positively for Fli-1 in 9 of 14 (64%), strongly for WT1 in 10 of 14 (71%), and strongly for p16 in only 2 of 15 (13%). Observed patterns of WT1 immunopositivity did not support the authors' hypothesis; it is not likely to be a good indicator of VGP. On the other hand, Fli-1 staining trended toward more positive deep tumor compartment staining and p16 to weaker staining in the deep compartment. At present, application of histological criteria remains the best method for assignment of growth phase in melanomas; however, p16 and possibly Fli-1 immunostains may serve as useful adjuncts in morphologically indeterminate cases.

  19. High Percentage of ADAM-10 Positive Melanoma Cells Correlates with Paucity of Tumor-Infiltrating Lymphocytes but Does Not Predict Prognosis in Cutaneous Melanoma Patients

    Directory of Open Access Journals (Sweden)

    Piotr Donizy

    2015-01-01

    Full Text Available ADAM-10 (CDw156, CD156c, and kuzbanian is a protein belonging to a superfamily of metalloproteases, enzymes capable of degrading the extracellular matrix. ADAMs have also been shown to be primarily involved in ectodomain cleavage. The aim of the study was to assess the expression and intracellular location of ADAM-10 in 104 primary skin melanomas and 16 metastatic lesions from regional lymph nodes. Also, prognostic significance of ADAM-10 expression in primary tumor cells and metastatic lesion cells was evaluated during 5-year observation. It was revealed that high expression of ADAM-10 positive cells was strictly related with lower intensity of tumor-infiltrating lymphocytes (P=0.037, which suggests that ADAM-10 regulates immunoresponse in melanoma initiation and progression. No statistically significant correlations were found between ADAM-10 expression in primary tumor cells and nodal metastases and other histopathological parameters analyzed. Decreased immunoreactivity of ADAM-10 in cancer cells from regional lymph nodes was correlated with worse prognosis; however this correlation was statistically nonsignificant (P=0.065. Review of the literature shows that our study is the first one ever to describe the significance of ADAM-10 expression in correlation with detailed histopathological parameters of the primary tumor and data on long-term survival of cutaneous melanoma patients.

  20. A Bayesian destructive weighted Poisson cure rate model and an application to a cutaneous melanoma data.

    Science.gov (United States)

    Rodrigues, Josemar; Cancho, Vicente G; de Castro, Mário; Balakrishnan, N

    2012-12-01

    In this article, we propose a new Bayesian flexible cure rate survival model, which generalises the stochastic model of Klebanov et al. [Klebanov LB, Rachev ST and Yakovlev AY. A stochastic-model of radiation carcinogenesis--latent time distributions and their properties. Math Biosci 1993; 113: 51-75], and has much in common with the destructive model formulated by Rodrigues et al. [Rodrigues J, de Castro M, Balakrishnan N and Cancho VG. Destructive weighted Poisson cure rate models. Technical Report, Universidade Federal de São Carlos, São Carlos-SP. Brazil, 2009 (accepted in Lifetime Data Analysis)]. In our approach, the accumulated number of lesions or altered cells follows a compound weighted Poisson distribution. This model is more flexible than the promotion time cure model in terms of dispersion. Moreover, it possesses an interesting and realistic interpretation of the biological mechanism of the occurrence of the event of interest as it includes a destructive process of tumour cells after an initial treatment or the capacity of an individual exposed to irradiation to repair altered cells that results in cancer induction. In other words, what is recorded is only the damaged portion of the original number of altered cells not eliminated by the treatment or repaired by the repair system of an individual. Markov Chain Monte Carlo (MCMC) methods are then used to develop Bayesian inference for the proposed model. Also, some discussions on the model selection and an illustration with a cutaneous melanoma data set analysed by Rodrigues et al. [Rodrigues J, de Castro M, Balakrishnan N and Cancho VG. Destructive weighted Poisson cure rate models. Technical Report, Universidade Federal de São Carlos, São Carlos-SP. Brazil, 2009 (accepted in Lifetime Data Analysis)] are presented.

  1. Retinal vasculitis and ocular vitreous metastasis following complete response to PD-1 inhibition in a patient with metastatic cutaneous melanoma.

    Science.gov (United States)

    Manusow, Joshua S; Khoja, Leila; Pesin, Nataly; Joshua, Anthony M; Mandelcorn, Efrem D

    2014-01-01

    We report on a 36-year-old woman treated with the anti PD-1 antibody Pembrolizumab for metastatic cutaneous melanoma in the first line setting. She achieved a complete response and then relapsed with metastases to the vitreous cavity with an associated angiographically determined retinal vasculitis. Vitreous metastasis without choroidal involvement is unusual and may be due to individual cell extravasation, vitreous hemorrhage containing malignant cells, or direct spread through the optic nerve. This finding highlights the need for immune sanctuary sites to be monitored in the presence of PD-1 inhibition and we hypothesize that the use of PD-1 inhibitor potentiated the patient's angiographically determined retinal vasculitis.

  2. Local cryosurgery and imiquimod: A successful combination for the treatment of locoregional cutaneous metastasis of melanoma: A case series.

    Science.gov (United States)

    Rivas-Tolosa, Nancy; Ortiz-Brugués, Ariadna; Toledo-Pastrana, Tomás; Baradad, Manel; Traves, Víctor; Soriano, Virtudes; Sanmartín, Verónica; Requena, Celia; Martí, Rosa; Nagore, Eduardo

    2016-05-01

    Locoregional cutaneous metastases of melanoma (LCMM) represent a therapeutic challenge. Many treatment options are available with varying results. The combination of cryotherapy and imiquimod, two treatments with a possible synergistic effect, has not yet been described for treating this disease. In this paper, we aimed to show the response of LCMM to cryotherapy combined with topical imiquimod 5%. A retrospective review of 20 patients diagnosed with LCMM and treated with cryotherapy combined with topical imiquimod 5% between November 2000 and May 2014 at three institutions was performed. The locoregional cutaneous response was evaluated. After a mean of five sessions, 13 patients (65%) responded to treatment, eight (40%) of these completely and five (25%) partially. Systemic disease progressed in 16 (80%) patients. Cryotherapy followed by topical imiquimod 5% is simple to apply, has minimal adverse effects and provides response rates similar to other, more complex treatment options. © 2015 Japanese Dermatological Association.

  3. Accuracy of routine cytology and immunocytochemistry in preoperative diagnosis of oral amelanotic melanomas in dogs.

    Science.gov (United States)

    Przeździecki, Rafał; Czopowicz, Michał; Sapierzyński, Rafał

    2015-12-01

    Amelanotic melanomas are one of the most common oral malignancies. The cytologic and histopathologic differentiation between amelanotic melanoma, sarcoma, and poorly differentiated carcinoma is often difficult or even impossible. The aim of this study was to assess the reliability of routine cytology and immunocytochemistry in preoperative diagnosis of canine oral amelanotic melanoma. Cytologic preparations from undifferentiated canine oral tumors were stained with Giemsa and by immunocytochemistry (ICC) using anti-cytokeratin, anti-vimentin, and anti-Melan A antibodies. The final cytologic diagnosis (including ICC) was compared to the final diagnosis based on histopathology and immunohistochemistry (IHC) results, and sensitivity and specificity of cytologic examination were determined. Final cytologic diagnoses of 38 cases agreed well with the histopathologic/immunohistochemical diagnoses, thus both specificity and sensitivity of combined routine cytology and ICC were 100% (95% confidence interval 90.8-100%). Of 32 oral tumors, diagnosis of amelanotic melanoma, sarcoma, and carcinoma was made using routine cytology and ICC. In 4 of 6 aspirates taken from lymph nodes, a preliminary diagnosis of metastatic amelanotic melanoma corresponded with the final diagnosis. Both sensitivity and specificity of routine cytology in diagnosis of amelanotic melanomas were considered moderate (66.7% and 85.7%, respectively). In conclusion, routine cytology is a reliable diagnostic method for canine oral amelanotic melanoma and metastatic amelanotic melanoma, and ICC, using anti-cytokeratin, anti-vimentin, and anti-Melan A antibodies, is an excellent supporting method for presurgical diagnosis of poorly differentiated oral malignancies in dogs. © 2015 American Society for Veterinary Clinical Pathology.

  4. Hypothesis: Is frequent, commercial jet travel by the general public a risk factor for developing cutaneous melanoma? [version 1; referees: 2 approved, 1 approved with reservations

    Directory of Open Access Journals (Sweden)

    Harvey Arbesman

    2015-08-01

    Full Text Available Melanoma incidence has been increasing worldwide over the past 50 years and various risk factors have been identified. Interestingly, multiple studies have shown a multifold increased risk of developing melanoma in jet pilots and airline crew. There has also been a dramatic increase in the availability and frequency of jet travel by the general population during this time period.. Therefore, it is hypothesized that frequent commercial jet travel may represent an additional risk factor for the development of cutaneous melanoma in susceptible individuals of the general public.

  5. Does the Type of Initial Biopsy Method Determine Re-Excision Rate of Cutaneous Melanoma?

    OpenAIRE

    Ramya Vangipuram; Mary Ramirez; Subhasis Misra; Yasir Al Abboodi

    2015-01-01

    Background: Various biopsy types are used to diagnose melanoma, after which wide local excision (WLE) is the gold standard for treatment. Depending on the final pathology report, further re-excision may be necessary despite an initial, presumably adequate, WLE. In this study, we analyzed the impact of initial biopsy type (shave, punch, or excision) on the management of melanoma. Methods: A retrospective chart review of 243 patients with clinically node-negative melanoma was completed. Eva...

  6. Histopathological diagnosis of acral lentiginous melanoma in early stages.

    Science.gov (United States)

    Fernandez-Flores, Angel; Cassarino, David S

    2017-02-01

    Acral lentiginous melanoma is a rare variant of melanoma that is associated with a relatively low survival rate. The latter is partly due to the advanced stage in which the tumor is usually diagnosed. The diagnostic delay is mainly due to difficulties in identifying the very early histopathological signs of acral melanoma. The current article is a review of diagnostic clues, concepts, and definitions from the literature, as well as illustrating examples from our own archives. We have sought to provide an article that can be easily consulted in difficult cases of acral lentiginous melanoma.

  7. Germline RAD51B truncating mutation in a family with cutaneous melanoma

    DEFF Research Database (Denmark)

    Wadt, Karin A W; Aoude, Lauren G; Golmard, Lisa

    2015-01-01

    Known melanoma predisposition genes only account for around 40% of high-density melanoma families. Other rare mutations are likely to play a role in melanoma predisposition. RAD51B plays an important role in DNA repair through homologous recombination, and inactivation of RAD51B has been implicated...... this case report is consistent with melanoma being part of the RAD51B cancer spectrum further population-based screening of large case-control sample series will be needed to definitively establish if this is the case....

  8. Ultraviolet Radiation-Induced Cytogenetic Damage in White, Hispanic and Black Skin Melanocytes: A Risk for Cutaneous Melanoma

    Directory of Open Access Journals (Sweden)

    Amrita Dasgupta

    2015-08-01

    Full Text Available Cutaneous Melanoma (CM is a leading cause of cancer deaths, with reports indicating a rising trend in the incidence rate of melanoma among Hispanics in certain U.S. states. The level of melanin pigmentation in the skin is suggested to render photoprotection from the DNA-damaging effects of Ultraviolet Radiation (UVR. UVR-induced DNA damage leads to cytogenetic defects visualized as the formation of micronuclei, multinuclei and polymorphic nuclei in cells, and a hallmark of cancer risk. The causative relationship between Sun exposure and CM is controversial, especially in Hispanics and needs further evaluation. This study was initiated with melanocytes from White, Hispanic and Black neonatal foreskins which were exposed to UVR to assess their susceptibility to UVR-induced modulation of cellular growth, cytogenetic damage, intracellular and released melanin. Our results show that White and Hispanic skin melanocytes with similar levels of constitutive melanin are susceptible to UVR-induced cytogenetic damage, whereas Black skin melanocytes are not. Our data suggest that the risk of developing UVR-induced CM in a skin type is correlated with the level of cutaneous pigmentation and its ethnic background. This study provides a benchmark for further investigation on the damaging effects of UVR as risk for CM in Hispanics.

  9. Ultraviolet Radiation-Induced Cytogenetic Damage in White, Hispanic and Black Skin Melanocytes: A Risk for Cutaneous Melanoma

    Energy Technology Data Exchange (ETDEWEB)

    Dasgupta, Amrita [Hampton University Skin of Color Research Institute, Hampton, VA 23668 (United States); Katdare, Meena, E-mail: mkatdare@gmail.com [Hampton University Skin of Color Research Institute, Hampton, VA 23668 (United States); Department of Dermatology, Eastern Virginia Medical School, Norfolk, VA 23507 (United States)

    2015-08-14

    Cutaneous Melanoma (CM) is a leading cause of cancer deaths, with reports indicating a rising trend in the incidence rate of melanoma among Hispanics in certain U.S. states. The level of melanin pigmentation in the skin is suggested to render photoprotection from the DNA-damaging effects of Ultraviolet Radiation (UVR). UVR-induced DNA damage leads to cytogenetic defects visualized as the formation of micronuclei, multinuclei and polymorphic nuclei in cells, and a hallmark of cancer risk. The causative relationship between Sun exposure and CM is controversial, especially in Hispanics and needs further evaluation. This study was initiated with melanocytes from White, Hispanic and Black neonatal foreskins which were exposed to UVR to assess their susceptibility to UVR-induced modulation of cellular growth, cytogenetic damage, intracellular and released melanin. Our results show that White and Hispanic skin melanocytes with similar levels of constitutive melanin are susceptible to UVR-induced cytogenetic damage, whereas Black skin melanocytes are not. Our data suggest that the risk of developing UVR-induced CM in a skin type is correlated with the level of cutaneous pigmentation and its ethnic background. This study provides a benchmark for further investigation on the damaging effects of UVR as risk for CM in Hispanics.

  10. Doença de Paget pigmentada do mamilo simulando melanoma cutâneo: importância da imuno-histoquímica na diferenciação dessas doenças Pigmented Paget's disease of the nipple mimicking cutaneous melanoma: importance of the immunohistochemical profile to differentiate between these diseases

    Directory of Open Access Journals (Sweden)

    Tatiana Villas Boas Gabbi

    2006-10-01

    Full Text Available A variante pigmentada da doença de Paget mamária é rara, com cerca de 12 casos relatados, e pode mimetizar clínica e histologicamente o melanoma. Como na forma clássica, em geral associa-se à neoplasia da mama acometida, com origem principalmente no carcinoma intraductal que se estende à epiderme através de ducto lactóforo. A fisiopatologia da hiperpigmentação permanece desconhecida. Relata-se o caso de paciente de 49 anos que apresentou lesão pigmentada do mamilo, suspeita de melanoma. O exame histológico não foi suficiente para confirmar o diagnóstico, sendo necessária realização de perfil imuno-histoquímico. Apesar de incomum, o diagnóstico de doença de Paget deve ser lembrado como diferencial de melanoma em lesões pigmentadas dessa região, em ambos os sexos.Pigmented mammary Paget's disease is a rare dermatosis, with approximately 12 reported cases in the literature, which can mimic cutaneous melanoma both clinically and histologically. As for classical mammary Paget's disease, the pigmented variant is associated with neoplasia of the breast, originating mainly from intraductal mammary carcinoma that extends to the epidermis of the nipple and areola through a lactiferous duct. Physiopathology of hyperpigmentation remains unknown. We present a 49-year-old female patient who presented with a pigmented lesion of the nipple suspected of melanoma. Histological examination was not sufficient to confirm diagnosis. Immunohistochemical examination confirmed the diagnosis of Paget's disease. Although uncommon, pigmented Paget's disease must be reminded as a differential diagnosis of melanoma in pigmented lesions of the nipple, in both genders.

  11. Comparison of Three Methods for Diagnosis of Cutaneous Leishmaniasis

    Directory of Open Access Journals (Sweden)

    P Habibi

    2010-12-01

    Full Text Available Background: Leishmaniasis is one of the infectious parasitic diseases of highest incidence in the world. Cutaneous Leishmaniasis (CL has long been reported in Shiraz, Southern Iran. There is a need to find a sensitive and specific method for treatment and control of the disease.Methods: We have compared the sensitivity of the conventional methods microscopy and cultiva­tion of lesion scrapes against PCR amplification of parasite kinetoplast DNA from these sam­ples. The samples (n=219 were obtained from the patients clinically suspected of CL. The smears were stained with Giemsa for microscopy and cultured in Novy-Nicolle-McNeal (NNN blood agar for promastigote growth. For PCR, the dry smears were scraped off the slides and DNA was extracted.Results: The positive rates from 219 specimens were 76.71%, 50.68%, and 93.61% for micros­copy, cultivation, and PCR, respectively. The highest correlation was found between PCR and micros­copy method (P= 0.014. In PCR assay, 95.61%, 3.9%, and 0.49% of the samples were identi­fied as Leishmania major, L. tropica, and dermatropic L. infantum, respectively.Conclusion: The PCR method appears to be the most sensitive for the diagnosis of CL and is valu­able for identifying the other species of Leishmania with confusing dermatropic signs.

  12. Mucosal malignant melanoma - a clinical, oncological, pathological and genetic survey.

    Science.gov (United States)

    Mikkelsen, Lauge H; Larsen, Ann-Cathrine; von Buchwald, Christian; Drzewiecki, Krzysztof T; Prause, Jan U; Heegaard, Steffen

    2016-06-01

    Mucosal melanomas constitute 1.3% of all melanomas and they may develop in any mucosal membrane. Conjunctival melanomas (0.5/million/year) and melanomas in the sinonasal cavity (0.5/million/year) are the most common, followed by anorectal melanomas (0.4/million/year) and melanomas in the oral cavity (0.2/million/year). Anorectal melanoma occurs slightly more often in females, whereas oral melanoma has a male predilection. Mucosal melanoma most commonly develops in a patient's sixth or seventh decade of life, and no differences between races have been found except for sinonasal melanoma and conjunctival melanoma, which are very rare in Black people. The symptoms are not tumour-specific and are related to the organ system affected, and the disease is most often diagnosed at an advanced clinical stage. The diagnosis of a primary tumour is difficult, and metastatic cutaneous melanoma and choroidal melanoma must be excluded. Mutations in KIT are frequently found, while BRAF and NRAS mutations are rarely found - except in conjunctival melanomas that carry BRAF mutations. Mutations in the TERT promotor region are also found in mucosal melanomas. Complete surgical resection with free margins is the treatment of choice. The prognosis is poor, with the 5-year survival rate ranging from 0% (gastric melanoma) to 80% (conjunctival melanoma).

  13. MGMT promoter methylation is associated with temozolomide response and prolonged progression-free survival in disseminated cutaneous melanoma.

    Science.gov (United States)

    Tuominen, Rainer; Jewell, Rosalyn; van den Oord, Joost J; Wolter, Pascal; Stierner, Ulrika; Lindholm, Christer; Hertzman Johansson, Carolina; Lindén, Diana; Johansson, Hemming; Frostvik Stolt, Marianne; Walker, Christy; Snowden, Helen; Newton-Bishop, Julia; Hansson, Johan; Egyházi Brage, Suzanne

    2015-06-15

    To investigate the predictive and prognostic value of O(6) -methylguanine DNA methyltransferase (MGMT) inactivation by analyses of promoter methylation in pretreatment tumor biopsies from patients with cutaneous melanoma treated with dacarbazine (DTIC) or temozolomide (TMZ) were performed. The patient cohorts consisted of Belgian and Swedish disseminated melanoma patients. Patients were subdivided into those receiving single-agent treatment with DTIC/TMZ (cohort S, n = 74) and those treated with combination chemotherapy including DTIC/TMZ (cohort C, n = 79). Median follow-up was 248 and 336 days for cohort S and cohort C, respectively. MGMT promoter methylation was assessed by three methods. The methylation-related transcriptional silencing of MGMT mRNA expression was assessed by real-time RT-PCR. Response to chemotherapy and progression-free survival (PFS) and overall survival were correlated to MGMT promoter methylation status. MGMT promoter methylation was detected in tumor biopsies from 21.5 % of the patients. MGMT mRNA was found to be significantly lower in tumors positive for MGMT promoter methylation compared to tumors without methylation in both treatment cohorts (p MGMT promoter methylation in cohort S (p = 0.0005), but did not reach significance in cohort C (p = 0.16). Significantly longer PFS was observed among patients with MGMT promoter-methylated tumors (p = 0.002). Multivariate Cox regression analysis identified presence of MGMT promoter methylation as an independent variable associated with longer PFS. Together, this implies that MGMT promoter methylation is associated with response to single-agent DTIC/TMZ and longer PFS in disseminated cutaneous melanoma.

  14. A systematic review of health-related quality of life in cutaneous melanoma.

    NARCIS (Netherlands)

    D. Cornish; C. Holterhues (Cynthia); L.V. van de Poll-Franse (Lonneke); J.W.W. Coebergh (Jan Willem); T.E.C. Nijsten (Tamar)

    2009-01-01

    textabstractMelanoma can be considered an emerging chronic disease that may considerably affect patients' lives. The authors systematically reviewed the available literature on health-related quality of life (HRQOL) and melanoma. Of reviews and the selected studies, reference lists were hand-searche

  15. Review of melanoma antigens recognized by monoclonal antibodies (MAbs). Their functional significance and applications in diagnosis and treatment of melanoma.

    Science.gov (United States)

    Hersey, P

    1985-04-01

    The introduction of monoclonal antibody techniques has led to a rapid advance in information concerning antigenic structures in melanoma cell membranes. These have been classified according to the extent of their expression on cells of other tissues, but it is evident that a more precise classification based on their biochemical nature is possible. Several monoclonal antibodies appear to define antigens restricted to melanoma cells and fetal tissues. Many antibodies recognize antigens shared with gliomas and nevi, whereas other groups can be defined which recognize antigens on melanocytes or other carcinomas. One of the commonly detected antigens was shown to be a high molecular weight (MW) proteoglycan which may be involved in reactions with other cells and the intercellular matrix. A second antigen was shown to be a ganglioside which may have receptor functions in cells. A third was shown to be a glycoprotein with iron transport functions. The latter antigen and the large MW proteoglycan have been a focus of attention for in vivo targeting studies in treatment and diagnosis. The ganglioside, large MW proteoglycan and a melanocarcinoma antigen may be detected in the circulation of patients and are being evaluated for monitoring of disease activity in patients with melanoma. Several monoclonals may be of value in histological evaluation of melanoma, e.g. diagnosis of preneoplastic lesions, metastatic lesions of unknown origin and identification of cell structures related to metastatic behaviour in the host. Further studies should help to define cellular structures recognized by the immune system in humans.

  16. KIR gene variability in cutaneous malignant melanoma: influence of KIR2D/HLA-C pairings on disease susceptibility and prognosis.

    Science.gov (United States)

    Campillo, José A; Legaz, Isabel; López-Álvarez, M Rocío; Bolarín, José Miguel; Las Heras, Beatriz; Muro, Manuel; Minguela, Alfredo; Moya-Quiles, María R; Blanco-García, Rosa; Martínez-Banaclocha, Helios; García-Alonso, Ana M; Alvarez-López, M Rocío; Martínez-Escribano, Jorge A

    2013-05-01

    Natural killer and CD8(+) T cells are believed to be involved in the immune protection against melanoma. Their function may be regulated by a group of receptors defined as killer immunoglobulin-like receptors (KIRs) and their cognate HLA class I ligands. In this study, we analyzed the influence of KIR genes and KIR/HLA-I combinations on melanoma susceptibility and/or prognosis in a Spanish Caucasian population. For this purpose, KIR genotyping by PCR-SSP and HLA-C genotyping by reverse PCR-SSO were performed in 187 melanoma patients and 200 matched controls. We found a significantly low frequency of KIR2DL3 in nodular melanoma (NM) patients (P = 0.001) and in ulcerated melanoma patients (P < 0.0001). Similarly, the KIR2DL3/C1 combination was significantly decreased in melanoma patients (Pc = 0.008) and in patients with sentinel lymph node (SLN) melanoma metastasis (Pc = 0.002). Multivariate logistic regression models showed that KIR2DL3 behaves as a protective marker for NM and ulcerated melanoma (P = 0.02, odds ratio (OR) = 0.14 and P = 0.04, OR = 0.28, respectively), whereas the KIR2DL3/C1 pair acts as a protective marker for melanoma (P = 0.017, OR = 0.54), particularly superficial spreading melanoma (P = 0.02, OR = 0.52), and SLN metastasis (P = 0.0004, OR = 0.14). In contrast, the KIR2DL3(-)/C1C2 genotype seems to be correlated with NM and ulceration. We also report that the KIR2DL1(+)/S1(-)/C2C2 genotype is associated with susceptibility to melanoma and SLN metastasis. Altogether, the study of KIR2D genes and HLA-C ligands may help in assessing cutaneous melanoma risk and prognosis.

  17. A multiple classifier system for early melanoma diagnosis.

    Science.gov (United States)

    Sboner, Andrea; Eccher, Claudio; Blanzieri, Enrico; Bauer, Paolo; Cristofolini, Mario; Zumiani, Giuseppe; Forti, Stefano

    2003-01-01

    Melanoma is the most dangerous skin cancer and early diagnosis is the key factor in its successful treatment. Well-trained dermatologists reach a diagnosis via visual inspection, and reach sensitivity and specificity levels of about 80%. Several computerised diagnostic systems were reported in the literature using different classification algorithms. In this paper, we will illustrate a novel approach by which a suitable combination of different classifiers is used in order to improve the diagnostic performances of single classifiers. We used three different kinds of classifiers, namely linear discriminant analysis (LDA), k-nearest neighbour (k-NN) and a decision tree, the inputs of which are 38 geometric and colorimetric features automatically extracted from digital images of skin lesions. Multiple classifiers were generated by combining the diagnostic outputs of single classifiers with appropriate voting schemata. This approach was evaluated on a set of 152 digital skin images. We compared the performances of multiple classifiers (2- and 3-classifier groups) between them and with respect to single ones (1-classifier group). We further compared the classifiers' performances with those of eight dermatologists. Classifiers' performances were measured in terms of distance from the ideal classifier. Compared with 1- and 2-classifier groups, performances of 3-classifier systems were significantly higher (Pclassifier groups (P=0.352). While the dermatologists group showed a level of performances significantly higher than the 1-classifier systems (Pclassifier groups and the dermatologists groups, indicating comparable performances. This work suggests that a suitable combination of different kinds of classifiers can improve the performances of an automatic diagnostic system.

  18. Utility of a Noninvasive 2-Gene Molecular Assay for Cutaneous Melanoma and Effect on the Decision to Biopsy.

    Science.gov (United States)

    Ferris, Laura K; Jansen, Burkhard; Ho, Jonhan; Busam, Klaus J; Gross, Kenneth; Hansen, Doyle D; Alsobrook, John P; Yao, Zuxu; Peck, Gary L; Gerami, Pedram

    2017-07-01

    Expression of long intergenic non-protein coding RNA 518 (LINC00518) and preferentially expressed antigen in melanoma (PRAME) genes, obtained via noninvasive adhesive patch biopsy, is a sensitive and specific method for detection of cutaneous melanoma. However, the utility of this test in biopsy decisions made by dermatologists has not been evaluated. To determine the utility of the pigmented lesion assay (PLA) for LINC00518/PRAME expression in decisions to biopsy a series of pigmented skin lesions. In this secure web-based, multiple-reader-multiple-case study, 45 board-certified dermatologists each evaluated 60 clinical and dermoscopic images of clinically atypical pigmented lesions, first without and then with PLA gene expression information and were asked whether the lesions should be biopsied. Data were collected from March 24, 2014, through November 13, 2015. Participants were given a report for each lesion, which included the results of an assay for expression of LINC00518/PRAME and a PLA score with data on the predictive values of the information provided. Biopsy sensitivity and specificity with vs without PLA data. Forty-five dermatologists (29 male and 16 female) performed the evaluation. After incorporating the PLA into their decision as to whether to biopsy a pigmented lesion suggestive of melanoma, dermatologists improved their mean biopsy sensitivity from 95.0% to 98.6% (P = .01); specificity increased from 32.1% to 56.9% (P biopsy specificity while maintaining or improving sensitivity. This result may increase the number of early melanomas biopsied and reduce the number of benign lesions biopsied, thereby improving patient outcomes and reducing health care costs.

  19. Time trends in incidence of cutaneous melanoma by detailed anatomical location and patterns of ultraviolet radiation exposure: a retrospective population-based study.

    Science.gov (United States)

    Gordon, Daniela; Gillgren, Peter; Eloranta, Sandra; Olsson, Henrik; Gordon, Max; Hansson, Johan; Smedby, Karin E

    2015-08-01

    Given the wide public health implications of the melanoma epidemic, ultraviolet radiation (UVR) exposure patterns contributing to cutaneous melanoma development should be clearly identified. To describe time trends of anatomic sites of melanoma using a UVR exposure model based on clothing and sun habits, we reviewed the medical records of all patients diagnosed with primary invasive melanoma or melanoma in situ (MIS) during the years 1977-78, 1983-84, 1989-90, 1995-96, and 2000-01 (n=3058) in one healthcare region of Sweden. Age-standardized incidence rates and relative risks (RRs) of melanoma by calendar period were estimated for intermittent and chronic UVR exposure sites. From 1977-78 to 2000-01, the incidence rates of all melanomas at intermittent UVR exposure sites increased both among men (7.8-16.5/10 person-years) and among women (7.6-14.6/10 person-years), with a sex-adjusted and age-adjusted RR of 2.1 [95% confidence interval (CI) 1.8-2.4, Ptrendexposure sites, the male sex was positively associated with central (core) areas (chest, back, neck, shoulders, thighs; RR 1.7, 95% CI 1.5-1.9), but negatively associated with peripheral areas (lateral arms, lower legs, dorsum of feet; RR 0.3, 95% CI 0.3-0.4), compared with the female sex. Sex-specific intermittent UVR exposure patterns drove the observed increase in melanoma incidence, whereas chronic UVR exposure contributed less.

  20. [Vulvar melanoma].

    Science.gov (United States)

    Chokoeva, A; Tchernev, G; Wollina, U

    2015-01-01

    Malignant melanoma of the vulva is a rare disease with aggressive behavior and poor prognosis. It consist melanoma in females, as the ratio of its manifestation, compared with the cutaneous melanoma is 1:71. Higher risk of developing melanoma of the vulva is established in white women, as the peak of the incidence is between 60 and 70 years of age. Clinically, MM of the vulva manifests as asymptomatic pigmented, rarely a pigmented lesion, as the usual clinical form is superficial spreading MM and much less common nodular MM, which is associated with a poorer prognosis in. general. The diagnosis is confirmed by histological examination. Conduction of PCR and DNA analysis for detection of BRAF mutations, NRAS mutations and KIT amplification is also appropriate. Advanced age, black race, tumor size, tumor thickness, ulceration, presence of satellite lesions, involvement of adjacent organs (vagina, urethra), and the presence of regional or distant metastases are identified as the most important prognostic markers. Radical wide excision followed by bilateral lymphadenectomy id considered as the optimal therapeutic approach.

  1. Frozen section diagnosis for non-melanoma skin cancers: correlation with permanent section diagnosis.

    Science.gov (United States)

    Onajin, Oluwakemi; Wetter, David A; Roenigk, Randall K; Gibson, Lawrence E; Weaver, Amy L; Comfere, Nneka I

    2015-07-01

    Frozen section pathology is routinely used for margin assessment of non-melanoma skin cancer (NMSC). Frozen section can also be used for the primary diagnosis of several skin lesions. Limited data exist on the accuracy of frozen section in the diagnosis of NMSC. We performed a retrospective chart review of 300 cases in which frozen section diagnoses were compared with permanent section diagnoses of NMSC. Frozen section and permanent section pathology were concordant 83.3% of the time, with the highest concordance rates noted for basal cell carcinoma (145/153, 95%). Our results show a high level of concordance between frozen section and corresponding permanent section pathology diagnosis for NMSC. The rapidity of frozen section tissue processing and pathology reporting makes this technique useful in dermatologic practice for immediate diagnosis and management of NMSC. Further studies should explore strategies to decrease or eliminate discrepancies between frozen and permanent section diagnosis. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  2. Frontline approach to metastatic BRAF-mutant melanoma diagnosis, molecular evaluation, and treatment choice.

    Science.gov (United States)

    Chapman, Paul B; Hauschild, Axel; Sondak, Vernon K

    2014-01-01

    An estimated 76,100 patients will be diagnosed with invasive melanoma in the United States in 2014, and 9,710 patients will die from the disease. In almost all cases, the cause of death is related to the development of widespread metastatic disease. Although death rates from most types of cancer have steadily decreased in the United States--a 20% decrease during two decades from a peak of 215.1 deaths per 100,000 population in 1991 to 171.8 in 2010--death rates from melanoma have steadily increased during the same time, especially among males. The news regarding melanoma is far from all bad. Increases in our understanding of the human immune system have led to the development of new immunotherapeutic drugs such as ipilimumab, which has been shown to improve survival in phase III trials in metastatic melanoma, and anti-programmed death 1 (anti-PD1) antibodies, recently hailed by ASCO as one of the past year's most noteworthy clinical cancer advances. However, no discovery has influenced and, indeed, transformed the management of metastatic melanoma more than the identifıcation of activating mutations in the BRAF gene in the mitogen-activated protein kinase (MAPK) pathway, which occur in about half of cutaneous melanomas and can be targeted with small molecule inhibitors of the BRAF protein, the downstream MEK protein, or both. This article will address how patients with metastatic melanoma are evaluated for their mutation status and how the presence of a targetable mutation influences therapeutic decisions regarding systemic therapy and even surgery.

  3. Polymerase chain reaction-based molecular diagnosis of cutaneous infections in dermatopathology.

    Science.gov (United States)

    Swick, Brian L

    2012-12-01

    Conventional methods, including microscopy, culture, and serologic studies, are a mainstay in the diagnosis of cutaneous infection. However, owing to limitations associated with these techniques, such as low sensitivity for standard microscopy and in the case of culture delay in diagnosis, polymerase chain-reaction based molecular techniques have taken on an expanding role in the diagnosis of infectious processes in dermatopathology. In particular, these assays are a useful adjunct in the diagnosis of cutaneous tuberculosis, atypical mycobacterial infection, leprosy, Lyme disease, syphilis, rickettsioses, leishmaniasis, and some fungal and viral infections. Already in the case of tuberculosis and atypical mycobacterial infection, standardized polymerase chain-reaction assays are commonly used for diagnostic purposes. With time, additional molecular-based techniques will decrease in cost and gain increased standardization, thus delivering rapid diagnostic confirmation for many difficult-to-diagnose cutaneous infections from standard formalin-fixed paraffin-embedded tissue specimens.

  4. Cutaneous Amebiasis: The Importance of Molecular Diagnosis of an Emerging Parasitic Disease

    OpenAIRE

    Morán, Patricia; Rojas, Liliana; Cerritos, René; Zermeño, Valeria; Valadez, Alicia; de Oca, Griselda Montes; Reyes, Miguel Ángel; González, Enrique; Partida, Oswaldo; Hernández, Eric; Nieves, Miriam; Portillo, Tobías; Gudiño, Marco; Ramiro, Manuel; Ximénez, Cecilia

    2013-01-01

    Cutaneous amebiasis is the least common clinical form of human amebiasis in Mexico, sexual amebiasis was only occasionally observed before the late 1980s. However, in the last few decades, most of the documented cases of cutaneous amebiasis from around the world are sexually transmitted. We present two cases of sexually transmitted genital amebiasis. The molecular characterization of the Entamoeba species in the affected tissues underlines the importance of an etiological diagnosis using spec...

  5. Eye and hair colour, skin type and constitutive skin pigmentation as risk factors for basal cell carcinoma and cutaneous malignant melanoma. A Danish case-control study

    DEFF Research Database (Denmark)

    Lock-Andersen, J; Drzewiecki, K T; Wulf, H C

    1999-01-01

    To assess the importance of hair and eye colour, skin type and constitutive skin pigmentation as risk factors for basal cell carcinoma and cutaneous malignant melanoma in fair-skinned Caucasians, we conducted two identical case-control studies in Denmark. We studied 145 cases with basal cell...... were of skin type II than skin type IV; skin type 11 was a risk factor for basal cell carcinoma with an odds ratio (OR) of 2.3. For cutaneous malignant melanoma, more cases than controls were red-haired or blond and of skin type II, but there was no difference in constitutive skin pigmentation. Hair...... colour and skin type were found to be independent risk factors for cutaneous malignant melanoma; red hair vs. black/brown: OR >9.7, blond hair vs. brown/black: OR = 2.4, and skin type 11 vs. type IV: OR=2.0. There were no gender-related differences in risk factors for basal cell carcinoma and cutaneous...

  6. [Cutaneous alternariosis and its diagnosis in an inmunocompromised patient].

    Science.gov (United States)

    Marín Montín, I; Camacho Fernández, M; Rubio Rubio, J M; Herrera, A

    2006-01-01

    In this paper, a cutaneous alternariosis is described. This is a strange opportunist infection with less than 100 cases. The patient was not VIH although inmunocompromised due to several factors: Malabsorption Syndrome, megaloblastic anemia secondary to gastrectomy and distal pancreatomy with gastrodigiunostomia due to gastric adenocarcinoma four years ago; splenectomied in the same operation, long treatment with hydantoin, and corticosteroids. The patient was managed in the internal medicine unit due to a problematic respiratory infection with cardiac rhythm disorder and progressive debility in lower limbs, together with cutaneous lesions in which "alternaria sp" was isolated by culture. After beginning treatment with oral itraconazole, his evolution was excellent. The main interest consists in the rareness and the original presentation of the cutaneous alternariosis in this case.

  7. [Cutaneous malignant melanoma: a retrospective study of seven years (2006-2012)].

    Science.gov (United States)

    Moreira, Jorge; Moreira, Elisabete; Azevedo, Filomena; Mota, Alberto

    2014-01-01

    Introdução: O melanoma maligno é a neoplasia cutânea mais agressiva, e a sua incidência tem vindo a aumentar nas últimas décadas. A possibilidade de cura depende de um diagnóstico atempado, sendo fundamental o conhecimento da sua epidemiologia para a implementação de programas de prevenção primária e deteção precoce do melanoma. Material e Métodos: Foi efetuada revisão dos processos clínicos dos doentes com melanoma maligno cutâneo primário, diagnosticados entre janeiro de 2006 e dezembro de 2012, no Centro Hospitalar de São João, Porto. Resultados: Analisaram-se os 148 casos de melanoma diagnosticados neste período, tendo-se observado um predomínio do sexo feminino (razão F:M - 1,6:1). A média etária na altura do diagnóstico foi de 61 anos. As localizações mais frequentemente envolvidas foram os membros inferiores e o tronco. No sexo masculino o dorso foi o local mais afetado, enquanto no sexo feminino as lesões ocorreram, preferencialmente, nas pernas. O melanoma de extensão superficial foi o subtipo predominante em quase todas as faixas etárias. Verificou-se um predomínio dos melanomas finos e o índice mitótico foi intermédio (1-6 mitoses/ mm2) na maioria dos doentes. A ulceração esteve presente em 22,3% dos casos e predominou nos melanomas espessos e no subtipo nodular. A maioria dos doentes encontrava-se no estádio IA. A progressão para doença metastática ocorreu em 20 doentes. Discussão: O perfil do doente com melanoma cutâneo, no Centro Hospitalar de São João, apresenta características relativamente semelhantes às descritas na literatura. Conclusão: O predomínio dos melanomas finos, considerados de melhor prognóstico, é provavelmente, o resultado de um diagnóstico cada vez mais precoce.

  8. Mutation Scanning of D1705 and D1709 in the RNAse IIIb Domain of MicroRNA Processing Enzyme Dicer in Cutaneous Melanoma.

    Science.gov (United States)

    Sand, Michael; Bechara, Falk G; Skrygan, Marina; Sand, Daniel; Gambichler, Thilo; Bromba, Michael; Stockfleth, Eggert; Hessam, Schapoor

    2016-07-01

    Since the discovery of microRNAs (miRNAs) there have been performed several studies showing perturbations in the expression of miRNAs and the miRNA expression machinery in cutaneous melanoma. Dicer, a pivotal cytosolic enzyme of miRNA maturation has shown to be affected by both somatic and germline mutations in a variety of cancers. Recent studies have shown that recurrent somatic mutations of Dicer frequently affect the metal-ion-binding sites D1709 and D1705 of its RNase IIIb domain, therefore called hot spot mutations. The present study investigates metal-ion-binding sites D1709 and D1705 of the Dicer RNase IIIb domain in cutaneous melanomas and melanoma metastasis by Sanger sequencing. All investigated samples showed wildtype sequence and no single mutation was detected. The miRNA processing enzyme Dicer of melanoma and melanoma metastasis does not appear to be affected by mutation in the metal-ion-binding sites D1709 and D1705 of its RNase IIIb domain.

  9. P-REX1 amplification promotes progression of cutaneous melanoma via the PAK1/P38/MMP-2 pathway.

    Science.gov (United States)

    Wang, Jinhua; Hirose, Hajime; Du, Guanhua; Chong, Kelly; Kiyohara, Eiji; Witz, Isaac P; Hoon, Dave S B

    2017-10-28

    P-REX1 (PIP3-dependent Rac exchange factor-1) is a guanine nucleotide exchange factor that activates Rac by catalyzing exchange of GDP for GTP bound to Rac. Aberrant up-regulation of P-REX1 expression has a role in metastasis however, copy number (CN) and function of P-REX1 in cutaneous melanoma are unclear. To explore the role of P-REX1 in melanoma, SNP 6.0 and Exon 1.0 ST microarrays were assessed. There was a higher CN (2.82-fold change) of P-REX1 in melanoma cells than in melanocytes, and P-REX1 expression was significantly correlated with P-REX1 CN. When P-REX1 was knocked down in cells by P-REX1 shRNA, proliferation, colony formation, 3D matrigel growth, and migration/invasiveness were inhibited. Loss of P-REX1 inhibited cell proliferation by inhibiting cyclin D1, blocking cell cycle, and increased cell apoptosis by reducing expression of the protein survivin. Knockdown of P-REX1 expression inhibited cell migration/invasiveness by disrupting P-REX1/RAC1/PAK1/p38/MMP-2 pathway. Assessment of patient tumors and disease outcome demonstrated lower distant metastasis-free survival among AJCC stage I/II/III patients with high P-REX1 expression compared to patients with low P-REX1 expression. These results suggest P-REX1 plays an important role in tumor progression and a potential theranostic target. Copyright © 2017. Published by Elsevier B.V.

  10. Effect of vaccination with N-glycolyl GM3/VSSP vaccine by subcutaneous injection in patients with advanced cutaneous melanoma.

    Science.gov (United States)

    Osorio, Marta; Gracia, Elias; Reigosa, Edmundo; Hernandez, Julio; de la Torre, Ana; Saurez, Giselle; Perez, Kirenia; Viada, Carmen; Cepeda, Meylán; Carr, Adriana; Avila, Yisel; Rodríguez, Migdalia; Fernandez, Luis E

    2012-01-01

    NeuGc-containing gangliosides have been described in melanoma cells and are an attractive target for cancer immunotherapy because they are minimally or not expressed in normal human tissues. Melanoma patients treated with a vaccine based on N-glycolyl gangliosides have shown benefit in progression free survival and overall survival. We conducted a multicenter Phase I/II clinical trial in patients with metastatic cutaneous melanoma treated with the N-gycolyl GM3/very-small-size proteoliposomes vaccine by the subcutaneous route. Selecting the optimal biological dose of the vaccine was the principal objective based on immunogenicity, efficacy, and safety results. Six dose levels were studied and the treatment schedule consisted of five doses administered every 2 weeks and then monthly until 15 doses had been given. Dose levels evaluated were 150, 300, 600, 900, 1200, and 1500 μg with five patients included in each dose level except the 900 μg dose (n = 10). Immunogenicity was determined by antibody titers generated in patients after vaccination. Antitumor effect was measured by response criteria of evaluation in solid tumors and safety was evaluated by common toxicity criteria of adverse events. The vaccine was safe and immunogenic at all doses levels. The most frequent adverse events related to vaccination were mild to moderate injection site reactions and flu-like symptoms. Vaccination induced specific anti-NeuGcGM3 immunoglobulin M and immunoglobulin G antibody responses in all patients. Disease control (objective response or stable disease) was obtained in 38.46% of patients. Global median overall survival was 20.20 months. Two patients achieved overall survival duration of about 4 and 5 years, respectively. The 900 μg dose resulted in overall survival duration of 19.40 months and was selected as the biological optimal dose.

  11. Identification of plasma microRNAs as new potential biomarkers with high diagnostic power in human cutaneous melanoma.

    Science.gov (United States)

    Fogli, Stefano; Polini, Beatrice; Carpi, Sara; Pardini, Barbara; Naccarati, Alessio; Dubbini, Nevio; Lanza, Maria; Breschi, Maria Cristina; Romanini, Antonella; Nieri, Paola

    2017-05-01

    Melanoma is a devastating disease with few therapeutic options in the advanced stage and with the urgent need of reliable biomarkers for early detection. In this context, circulating microRNAs are raising great interest as diagnostic biomarkers. We analyzed the expression profiles of 21 selected microRNAs in plasma samples from melanoma patients and healthy donors to identify potential diagnostic biomarkers. Data analysis was performed using global mean normalization and NormFinder algorithm. Linear regression followed by receiver operating characteristic analyses was carried out to evaluate whether selected plasma miRNAs were able to discriminate between cases and controls. We found five microRNAs that were differently expressed among cases and controls after Bonferroni correction for multiple testing. Specifically, miR-15b-5p, miR-149-3p, and miR-150-5p were up-regulated in plasma of melanoma patients compared with healthy controls, while miR-193a-3p and miR-524-5p were down-regulated. Receiver operating characteristic analyses of these selected microRNAs provided area under the receiver operating characteristic curve values ranging from 0.80 to 0.95. Diagnostic value of microRNAs is improved when considering the combination of miR-149-3p, miR-150-5p, and miR-193a-3p. The triple classifier had a high capacity to discriminate between melanoma patients and healthy controls, making it suitable to be used in early melanoma diagnosis.

  12. Recurrence and survival after neck dissections in cutaneous head and neck melanoma

    DEFF Research Database (Denmark)

    Andersen, Peter Stemann; Chakera, Annette Hougaard; Thamsborg, Andreas Key Milan

    2014-01-01

    INTRODUCTION: An important prognostic factor in head and neck melanoma is the status of the regional lymph nodes since the presence of metastatic disease in the nodes greatly aggravates the prognosis. There is no consensus on the surgical treatment algorithm for this group. Our aim was to study...... if there is a difference in nodal recurrence and survival after radical, modified or selective neck dissection. METHODS: A total of 57 patients treated for regional meta-stases of head and neck melanoma were analysed retrospectively with respect to type of neck dissection, use of sentinel node biopsy, nodal recurrence...

  13. Survival after a psychoeducational intervention for patients with cutaneous malignant melanoma: a replication study

    DEFF Research Database (Denmark)

    Boesen, Ellen H; Boesen, Sidsel H; Frederiksen, Kirsten

    2007-01-01

    The results of a randomized, intervention study done in 1993 of psychoeducation for patients with early-stage malignant melanoma showed a beneficial effect on recurrence and survival 6 years after the intervention. In the present study, we replicated the study with 258 Danish patients with malign...

  14. New diagnostic techniques in staging in the surgical treatment of cutaneous malignant melanoma

    NARCIS (Netherlands)

    Cobben, DCP; Koopal, S; Tiebosch, ATMG; Jager, PL; Elsinga, PH; Wobbes, T; Hoekstra, HJ

    2002-01-01

    The emphasis of the research on the surgical treatment of melanoma has been on the resection margins, the role of elective lymph node dissection. in high risk patients and the value of adjuvant regional treatment with hyperthermic isolated lymph perfusion with melphalan. Parallel to this research,

  15. Tratamiento de los melanomas cutáneos de la cabeza y el cuello: Estado actual The current state of treatment for cutaneous melanoma of the head and neck

    Directory of Open Access Journals (Sweden)

    P.M. Villarreal Renedo

    2005-08-01

    Full Text Available Objetivo. Demostrar nuestra experiencia en el tratamiento del melanoma cutáneo de cabeza y cuello, así como en el estadiaje ganglionar regional a través de la detección y biopsia de los ganglios centinelas cervicofaciales. Métodos. Analizamos los casos de melanoma de cabeza y cuello tratados a lo largo de los últimos 3 años. Los pacientes que nos fueron enviados con metástasis cervicofaciales fueron tratados mediante linfadenectomías cervicales acompañadas de parotidectomías si existían ganglios peri o intraparotídeos afectos. En los pacientes enviados sin resecar el tumor primario, tras la biopsia preoperatoria y el estudio de extensión, se realizó la identificación y exéresis de los ganglios centinelas cervicofaciales, la resección del primario y la reconstrucción del defecto creado mediante colgajos locorregionales. Resultados. El melanoma se asocia con un excelente pronóstico a largo plazo si se detecta y trata en estadios precoces. La técnica de la identificación y exéresis de los ganglios centinelas cervicofaciales es factible en los melanomas de cabeza y cuello. Conclusión. La técnica de detección y biopsia de los ganglios centinelas regionales se considera el procedimiento de elección para realizar el estadiaje ganglionar regional en el melanoma de cabeza y cuello. Permite aumentar la eficacia y sensibilidad del estudio histopatológico, al seleccionar los ganglios linfáticos cervicofaciales con mayor probabilidad de encontrar focos metastásicos.Objective. To demonstrate our experience in the treatment of head and neck cutaneous melanoma and the regional lymph nodes staging, by the sentinel lymph nodes biopsy technique. Methods. We analyze the cases of head and neck cutaneous melanoma treated during the last 3 years. Patients with cervical and/or facial metastases were treated by neck dissection plus parotidectomy if peripheral or intra-parotid nodes were affected. In the patients with primary tumours, a

  16. High-Dose Recombinant Interferon Alfa-2B, Ipilimumab, or Pembrolizumab in Treating Patients With Stage III-IV High Risk Melanoma That Has Been Removed by Surgery

    Science.gov (United States)

    2016-10-10

    Metastatic Non-Cutaneous Melanoma; Non-Cutaneous Melanoma; Recurrent Melanoma of the Skin; Recurrent Non-Cutaneous Melanoma; Stage III Mucosal Melanoma of the Head and Neck; Stage IIIA Skin Melanoma; Stage IIIB Skin Melanoma; Stage IIIC Skin Melanoma; Stage IV Skin Melanoma; Stage IVA Mucosal Melanoma of the Head and Neck; Stage IVB Mucosal Melanoma of the Head and Neck; Stage IVC Mucosal Melanoma of the Head and Neck

  17. Dual-energy computed tomography in patients with cutaneous malignant melanoma: Comparison of noise-optimized and traditional virtual monoenergetic imaging.

    Science.gov (United States)

    Martin, Simon S; Wichmann, Julian L; Weyer, Hendrik; Albrecht, Moritz H; D'Angelo, Tommaso; Leithner, Doris; Lenga, Lukas; Booz, Christian; Scholtz, Jan-Erik; Bodelle, Boris; Vogl, Thomas J; Hammerstingl, Renate

    2017-10-01

    The aim of this study was to investigate the impact of noise-optimized virtual monoenergetic imaging (VMI+) reconstructions on quantitative and qualitative image parameters in patients with cutaneous malignant melanoma at thoracoabdominal dual-energy computed tomography (DECT). Seventy-six patients (48 men; 66.6±13.8years) with metastatic cutaneous malignant melanoma underwent DECT of the thorax and abdomen. Images were post-processed with standard linear blending (M_0.6), traditional virtual monoenergetic (VMI), and VMI+ technique. VMI and VMI+ images were reconstructed in 10-keV intervals from 40 to 100keV. Attenuation measurements were performed in cutaneous melanoma lesions, as well as in regional lymph node, subcutaneous and in-transit metastases to calculate objective signal-to-noise (SNR) and contrast-to-noise (CNR) ratios. Five-point scales were used to evaluate overall image quality and lesion delineation by three radiologists with different levels of experience. Objective indices SNR and CNR were highest at 40-keV VMI+ series (5.6±2.6 and 12.4±3.4), significantly superior to all other reconstructions (all PVMI+ reconstructions (median 5, respectively; P≤0.019) regarding overall image quality. Moreover, qualitative assessment of lesion delineation peaked in 40-keV VMI+ (median 5) and 50-keV VMI+ (median 4; P=0.055), significantly superior to all other reconstructions (all PVMI+ reconstructions substantially increase quantitative and qualitative image parameters, as well as subjective lesion delineation compared to standard image reconstruction and traditional VMI in patients with cutaneous malignant melanoma at thoracoabdominal DECT. Copyright © 2017 Elsevier B.V. All rights reserved.

  18. Melanoma

    Science.gov (United States)

    ... from generations ago. Back in your parents' and grandparents' day, most people (including doctors) thought it was safe and even ... it again somewhere else) Although it's less likely, people can still get melanoma even if they're dark skinned, young, and have no family history. Even for them, ...

  19. Computer-Aided Diagnosis of Micro-Malignant Melanoma Lesions Applying Support Vector Machines.

    Science.gov (United States)

    Jaworek-Korjakowska, Joanna

    2016-01-01

    Background. One of the fatal disorders causing death is malignant melanoma, the deadliest form of skin cancer. The aim of the modern dermatology is the early detection of skin cancer, which usually results in reducing the mortality rate and less extensive treatment. This paper presents a study on classification of melanoma in the early stage of development using SVMs as a useful technique for data classification. Method. In this paper an automatic algorithm for the classification of melanomas in their early stage, with a diameter under 5 mm, has been presented. The system contains the following steps: image enhancement, lesion segmentation, feature calculation and selection, and classification stage using SVMs. Results. The algorithm has been tested on 200 images including 70 melanomas and 130 benign lesions. The SVM classifier achieved sensitivity of 90% and specificity of 96%. The results indicate that the proposed approach captured most of the malignant cases and could provide reliable information for effective skin mole examination. Conclusions. Micro-melanomas due to the small size and low advancement of development create enormous difficulties during the diagnosis even for experts. The use of advanced equipment and sophisticated computer systems can help in the early diagnosis of skin lesions.

  20. Computer-Aided Diagnosis of Micro-Malignant Melanoma Lesions Applying Support Vector Machines

    Directory of Open Access Journals (Sweden)

    Joanna Jaworek-Korjakowska

    2016-01-01

    Full Text Available Background. One of the fatal disorders causing death is malignant melanoma, the deadliest form of skin cancer. The aim of the modern dermatology is the early detection of skin cancer, which usually results in reducing the mortality rate and less extensive treatment. This paper presents a study on classification of melanoma in the early stage of development using SVMs as a useful technique for data classification. Method. In this paper an automatic algorithm for the classification of melanomas in their early stage, with a diameter under 5 mm, has been presented. The system contains the following steps: image enhancement, lesion segmentation, feature calculation and selection, and classification stage using SVMs. Results. The algorithm has been tested on 200 images including 70 melanomas and 130 benign lesions. The SVM classifier achieved sensitivity of 90% and specificity of 96%. The results indicate that the proposed approach captured most of the malignant cases and could provide reliable information for effective skin mole examination. Conclusions. Micro-melanomas due to the small size and low advancement of development create enormous difficulties during the diagnosis even for experts. The use of advanced equipment and sophisticated computer systems can help in the early diagnosis of skin lesions.

  1. Improving outcomes in patients with melanoma: strategies to ensure an early diagnosis

    Directory of Open Access Journals (Sweden)

    Voss RK

    2015-11-01

    Full Text Available Rachel K Voss,1 Tessa N Woods,1 Kate D Cromwell,1 Kelly C Nelson,2 Janice N Cormier1 1Department of Surgical Oncology, 2Department of Dermatology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA Abstract: Patients with thin, low-risk melanomas have an excellent long-term prognosis and higher quality of life than those who are diagnosed at later stages. From an economic standpoint, treatment of early stage melanoma consumes a fraction of the health care resources needed to treat advanced disease. Consequently, early diagnosis of melanoma is in the best interest of patients, payers, and health care systems. This review describes strategies to ensure that patients receive an early diagnosis through interventions ranging from better utilization of primary care clinics, to in vivo diagnostic technologies, to new “apps” available in the market. Strategies for screening those at high risk due to age, male sex, skin type, nevi, genetic mutations, or family history are discussed. Despite progress in identifying those at high risk for melanoma, there remains a lack of general consensus worldwide for best screening practices. Strategies to ensure early diagnosis of recurrent disease in those with a prior melanoma diagnosis are also reviewed. Variations in recurrence surveillance practices by type of provider and country are featured, with evidence demonstrating that various imaging studies, including ultrasound, computed tomography, positron emission tomography, and magnetic resonance imaging, provide only minimal gains in life expectancy, even for those with more advanced (stage III disease. Because the majority of melanomas are attributable to ultraviolet radiation in the form of sunlight, primary prevention strategies, including sunscreen use and behavioral interventions, are reviewed. Recent international government regulation of tanning beds is described, as well as issues surrounding the continued use artificial ultraviolet

  2. Superficial and deep lymph node dissection for stage III cutaneous melanoma: clinical outcome and prognostic factors

    Directory of Open Access Journals (Sweden)

    Mozzillo Nicola

    2013-02-01

    Full Text Available Abstract Background The aims of this retrospective analysis were to evaluate the effect of combined superficial and deep groin dissection on disease-free and melanoma-specific survival, and to identify the most important factors for predicting the involvement of deep nodes according to clinically or microscopically detected nodal metastases. Methods Between January 1996 and December 2005, 133 consecutive patients with groin lymph node metastases underwent superficial and deep dissection at the National Cancer Institute, Naples. Lymph node involvement was clinically evident in 84 patients and detected by sentinel node biopsy in 49 cases. Results The 5-year disease-free survival was significantly better for patients with superficial lymph node metastases than for patients with involvement of both superficial and deep lymph nodes (34.9% vs. 19.0%; P = 0.001. The 5-year melanoma-specific survival was also significantly better for patients with superficial node metastases only (55.6% vs. 33.3%; P = 0.001. Conclusions Metastasis in the deep nodes is the strongest predictor of both disease-free and melanoma-specific survival. Deep groin dissection should be considered for all patients with groin clinical nodal involvement, but might be spared in patients with a positive sentinel node. Prospective studies will clarify the issue further.

  3. BRAF mutations in cutaneous melanoma: no correlation with histological prognostic factors or overall survival Mutações BRAF em melanomas cutâneos: nenhuma correlação com fatores prognósticos e sobrevida global

    Directory of Open Access Journals (Sweden)

    Juliana Elizabeth Jung

    2010-12-01

    Full Text Available INTRODUCTION: Molecular biology techniques allow identification of molecular markers such as BRAF and c-Kit gene mutations in melanomas. Studies on genetic alterations in melanomas of South-American patients are sparse. OBJECTIVES: To identify the incidence of BRAF and c-Kit gene mutations in primary cutaneous melanomas in Brazilian patients and to evaluate pathogenetic and prognostic implications of these mutations correlating them with clinical and histopathological data. MATERIAL AND METHODS: Ninety-six surgical specimens of primary cutaneous melanoma and 15 corresponding metastasis were analyzed using TaqMan Real-Time polymerase chain reaction (PCR assays. RESULTS: In comparison with the medical literature, a relatively low frequency of BRAF mutation in primary (39% and metastatic (40% melanomas and complete absence of c-Kit gene mutations were demonstrated. BRAF mutations arose at an early stage during melanoma progression and were not involved in the transition of thin ( 1 mm melanomas. BRAF mutations are related to patients' younger age and to the pattern of sun exposure, although there was no correlation with any histological prognostic factor or overall survival. CONCLUSION: The identification of both BRAF and c-Kit mutation is not a suitable prognostic indicator in the Brazilian population. Moreover, the relatively low frequency of BRAF mutations brings into question if it actually plays a key role in melanoma pathogenesis.INTRODUÇÃO: Técnicas de biologia molecular permitem a identificação de marcadores moleculares como mutações dos genes BRAF e c-Kit em melanomas. Estudos de alterações genéticas em pacientes sul-americanos são escassos. OBJETIVOS: Identificar a incidência de mutações dos genes BRAF e c-Kit em melanomas cutâneos primários em uma série de pacientes brasileiros e avaliar as implicações patogenéticas e prognósticas dessas mutações, correlacionando-as com dados clínicos e histopatológicos. MATERIAL

  4. Systematic review of dermoscopy and digital dermoscopy/ artificial intelligence for the diagnosis of melanoma.

    Science.gov (United States)

    Rajpara, S M; Botello, A P; Townend, J; Ormerod, A D

    2009-09-01

    Dermoscopy improves diagnostic accuracy of the unaided eye for melanoma, and digital dermoscopy with artificial intelligence or computer diagnosis has also been shown useful for the diagnosis of melanoma. At present there is no clear evidence regarding the diagnostic accuracy of dermoscopy compared with artificial intelligence. To evaluate the diagnostic accuracy of dermoscopy and digital dermoscopy/artificial intelligence for melanoma diagnosis and to compare the diagnostic accuracy of the different dermoscopic algorithms with each other and with digital dermoscopy/artificial intelligence for the detection of melanoma. A literature search on dermoscopy and digital dermoscopy/artificial intelligence for melanoma diagnosis was performed using several databases. Titles and abstracts of the retrieved articles were screened using a literature evaluation form. A quality assessment form was developed to assess the quality of the included studies. Heterogeneity among the studies was assessed. Pooled data were analysed using meta-analytical methods and comparisons between different algorithms were performed. Of 765 articles retrieved, 30 studies were eligible for meta-analysis. Pooled sensitivity for artificial intelligence was slightly higher than for dermoscopy (91% vs. 88%; P = 0.076). Pooled specificity for dermoscopy was significantly better than artificial intelligence (86% vs. 79%; P artificial intelligence, which were not significantly different (P = 0.783). There were no significance differences in diagnostic odds ratio among the different dermoscopic diagnostic algorithms. Dermoscopy and artificial intelligence performed equally well for diagnosis of melanocytic skin lesions. There was no significant difference in the diagnostic performance of various dermoscopy algorithms. The three-point checklist, the seven-point checklist and Menzies score had better diagnostic odds ratios than the others; however, these results need to be confirmed by a large-scale high

  5. Genetic susceptibility to cutaneous melanoma in southern Switzerland: role of CDKN2A, MC1R and MITF.

    Science.gov (United States)

    Mangas, C; Potrony, M; Mainetti, C; Bianchi, E; Carrozza Merlani, P; Mancarella Eberhardt, A; Maspoli-Postizzi, E; Marazza, G; Marcollo-Pini, A; Pelloni, F; Sessa, C; Simona, B; Puig-Butillé, J A; Badenas, C; Puig, S

    2016-11-01

    Nearly 10% of all cases of cutaneous melanoma (CM) occur in patients with a personal or family history of the disease. To obtain information about genetic predisposition to CM in Ticino, the southern region of Switzerland, a zone with moderate-to-high CM incidence. We identified germline mutations in highly CM-associated genes (CDKN2A and CDK4) and low/medium-penetrance variants (MC1R and MITF) in patients with multiple primary CMs or individuals with one or more CM and a positive family history for CM or pancreatic cancer among first- or second-degree relatives. Healthy blood donors (n = 146) were included as a control group. From July 2010 to July 2012, 57 patients (41 pedigrees) were included. Twenty-six were melanoma-prone families (with at least two cases) and 15 had multiple CMs. Pancreatic cancer was found in six families. The CDKN2A mutation p.V126D was identified in seven patients (four families) with a founder effect, whereas CDKN2A A148T was detected in seven cases (five families) and seven healthy donors (odds ratio 2·76, 95% confidence interval 0·83-9·20). At least one MC1R melanoma-associated polymorphism was detected in 32 patients (78%) and 97 healthy donors (66%), with more than one polymorphism in 12 patients (29%) and 25 healthy donors (17%). The MITF variant p.E318K was identified in four patients from three additional pedigrees (7%) and one healthy control (0·7%). Inclusion criteria for the Ticino population for genetic assessment should follow the rule of two (two affected individuals in a family or a patient with multiple CMs), as we detected a CDKN2A mutation in almost 10% of our pedigrees (four of 41), MITF p.E318K in 7% (three of 41) and a higher number of MC1R variants than in the control population. © 2016 British Association of Dermatologists.

  6. Melanoma cutâneo: estudo epidemiológico de 30 anos em cidade do sul do Brasil, de 1980-2009 Cutaneous melanoma: a 30-year-long epidemiological study conducted in a city in southern Brazil, from 1980-2009

    Directory of Open Access Journals (Sweden)

    Nilton Naser

    2011-10-01

    Full Text Available FUNDAMENTOS: A incidência do melanoma e a mortalidade pela doença aumentaram nos últimos 30 anos na população caucasiana. No Brasil, dados em municípios não-capitais são escassos, necessitando de estudos epidemiológicos. OBJETIVOS: Avaliar a incidência e classificar melanomas cutâneos em Blumenau de 1980 a 2009. MÉTODO: Foram coletadas informações de 1.002 exames histopatológicos de indivíduos de Blumenau, considerando sexo, idade, localização primária, tipo histológico, nível de invasão (Clark e espessura tumoral (Breslow. Os coeficientes de incidência anuais brutos e ajustados foram calculados utilizandose o número de melanomas e a população estimada pelo Instituto Brasileiro de Geografia e Estatística entre 1980 e 2009. RESULTADOS: As taxas de incidência do melanoma atingiram 22,4 casos/100.000 habitantes/ano, 31,5 nas mulheres e 30,4 nos homens na taxa ajustada. As taxas de incidência padronizadas por década, faixa etária e sexo atingiram 141 casos em homens e 103 no sexo feminino por 100.000 habitantes/ano entre 65 a 69 anos. O melanoma disseminativo superficial aconteceu em 53% dos casos, seguido do melanoma nodular com 37%, e a principal localização foi no tronco (47%. Os diagnósticos precoces atingiram 62,5% com Breslow BACKGROUND: Melanoma incidence and mortality rates have increased over the past 30 years in the Caucasian population. In Brazil, data on non-capital cities are scarce, making epidemiological stu dies necessary. OBJECTIVES: To evaluate the incidence of and classify cutaneous melanomas in Blumenau from 1980 to 2009. METHOD: Data from 1002 histopathological examinations of individuals from Blumenau were collected, considering sex, age, primary site of involvement, histological type, level of invasion (Clark's level and tumor thickness (Breslow's depth. The gross and adjusted coefficients of annual incidences were calculated based on the number of melanoma cases and the population estimated

  7. When narrative medicine helps in the diagnosis of conjunctival melanoma – an exceptional case report [

    Directory of Open Access Journals (Sweden)

    Nunes, Ana Teresa

    2012-07-01

    Full Text Available [english] Introduction: Conjunctival melanoma is a relatively rare ocular malignancy with substantial associated morbidity and mortality. It can arise in previously unblemished and unpigmented regions (approximately 10% of cases, from a preexisting nevus (approximately 20% of cases, or from the flat, spreading pigmentation of primary acquired melanosis with atypia (60–70% of cases, actually called conjunctival melanocytic intraepithelial neoplasia (C-MIN with atypia (histopathologically more accurately term. Purpose: The authors describe an extremely rare case of malignant conjunctival melanoma, with a long evolution, in a young black woman. Results: Until now the patient has not shown any sign of relapse of this melanoma, after local excision.Conclusion: Conjunctival melanoma is a condition of concern because of its rarity and lethal potential. Advances in the understanding and management of this neoplasm have markedly reduced the mortality and possibly the morbidity associated with this malignancy. We observe that there are some cases of conjunctival melanoma that might be cured with only a local excision with posterior cryotherapy without more aggressive methods. The practice of narrative medicine brings new possibilities in the diagnosis and collection of classical history.

  8. Influence of having a home garden on personal UVR exposure behavior and risk of cutaneous malignant melanoma in Denmark.

    Science.gov (United States)

    Idorn, Luise Winkel; Thieden, Elisabeth; Philipsen, Peter Alshede; Wulf, Hans Christian

    2013-03-15

    There is a need for more knowledge concerning the association of higher socioeconomic status (SES) with cutaneous malignant melanoma (CMM). Having a home garden is associated with a higher SES. We aimed to study the influence of having a home garden on UVR exposure behavior and risk of CMM. Register study: We collected information from Danish national registers about gender, age, type of home and CMM among persons aged 16-75 in 2002-2006. A total of 5,118 CMM cases were identified. Risk of CMM of the trunk was increased by 46% (p Dosimeter study: During a summer season 194 participants living in the Capital area, Denmark, equally distributed in homes with and without a garden, wore personal electronic UVR dosimeters measuring time-stamped UVR doses continuously and filled in sun exposure diaries. While no difference was found in estimated yearly UVR dose between groups, participants with a home garden had more days exposing shoulders or upper body, and upper extremities outdoors than those without a garden (p = 0.026, age adjusted). People with a home garden are at increased risk of CMM of the trunk and extremities-body sites that seems to be exposed to a higher extent among people with home gardens. People with a higher SES are more likely to have a home garden. This may partly explain the well-known association of higher SES with CMM incidence. Copyright © 2012 UICC.

  9. Staging of cutaneous malignant melanoma by CT; CT-Staging kutaner maligner Melanome

    Energy Technology Data Exchange (ETDEWEB)

    Hoffend, J. [Klinikum der Stadt Ludwigshafen gGmbH, Zentralinstitut fuer diagnostische und interventionelle Radiologie, Ludwigshafen (Germany)

    2015-01-30

    Malignant melanomas are a challenge in radiological imaging diagnostics as they may metastasize into every organ and tissue. Cross-sectional imaging, in particular positron emission tomography computed tomography (PET/CT) and whole body magnetic resonance imaging (MRI), are considered the standards in the staging of melanomas. Because of its excellent availability CT, however, remains a widely employed staging modality. Familiarity with the manifold CT morphology of metastasized melanomas as it is described here is essential when interpreting dedicated CT and in addition useful when interpreting PET/CT results. In individual cases CT can assist in the detection of transient metastases. In the detection of locoregional lymph node metastases CT has a median sensitivity and specificity in meta-analyses of at best 61 % and 97 %, respectively, which is inferior to the performance of ultrasound (96 % and 99 %, respectively). According to meta-analyses, in the assessment of systemic tumor spread CT can detect the majority of metastases with a sensitivity and specificity of 51-63 % and 69-78 %, respectively, which is inferior to MRI and PET/CT. Therefore, if an exact staging is required for critical management decisions, MRI or PET/CT should be employed whenever possible. (orig.) [German] Maligne Melanome koennen in praktisch jedes Organ und Gewebe metastasieren und stellen daher eine Herausforderung fuer die radiologische Diagnostik dar. Schnittbildverfahren, bevorzugt PET/CT und MRT, werden heute als Standard in der Ausbreitungsdiagnostik von Melanomen angesehen. Wegen ihrer ubiquitaeren Verfuegbarkeit bleibt jedoch die CT ein vielfach genutztes Staginginstrument. Die Kenntnis der vielfaeltigen CT-Morphologie von Melanommetastasen, wie sie in diesem Beitrag beschrieben wird, ist ueber die dedizierte CT hinaus uebertragbar auf die von der aktuellen Leitlinie bevorzugte Bildgebung mit der PET/CT. Im Einzelfall kann die CT hilfreich bei der Detektion von In

  10. Dynamic infrared imaging of cutaneous melanoma and normal skin in patients treated with BNCT

    Energy Technology Data Exchange (ETDEWEB)

    Santa Cruz, G.A. [Dpto. de Instrumentacion y Control, Comision Nacional de Energia Atomica, Av. del Libertador 8250 (1429), Buenos Aires (Argentina)], E-mail: santacr@cnea.gov.ar; Bertotti, J.; Marin, J. [Universidad Favaloro, Solis 453 (1078), Buenos Aires (Argentina); Gonzalez, S.J. [Dpto. de Instrumentacion y Control, Comision Nacional de Energia Atomica, Av. del Libertador 8250 (1429), Buenos Aires (Argentina); CONICET, Avda. Rivadavia 1917 (1033), Buenos Aires (Argentina); Gossio, S. [FCEyN, Pabellon II, Ciudad Universitaria (1428), Buenos Aires (Argentina); Alvarez, D. [Fundacion Favaloro, Av. Belgrano 1746 (1093), Buenos Aires (Argentina); Roth, B.M.C.; Menendez, P. [Instituto de Oncologia Angel H. Roffo, Av. San Martin 5481 (1417), Buenos Aires (Argentina); Pereira, M.D. [Agencia Nacional de Promocion Cientifica y Tecnologica, PAV 22393 (Argentina); Albero, M.; Cubau, L.; Orellano, P. [INVAP S.E., F.P. Moreno 1089 (R8400AMU), S.C. de Bariloche, Rio Negro (Argentina); Liberman, S.J. [Dpto. de Instrumentacion y Control, Comision Nacional de Energia Atomica, Av. del Libertador 8250 (1429), Buenos Aires (Argentina)

    2009-07-15

    We recently initiated a program aimed to investigate the suitability of dynamic infrared imaging for following-up nodular melanoma patients treated with BNCT. The reason that makes infrared imaging attractive is the fact that it constitutes a functional and non-invasive imaging method, providing information on the normal and abnormal physiologic response of the nervous and vascular systems, as well as the local metabolic rate and inflammatory processes that ultimately appear as differences in the skin temperature. An infrared camera, with a focal plane array of 320x240 uncooled ferroelectric detectors is employed, which provides a video stream of the infrared emission in the 7-14 {mu}m wavelength band. A double blackbody is used as reference for absolute temperature calibration. After following a protocol for patient preparation and acclimatization, a basal study is performed. Subsequently, the anatomic region of interest is subjected to a provocation test (a cold stimulus), which induces an autonomic vasoconstriction reflex in normal structures, thus enhancing the thermal contrast due to the differences in the vasculature of the different skin regions. Radiation erythema reactions and melanoma nodules possess typically a faster temperature recovery than healthy, non-irradiated skin. However, some other non-pathological structures are also detectable by infrared imaging, (e.g. scars, vessels, arteriovenous anastomoses and injuries), thus requiring a multi-study comparison in order to discriminate the tumor signal. Besides the superficial nodules, which are readily noticeable by infrared imaging, we have detected thermal signals that are coincident with the location of non-palpable nodules, which are observable by CT and ultrasound. Diffuse regions of fast temperature recovery after a cold stimulus were observed between the third and sixth weeks post-BNCT, concurrent with the clinical manifestation of radiation erythema. The location of the erythematous visible and

  11. Factores de riesgo para melanoma cutáneo: Estudio de casos y controles en Córdoba, Argentina Risk factors for cutaneous melanoma: case-control study in Cordoba, Argentina

    Directory of Open Access Journals (Sweden)

    Alejandro Ruiz Lascano

    2004-12-01

    Full Text Available En los últimos años se han realizado considerables esfuerzos para identificar factores de riesgo asociados al incremento en la incidencia de melanoma maligno en la población blanca mundial. En Argentina los datos concernientes a factores de riesgo para melanoma maligno son limitados. Realizamos en el Hospital Privado de Córdoba un estudio de casos-controles con el objetivo de determinar factores de riesgo para melanoma maligno. El grupo de estudio fue de 65 pacientes con melanoma maligno y 195 controles pareados por sexo y edad. Los siguientes factores de riesgo fueron significativos en el análisis estadístico univariado: abuelos nacidos en Italia o España y en otros países europeos, color de pelo castaño y claro, color de piel claro, color de ojos marrón y claros, efélides, presencia de nevos melanocíticos, quemaduras solares graves antes de los 18 años de edad, exposición solar tanto laboral como recreativa y antecedente familiar de melanoma maligno, de éstos se mantienen como factores de riesgo independientes en el análisis multivariado abuelos nacidos en países europeos (OR 2.27, IC95% 1.08 a 3.46, piel clara (OR 4.99, IC95% 2.72 a 7.28 quemadura solar grave en más de 3 episodios antes de los 18 años (OR 6.47, IC95% 5.29 a 7.65 y antecedentes familiares de melanoma (OR 1525, IC95% 1467 a 1584. La mayoría de los datos que obtuvimos guardan semejanza con los descriptos en otras poblaciones.Over the past years, considerable effort has been directed toward the identification of risk factors associated with the increasing incidence of cutaneous melanoma in white populations worldwide. Limited data are available from Argentine populations concerning risk factors for malignant melanoma. A case-control study was performed in Cordoba to estimate the risk factors for cutaneous malignant melanoma. The study group comprised 65 patients and 195 controls, matched by age and sex. The following risk factors were significant in the

  12. Molecular biology techniques for the diagnosis of cutaneous T-cell lymphoma.

    Science.gov (United States)

    Wood, G S; Haeffner, A; Dummer, R; Crooks, C F

    1994-04-01

    The molecular biologic analysis of TCR gene rearrangements by Southern blot analysis and various PCR-based assays has contributed significantly to the understanding of CTCL. It is now known that CTCL is a monoclonal T-cell disorder like other T-cell neoplasms and that the same tumor clone is generally present in all sites of tissue involvement. Relative to histopathologic examination, the enhanced sensitivity of molecular biologic assays has allowed the diagnosis of CTCL at an early stage in many cases. In fact, molecular biologic analysis of TCR gene rearrangements suggests that CTCL may contain a dominant monoclonal tumor cell population from the time of its earliest clinically recognizable lesions, such as the cutaneous patches once termed large plaque parapsoriasis and now generally regarded as early CTCL. Furthermore, available data indicate that, at least in some cases, tumor cells are distributed widely among cutaneous and extracutaneous tissues at a time long before this involvement can be appreciated morphologically. It is apparent that, in addition to their value in the early diagnosis and staging of cutaneous lymphomas, these molecular biologic assays are valuable in monitoring the response to therapy, detecting early relapse, and improving understanding of the compartmentalization and trafficking of tumor cells. In order to reap the full clinical benefit from this new information, however, it is important to perform prospective long-term studies designed to determine the clinical significance of molecular biologic data. In addition, the complexity of cutaneous lymphoproliferative disorders dictates that molecular biologic clonality data should never be interpreted in a vacuum. In skin disease, dominant clonality does not always equate with clinical malignancy. The proper diagnosis of CTCL and other cutaneous lymphoproliferative diseases requires the thoughtful integration of molecular biologic data with the clinicopathologic and immunophenotypic

  13. Improved immunohistochemical evaluation of micrometastases in sentinel lymph nodes of cutaneous melanoma with 'MCW Melanoma Cocktail' – A mixture of monoclonal antibodies to MART-1, melan-A, and tyrosinase

    Directory of Open Access Journals (Sweden)

    Kampalath Bal

    2003-05-01

    Full Text Available Abstract Background MART-1, Melan-A, and Tyrosinase have shown encouraging results for evaluation of melanoma micrometastases in sentinel lymph nodes, as compared to conventionally used S-100 protein and HMB-45. To achieve higher sensitivity, some studies recommend evaluation of three sections, each at intervals of 200 μ. This would mean, routine staining of three adjacent sections in each of the three clusters at intervals of 200 μ, requiring nine slides resulting in added expense. If a cocktail of these antibodies could be used, only one section would be required instead of three generating significant cost savings. Methods We prepared a combination of monoclonal antibodies to these three immunomarkers in optimized dilutions (MART-1, clone M2-7C10, dilution 1:500; Melan-A, clone A103, dilution 1:100; and Tyrosinase, clone T311, dilution 1:50 and designated it as 'MCW melanoma cocktail'. Formalin-fixed paraffin-embedded tissue sections of sentinel lymph nodes from patients with cutaneous melanoma, without macro-metastases were evaluated with this cocktail. Results Melanoma micrometastases were easily detectable with the cocktail in 41 out of 188 slices (8/24 cases. The diagnostic accuracy amongst five pathologists did not show statistically significant difference. Out of 188 slices, 78 had adjacent sections immunostained individually with MART-1 and Melan-A during our previous study. Of these 78 slices, 21 were positive for melanoma micrometastases with MART-1 and Melan-A individually. However, the adjacent section of these slices immunostained with the cocktail detected metastases in four additional slices. Thus, MART-1 and Melan-A could not detect melanoma micrometastases individually in 16% (4/25 of slices positive with the cocktail. Benign capsular nevi were immunoreactive for the cocktail in 4.8% (9/188 slices. All 81 slices of negative test controls (sentinel lymph nodes of mammary carcinoma were interpreted correctly as negative for

  14. Methods of formation of the knowledge base in the diagnosis of melanoma

    Science.gov (United States)

    Selchuk, V. Y.; Rodionova, O. V.; Sukhova, O. G.; Polyakov, E. V.; Grebennikova, O. P.; Burov, D. A.; Emelianova, G. S.

    2017-01-01

    The method of building of information systems for the diagnosis of skin melanoma is described in the presented work. Malignant tumors at the level of macro - and microimages in combination with clinical data are investigated. The development is made with the use of MySQL. An information system is a result of joint activities of the National research nuclear University “MEPhI” (Moscow Engineering Physics Institute) with N. N. Blokhin Russian Cancer Scientific Center.

  15. How Is Melanoma Skin Cancer Diagnosed?

    Science.gov (United States)

    ... Early Detection, Diagnosis, and Staging Tests for Melanoma Skin Cancer Most melanomas are brought to a doctor’s attention ... Melanoma Skin Cancer, by Stage More In Melanoma Skin Cancer About Melanoma Skin Cancer Causes, Risk Factors, and ...

  16. Workplace investigation of increased diagnosis of malignant melanoma among employees of Lawrence Livermore National Laboratory

    Energy Technology Data Exchange (ETDEWEB)

    Moore, D.H. II; Patterson, H.W.; Hatch, F.; Discher, D.; Schneider, J.S.; Bennett, D.

    1994-08-01

    Based on rates for the surrounding communities, the diagnosis rate of malignant melanoma for employees of Lawrence Livermore National Laboratory (LLNL) during 1972 to 1977 was three to four times higher than expected. In 1984 Austin and Reynolds concluded, as a result of a case-control study, that five occupational factors were {open_quotes}causally associated{close_quotes} with melanoma risk at LLNL. These factors were: (1) exposure to radioactive materials, (2) work at Site 300, (3) exposure to volatile photographic chemicals, (4) presence at the Pacific Test Site, and (5) chemist duties. Subsequent reviews of the Austin and Reynolds report concluded that the methods used were appropriate and correctly carried out. These reports did determine, however, that Austin and Reynolds` conclusion concerning a causal relationship between occupational factors and melanoma among employees was overstated. There is essentially no supporting evidence linking the occupational factors with melanoma from animal studies or human epidemiology. Our report summarizes the results of further investigation of potential occupational factors.

  17. 4-nitroquinoline-1-oxide-induced mutagen sensitivity and risk of cutaneous melanoma: a case-control analysis.

    Science.gov (United States)

    Wang, Li-E; Li, Chunying; Xiong, Ping; Gershenwald, Jeffrey E; Prieto, Victor G; Duvic, Madeleine; Lee, Jeffrey E; Grimm, Elizabeth A; Hsu, Tao C; Wei, Qingyi

    2016-04-01

    Mutagen sensitivity assay, which measures the enhanced cellular response to DNA damage induced in vitro by mutagens/carcinogens, has been used in the study of cancer susceptibility. 4-Nitroquinoline-1-oxide (4-NQO), an ultraviolet (UV) radiation-mimetic chemical, can produce chromosomal breaks in mammalian cells and induce cancer. Given the potential role of 4-NQO as the experimental mutagen substituting for UV as the etiological carcinogen of cutaneous melanoma (CM), we tested the hypothesis that cellular sensitivity to 4-NQO is associated with the risk of developing CM in a case-control study of 133 patients with primary CM and 176 cancer-free controls. Short-term blood cultures were treated with 4-NQO at a final concentration of 10 μmol/l for 24 h and scored chromatid breaks in 50 well-spread metaphases. Multivariate logistic regression was used to calculate odds ratios and 95% confidence intervals. We found that the log-transformed frequency of chromatid breaks was significantly higher in 133 patients than in 176 controls (P=0.004) and was associated with an increased risk for CM (adjusted odds ratio=1.78, 95% confidence interval: 1.12-2.84) after adjustment for age and sex. Moreover, as the chromatid break values increased, the risk for CM increased in a dose-dependent manner (P(trend)=0.003). Further analysis explored a multiplicative interaction between the sensitivity to 4-NQO and a family history of skin cancer (P(interaction)=0.004) on the risk of CM. Therefore, our findings suggest that sensitivity to 4-NQO may be a risk factor for the risk of CM, which is more sensitive than UV-induced chromotid breaks.

  18. The measurement of constitutive and facultative skin pigmentation and estimation of sun exposure in Caucasians with basal cell carcinoma and cutaneous malignant melanoma

    DEFF Research Database (Denmark)

    Lock-Andersen, J; Drzewiecki, K T; Wulf, H C

    1998-01-01

    In two identical and simultaneously performed case-control studies of basal cell carcinoma (BCC) and cutaneous malignant melanoma (CMM) with age-matched, sex-matched and residence-matched controls, skin pigmentation was measured objectively by skin reflectance spectroscopy in 145 BCC patients...... by all subjects. There were no statistically significant differences in constitutive skin pigmentation at the buttocks between BCC patients and controls (P = 0.96) or between CMM patients and controls (P = 0.13). Facultative skin pigmentation in ultraviolet-exposed sites was not significantly different...

  19. Eye and hair colour, skin type and constitutive skin pigmentation as risk factors for basal cell carcinoma and cutaneous malignant melanoma. A Danish case-control study

    DEFF Research Database (Denmark)

    Lock-Andersen, J; Drzewiecki, K T; Wulf, H C

    1999-01-01

    the present hair colour and eye colour, and the constitutive skin pigmentation was measured objectively by skin reflectance of UV unexposed buttock skin. There were no differences between basal cell carcinoma cases and controls in hair colour or eye colour or constitutive skin pigmentation, but more cases......To assess the importance of hair and eye colour, skin type and constitutive skin pigmentation as risk factors for basal cell carcinoma and cutaneous malignant melanoma in fair-skinned Caucasians, we conducted two identical case-control studies in Denmark. We studied 145 cases with basal cell...

  20. Sporothrix schenckii Sensu Lato identification in fragments of skin lesion cultured in NNN medium for differential diagnosis of cutaneous leishmaniasis.

    Science.gov (United States)

    Antonio, Liliane de Fátima; Pimentel, Maria Inês Fernandes; Lyra, Marcelo Rosandiski; Madeira, Maria de Fátima; Miranda, Luciana de Freitas Campos; Paes, Rodrigo Almeida; Brito-Santos, Fábio; Carvalho, Maria Helena Galdino Figueredo; Schubach, Armando de Oliveira

    2017-02-01

    Eighty-nine patients with clinical suspicion of leishmaniasis were referred for differential diagnosis. Sporothrix schenckii sensu lato was isolated in Novy-MacNeal-Nicolle + Schneider media in 98% of 64 patients with final diagnosis of sporotrichosis. This medium may be suitable for diagnosis of sporotrichosis in areas where cutaneous leishmaniasis is also endemic.

  1. Histologic and Phenotypic Factors and MC1R Status Associated with BRAF(V600E), BRAF(V600K), and NRAS Mutations in a Community-Based Sample of 414 Cutaneous Melanomas.

    Science.gov (United States)

    Hacker, Elke; Olsen, Catherine M; Kvaskoff, Marina; Pandeya, Nirmala; Yeo, Abrey; Green, Adèle C; Williamson, Richard M; Triscott, Joe; Wood, Dominic; Mortimore, Rohan; Hayward, Nicholas K; Whiteman, David C

    2016-04-01

    Cutaneous melanomas arise through causal pathways involving interplay between exposure to UV radiation and host factors, resulting in characteristic patterns of driver mutations in BRAF, NRAS, and other genes. To gain clearer insights into the factors contributing to somatic mutation genotypes in melanoma, we collected clinical and epidemiologic data, performed skin examinations, and collected saliva and tumor samples from a community-based series of 414 patients aged 18 to 79, newly diagnosed with cutaneous melanoma. We assessed constitutional DNA for nine common polymorphisms in melanocortin-1 receptor gene (MC1R). Tumor DNA was assessed for somatic mutations in 25 different genes. We observed mutually exclusive mutations in BRAF(V600E) (26%), BRAF(V600K) (8%), BRAF(other) (5%), and NRAS (9%). Compared to patients with BRAF wild-type melanomas, those with BRAF(V600E) mutants were significantly younger, had more nevi but fewer actinic keratoses, were more likely to report a family history of melanoma, and had tumors that were more likely to harbor neval remnants. BRAF(V600K) mutations were also associated with high nevus counts. Both BRAF(V600K) and NRAS mutants were associated with older age but not with high sun exposure. We also found no association between MC1R status and any somatic mutations in this community sample of cutaneous melanomas, contrary to earlier reports.

  2. Cytological diagnosis of Langerhans cell histiocytosis with cutaneous involvement

    Directory of Open Access Journals (Sweden)

    Sushama A Chandekar

    2013-01-01

    Full Text Available Langerhans cell histiocytosis (LCH is a rare disease affecting predominantly children. The course of the disease varies, from spontaneous resolution to a progressive multisystem disorder with organ dysfunction and potential life-threatening complications. Diagnosis of LCH is often difficult and may be delayed because of its rarity and especially so if it occurs with unusual presentation. Fine needle aspiration cytology of a 4 year old male child, a case of LCH is presented with a purpose of highlighting the characteristic cytological features. A high index of suspicion, awareness of characteristic cytological features of LCH and its differential diagnoses is necessary. This can obviate the need of biopsy and electron microscopy. Immunohistochemistry if available can be performed on cytology smear and cell block.

  3. Are all melanomas dangerous?

    DEFF Research Database (Denmark)

    Nørgaard, Carsten; Glud, Martin; Gniadecki, Robert

    2011-01-01

    The increased incidence of cutaneous malignant melanoma, together with only minor changes in mortality, has brought into question the existence of a melanoma epidemic. The discrepancy between incidence and mortality suggests that most newly diagnosed melanomas have indolent behaviour. This review...

  4. Burden of Melanoma

    NARCIS (Netherlands)

    C. Holterhues (Cynthia)

    2011-01-01

    markdownabstract__Abstract__ Melanoma is a type of skin cancer that arises from melanocytes. More than 95% of all melanomas occur in the skin, but rarely in the pigmented cells of the eye, meninges or mucosa. This thesis will only regard the invasive cutaneous malignant melanomas.

  5. Drug effects on melanoma

    NARCIS (Netherlands)

    Koomen, Elsje Rosalie

    2010-01-01

    Cutaneous melanoma is the most aggressive form of skin cancer and its incidence among Caucasian populations has increased whereas mortality rates are stabilizing or decreasing. The total burden of melanoma is expected to be increasing. As effective treatment options for advanced melanoma are lackin

  6. Drug effects on melanoma

    NARCIS (Netherlands)

    Koomen, Elsje Rosalie

    2010-01-01

    Cutaneous melanoma is the most aggressive form of skin cancer and its incidence among Caucasian populations has increased whereas mortality rates are stabilizing or decreasing. The total burden of melanoma is expected to be increasing. As effective treatment options for advanced melanoma are

  7. Mobile teledermoscopy--melanoma diagnosis by one click?

    Science.gov (United States)

    Massone, Cesare; Brunasso, Alexandra M G; Campbell, Terri M; Soyer, H Peter

    2009-09-01

    Mobile telemedicine integrates wireless communications for different telemedical applications, such as mobile phones and personal digital assistants, and with the implementation of modern wireless telecommunication, wireless local area network and satellite communication is a reality. New generation cellular phones or personal digital assistants have overcome limitations of image quality seen in older devices and, with dermatology being a visual profession, mobile teledermatology is perhaps the most recent development in this field. Mobile teledermatology may provide a triage service aimed toward management of patients with emergent skin disease or for follow-up with patients requiring systemic treatment. Teledermoscopy enables rapid transmission of dermoscopic images via e-mail or specific web-application and studies have demonstrated a high, 91%, concordance between face-to-face diagnosis and remote diagnosis of such images. Further to this, telediagnosis of melanocytic skin neoplasms achieved a diagnostic accuracy of 83% versus the conventional histopathologic diagnosis. Mobile teledermoscopy is the combination of such approaches enabling transfer of images captured with cellular phones coupled with a pocket dermatoscope and preliminary studies have demonstrated the feasibility and potential of its use in triage of pigmented lesions. Such applications are of benefit to physicians in enabling easy storage of data for follow-up or referral of images for expert second opinion and may facilitate a "person-centered health system" for patients with numerous moles and pigmented skin lesions who could forward images for evaluation. The incidence of skin cancers has reached epidemic proportions among whites and the trend is still going upward. Mobile teledermatology and teledermoscopy may be implemented as a triage or screening tool for malignant tumors to facilitate early detection and diagnosis, which is crucial for improved patient outcomes. While the legal aspects

  8. Chronic Localized Back Pain Due to Posterior Cutaneous Nerve Entrapment Syndrome (POCNES): A New Diagnosis.

    Science.gov (United States)

    Boelens, Oliver B; Maatman, Robert C; Scheltinga, Marc R; van Laarhoven, Kees; Roumen, Rudi M

    2017-03-01

    Most patients with chronic back pain suffer from degenerative thoracolumbovertebral disease. However, the following case illustrates that a localized peripheral nerve entrapment must be considered in the differential diagnosis of chronic back pain. We report the case of a 26-year-old woman with continuous excruciating pain in the lower back area. Previous treatment for nephroptosis was to no avail. On physical examination the pain was present in a 2 x 2 cm area overlying the twelfth rib some 4 cm lateral to the spinal process. Somatosensory testing using swab and alcohol gauze demonstrated the presence of skin hypo- and dysesthesia over the painful area. Local pressure on this painful spot elicited an extreme pain response that did not irradiate towards the periphery. These findings were highly suggestive of a posterior version of the anterior cutaneous nerve entrapment syndrome (ACNES), a condition leading to a severe localized neuropathic pain in anterior portions of the abdominal wall. She demonstrated a beneficial albeit temporary response after lidocaine infiltration as dictated by an established diagnostic and treatment protocol for ACNES. She subsequently underwent a local neurectomy of the involved superficial branch of the intercostal nerve. This limited operation had a favorable outcome resulting in a pain-free return to normal activities up to this very day (follow-up of 24 months).We propose to name this novel syndrome "posterior cutaneous nerve entrapment syndrome" (POCNES). Each patient with chronic localized back pain should undergo simple somatosensory testing to detect the presence of overlying skin hypo- and dysesthesia possibly reflecting an entrapped posterior cutaneous nerve.Key words: Chronic pain, back pain, posterior cutaneous nerve entrapment, peripheral nerve entrapment, surgical treatment for pain, anterior cutaneous nerve entrapment.

  9. Systemic Levamisole-Induced Vasculitis in a Cocaine User without Cutaneous Findings: A Consideration in Diagnosis.

    Science.gov (United States)

    Baptiste, Gillian G; Alexopoulos, Anastasia-Stefania; Masud, Tahsin; Bonsall, Joanna M

    2015-01-01

    Levamisole is a known immunomodulating agent frequently used as a cutting agent in cocaine consumed in the United States today. Numerous cases of anti-neutrophil cytoplasmic antibody (ANCA) vasculitis connected with the use of levamisole-adulterated cocaine have previously been reported in the literature, classically characterized by a retiform purpuric rash. We report a case of a crack-cocaine user without cutaneous abnormalities who developed ANCA-associated glomerulonephritis that progressed to renal failure. This case demonstrates the difficulties in solidifying the diagnosis of levamisole-induced vasculitis in the absence of cutaneous findings and the need to pursue more testing to establish causality in ANCA-associated vasculitis that has potential for severe end-organ damage in patients who continue to use cocaine.

  10. Systemic Levamisole-Induced Vasculitis in a Cocaine User without Cutaneous Findings: A Consideration in Diagnosis

    Directory of Open Access Journals (Sweden)

    Gillian G. Baptiste

    2015-01-01

    Full Text Available Levamisole is a known immunomodulating agent frequently used as a cutting agent in cocaine consumed in the United States today. Numerous cases of anti-neutrophil cytoplasmic antibody (ANCA vasculitis connected with the use of levamisole-adulterated cocaine have previously been reported in the literature, classically characterized by a retiform purpuric rash. We report a case of a crack-cocaine user without cutaneous abnormalities who developed ANCA-associated glomerulonephritis that progressed to renal failure. This case demonstrates the difficulties in solidifying the diagnosis of levamisole-induced vasculitis in the absence of cutaneous findings and the need to pursue more testing to establish causality in ANCA-associated vasculitis that has potential for severe end-organ damage in patients who continue to use cocaine.

  11. Case report: Cutaneous amebiasis: the importance of molecular diagnosis of an emerging parasitic disease.

    Science.gov (United States)

    Morán, Patricia; Rojas, Liliana; Cerritos, René; Zermeño, Valeria; Valadez, Alicia; de Oca, Griselda Montes; Reyes, Miguel Ángel; González, Enrique; Partida, Oswaldo; Hernández, Eric; Nieves, Miriam; Portillo, Tobías; Gudiño, Marco; Ramiro, Manuel; Ximénez, Cecilia

    2013-01-01

    Cutaneous amebiasis is the least common clinical form of human amebiasis in Mexico, sexual amebiasis was only occasionally observed before the late 1980s. However, in the last few decades, most of the documented cases of cutaneous amebiasis from around the world are sexually transmitted. We present two cases of sexually transmitted genital amebiasis. The molecular characterization of the Entamoeba species in the affected tissues underlines the importance of an etiological diagnosis using specific and sensitive techniques that avoid the rapid destruction of tissues and the irreversible sequelae to the anatomy and function of the affected organs. In addition, for those interested in the study of the human-amoebic disease relationship and its epidemiology, the detection of a new, mixed infection in an invasive case of amebiasis reveals new perspectives in the study of the extraordinarily complex host-parasite relationship in amebiasis.

  12. Cutaneous Amebiasis: The Importance of Molecular Diagnosis of an Emerging Parasitic Disease

    Science.gov (United States)

    Morán, Patricia; Rojas, Liliana; Cerritos, René; Zermeño, Valeria; Valadez, Alicia; de Oca, Griselda Montes; Reyes, Miguel Ángel; González, Enrique; Partida, Oswaldo; Hernández, Eric; Nieves, Miriam; Portillo, Tobías; Gudiño, Marco; Ramiro, Manuel; Ximénez, Cecilia

    2013-01-01

    Cutaneous amebiasis is the least common clinical form of human amebiasis in Mexico, sexual amebiasis was only occasionally observed before the late 1980s. However, in the last few decades, most of the documented cases of cutaneous amebiasis from around the world are sexually transmitted. We present two cases of sexually transmitted genital amebiasis. The molecular characterization of the Entamoeba species in the affected tissues underlines the importance of an etiological diagnosis using specific and sensitive techniques that avoid the rapid destruction of tissues and the irreversible sequelae to the anatomy and function of the affected organs. In addition, for those interested in the study of the human-amoebic disease relationship and its epidemiology, the detection of a new, mixed infection in an invasive case of amebiasis reveals new perspectives in the study of the extraordinarily complex host-parasite relationship in amebiasis. PMID:23208883

  13. Melanoma cutâneo: estudo de base populacional em Goiânia, Brasil, de 1988 a 2000 Cutaneous melanoma: population-based study in Goiania, Brazil, from 1988 to 2000

    Directory of Open Access Journals (Sweden)

    Ana Maria Sortino-Rachou

    2006-10-01

    Full Text Available FUNDAMENTOS: O Registro de Câncer de Base Populacional de Goiânia disponibiliza dados de melanoma de uma série temporal de 13 anos, com 96,6% de confirmação histopatológica. OBJETIVO: Comparar incidência, mortalidade e tendências mundiais com os dados do primeiro estudo de base populacional de melanoma cutâneo do Brasil. MÉTODOS: Foram analisados 290 casos novos diagnosticados em residentes do município (incidência e 54 óbitos reportados ao Registro de Câncer de Goiânia (mortalidade, entre 1988 e 2000. Os coeficientes padronizados por idade e sexo foram calculados pela população mundial. Para análise das tendências, um modelo de regressão linear simples foi utilizado. RESULTADOS: Cento e quarenta e quatro casos de melanoma em mulheres e 146 em homens. Os coeficientes padronizados médios de incidência foram crescentes tanto para homens (r²=0,33; p=0,040 como para mulheres (r²=0,41; p=0,019, com tendência crescente nos homens acima de 60 anos e mulheres até 59 anos. Os coeficientes padronizados médios de mortalidade foram crescentes nos homens (r²=0,32; p=0,042 e estáveis nas mulheres, com tendência crescente para homens acima de 60 anos. CONCLUSÃO: Tanto em Goiânia como no mundo, a incidência de melanoma cutâneo é crescente para ambos os sexos. A mortalidade tende à estabilidade nas mulheres e é crescente para homens.BACKGROUND: The Goiania Population-Based Cancer Registry grants access to a 13-year temporal series on melanoma data, with a histopathologic confirmation of 96.6%. OBJECTIVE: To compare the world incidence, mortality and trends with data of the first populationbased study on cutaneous melanoma in Brazil. METHODS: Two hundred and ninety new cases of melanoma diagnosed in city residents (incidence and 54 deaths reported to the Goiania Cancer Registry (mortality were analyzed between 1988 and 2000. The standardized coefficients of age and sex were calculated using the world population. The trends

  14. Epidemiological Aspects and Differential Diagnosis of the Cutaneous Round Cell Tumors in Dogs

    Directory of Open Access Journals (Sweden)

    Roxana CORA

    2017-05-01

    Full Text Available Round cell neoplasms (RCNs are frequent cutaneous lesions in dogs, with high percentages among skin tumors. In this category are included histiocytoma, mast cell tumor, plasmacytoma, lymphoma and transmissible venereal tumor. The aim of the study was to perform an epidemiological study with reference to the cutaneous round cell tumors in a period of 10 years in the Department of Pathology (Faculty of Veterinary Medicine, Cluj-Napoca, Romania. Additionally, in the recorded cases with round cell tumors (mast cell tumor, histiocytoma and lymphoma we described the main histological and cytological features. The epidemiological data were collected from the records of Pathology Department between 2005-2014. The investigation included dogs diagnosed with cutaneous round cell neoplasms, following necropsy analysis or assessment of biopsies or cytological samples. All collected specimens were analyzed by histopathological and/or cytological techniques. The staining used for histological investigation were Hematoxylin-eosin, Masson’s trichrome and Toluidine blue, whereas Diff Quik and Wright methods were utilized in cytological specimens. The distribution of the cutaneous round cell tumors in relation to age, breed and sex was also assessed. The most frequent round cell tumor type was the mast cell tumor (19.54% followed by histiocytoma (11.33% and lymphoma (1.98%. The round cell tumors recorded were equally distributed in both males and females. Concerning the distribution of cutaneous RCNs by age (average age, histiocytoma occurred in 5 years old subjects, mast cell tumor in 11.9 years old subjects, and lymphoma in 6 years old subjects. Mast cell tumor was more frequent in stray dogs and Boxer breed, while histiocytoma occurred more commonly in stray dogs. Histological and cytological analysis was mandatory to perform the differential diagnosis between RCNs. Microscopic details concerning cytoplasm and nucleus of tumoral cells, together with the

  15. 皮肤黑素瘤70例临床与病理特征分析%Cutaneous Malignant Melanoma: Clinicopathological Analysis of 70 Cases

    Institute of Scientific and Technical Information of China (English)

    李薇薇; 涂平; 汪旸; 李航; 陈喜雪; 杨淑霞; 武玲慎; 李雪迎

    2012-01-01

    Objective To investigate the clinical and pathological features of cutaneous melanoma. Methods Clinical data of cutaneous melanoma confirmed pathologically from 1983 to 2010 in Peking University First Hospital were retrospectively analyzed by statistical methods. The cases which were pathologically diagnosed indecisively were confirmed by immunohistochemical stain. Results The peak age of onset were the fifth decade of life. Acral and non-acral malignant accounted for 70.00% and 30.00% respectively. The most common pathological subtype was acral lentiginous melanoma (ALM)which accounted 67.14%, following by lentigo maligna melanoma (LMM ) and superficial spreading melanoma (SSM) which accounted 11.43% and 10.00% respectively. The subtype of nodular melanoma(NM)was only 3 cases. There were statistical significances between exposed and unexposed location with regard to the primary lesions, and the distribution of invasive or situ(P = 0.045,0.013). Subungual melanomas have a predilection for fingers(P = 0.000). Conclusion The age of onset of melanoma may have been dropping in Chinese people; The relationship between trauma and occurrence of melanoma of acral sites should be confirmed further; The clinical ABCD criteria, which has high sensitivity, can be extended and become the patient self-test method.%目的 探讨皮肤黑素瘤的临床和病理特点.方法 回顾分析1983-2010年本院病理诊断为皮肤黑素瘤患者的临床资料,重新阅片,再次进行确认诊断和病理分型,对病理诊断不明确者行免疫组化检查,并进行统计学分析.结果 皮肤黑素瘤高峰发病年龄为51~60岁,肢端、非肢端部位黑素瘤各占70.00%和30.00%,肢端雀斑样黑素瘤最多,占67.14%,其次为恶性雀斑样痣型黑素瘤(11.43%)和浅表扩散型黑素瘤(10.00%),本研究中结节型仅有3例(4.29%),非暴露与暴露部位在原发损害、原位和侵袭的分布上差异有统计学意义(P=0.045,0.013).甲下黑素

  16. Surgery of Primary Melanomas

    Energy Technology Data Exchange (ETDEWEB)

    Rutkowski, Piotr, E-mail: rutkowskip@coi.waw.pl; Zdzienicki, Marcin; Nowecki, Zbigniew I. [Soft Tissue/Bone Sarcoma and Melanoma Department, M. Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw (Poland); Akkooi, Alexander C. J. van [Erasmus University Medical Center-Daniel den Hoed Cancer Center, Rotterdam (Netherlands)

    2010-05-11

    Surgery remains the mainstay of melanoma therapy, regardless of the tumor site. Only the early diagnosis combined with proper surgical therapy currently gives patients affected by this malignancy the chance for a full cure. The main goal of surgical therapy is to provide the local control of the disease and to secure long-term survival of the patient without reasonable functional and esthetic impairment. The recommended method of biopsy—excisional biopsy, as an initial diagnostic and, to some extent, therapeutic procedure—is performed under local anesthesia as an elliptical incision with visual clear margins of 1–3 mm and with some mm of subcutaneous tissue. The extent of radical excision of the primary tumor (or scar after excisional biopsy) is based on the histopathologic characteristics of the primary tumor and usually consists of 1–2 cm margins with primary closure. The philosophy behind conducted randomized clinical trials has been to find the most conservative surgical approach that is able to guarantee the same results as more demolitive treatment. This has been the background of the trials designed to define the correct margins of excision around a primary cutaneous melanoma. Much less definition can be dedicated to the surgical management of patients with non-cutaneous melanomas.

  17. The Role of Neighborhood Characteristics in Late Stage Melanoma Diagnosis among Hispanic Men in California, Texas, and Florida, 1996–2012

    Directory of Open Access Journals (Sweden)

    Valerie M. Harvey

    2017-01-01

    Full Text Available Background. Hispanics diagnosed with cutaneous melanoma are more likely to present at advanced stages but the reasons for this are unknown. We identify census tracts at high risk for late stage melanoma diagnosis (LSMD and examine the contextual predictors of LSMD in California, Texas, and Florida. Methods. We conducted a cross-sectional study using geocoded state cancer registry data. Using hierarchical multilevel logistic regression models we estimated ORs and 95% confidence intervals for the impact of socioeconomic, Hispanic ethnic concentration, index of dissimilarity, and health resource availability measures on LSMD. Results. We identified 12,493 cases. In California, late stage cases were significantly more likely to reside within census tracts composed mostly of Hispanics and immigrants. In Texas, LSMD was associated with residence in areas of socioeconomic deprivation and a higher proportion of immigrants. In Florida, living in areas of low education attainment, high levels of poverty, and a high percentage of Hispanic residents was significantly associated with LSMD. Residential segregation did not independently affect LSMD. Conclusion. The influence of contextual predictors on LSMD varied in magnitude and strength by state, highlighting both the cosegregation of social adversity and poverty and the complexity of their interactions.

  18. Design of a decision support system, trained on GPU, for assisting melanoma diagnosis in dermatoscopy images

    Science.gov (United States)

    Glotsos, Dimitris; Kostopoulos, Spiros; Lalissidou, Stella; Sidiropoulos, Konstantinos; Asvestas, Pantelis; Konstandinou, Christos; Xenogiannopoulos, George; Konstantina Nikolatou, Eirini; Perakis, Konstantinos; Bouras, Thanassis; Cavouras, Dionisis

    2015-09-01

    The purpose of this study was to design a decision support system for assisting the diagnosis of melanoma in dermatoscopy images. Clinical material comprised images of 44 dysplastic (clark's nevi) and 44 malignant melanoma lesions, obtained from the dermatology database Dermnet. Initially, images were processed for hair removal and background correction using the Dull Razor algorithm. Processed images were segmented to isolate moles from surrounding background, using a combination of level sets and an automated thresholding approach. Morphological (area, size, shape) and textural features (first and second order) were calculated from each one of the segmented moles. Extracted features were fed to a pattern recognition system assembled with the Probabilistic Neural Network Classifier, which was trained to distinguish between benign and malignant cases, using the exhaustive search and the leave one out method. The system was designed on the GPU card (GeForce 580GTX) using CUDA programming framework and C++ programming language. Results showed that the designed system discriminated benign from malignant moles with 88.6% accuracy employing morphological and textural features. The proposed system could be used for analysing moles depicted on smart phone images after appropriate training with smartphone images cases. This could assist towards early detection of melanoma cases, if suspicious moles were to be captured on smartphone by patients and be transferred to the physician together with an assessment of the mole's nature.

  19. Cutaneous amebiasis.

    Science.gov (United States)

    Rimsza, M E; Berg, R A

    1983-04-01

    An infant with cutaneous amebiasis of the vulva and amebic liver abscess is described. Epidemiologic investigations and serologic studies were crucial in establishing the diagnosis. The vulvar amebic ulcers responded dramatically to metronidazole therapy. Cutaneous amebiasis is a rare complication of Entamoeba histolytica infection which should be considered in the differential diagnosis of perineovulvar or penile ulcers. Cutaneous amebiasis may also occur on the abdominal wall surrounding a draining hepatic abscess, colostomy site, or laparotomy incision.

  20. Utility of Western Blot Analysis for the Diagnosis of Cutaneous Leishmaniasis

    Directory of Open Access Journals (Sweden)

    Marzieh ASHRAFMANSOURI

    2015-12-01

    Full Text Available Background: Cutaneous leishmaniasis (CL is a parasitic disease with a relatively wide distribution in different areas of the world, including Iran. The parasite is mainly diagnosed microscopically, but serological approaches might be useful for diagnosis as well.  This study aimed to assess the efficacy of an immunoblotting system for serodiagnosis of cutaneous leishmaniasis in Iran.Methods: Sixty-one sera samples from parasitologically confirmed CL patients and 50 sera samples from healthy controls along with 50 sera sample from non-CL patients were collected. Native strain of Leishmania major was cultured in Schnei­der medium and soluble Leishmania antigens were prepared from amastigotes-like parasites. All of sera samples were evaluated by an immunoblot­ting system.Results: Components of 14 to 135 kDa were detectable by the sera of CL pa­tients. From 61 sera of CL patients, 59 cases (96.7% detected a 63 kDa subunit and 51 cases (83.6% recognized a 32-35 kDa component. Among all subunits, the 63 kDa band showed the highest sensitivity (96.7% and a 75 kDa band had the highest (98% specificity.Conclusion: Immunoblotting has a satisfactory performance in diagnosis of CL and this test can be used, as an aid, for proper diagnosis of CL.

  1. The Danish Melanoma Database

    Directory of Open Access Journals (Sweden)

    Hölmich Lr

    2016-10-01

    Full Text Available Lisbet Rosenkrantz Hölmich,1 Siri Klausen,2 Eva Spaun,3 Grethe Schmidt,4 Dorte Gad,5 Inge Marie Svane,6,7 Henrik Schmidt,8 Henrik Frank Lorentzen,9 Else Helene Ibfelt10 1Department of Plastic Surgery, 2Department of Pathology, Herlev-Gentofte Hospital, University of Copenhagen, Herlev, 3Institute of Pathology, Aarhus University Hospital, Aarhus, 4Department of Plastic and Reconstructive Surgery, Breast Surgery and Burns, Rigshospitalet – Glostrup, University of Copenhagen, Copenhagen, 5Department of Plastic Surgery, Odense University Hospital, Odense, 6Center for Cancer Immune Therapy, Department of Hematology, 7Department of Oncology, Herlev-Gentofte Hospital, University of Copenhagen, Herlev, 8Department of Oncology, 9Department of Dermatology, Aarhus University Hospital, Aarhus, 10Registry Support Centre (East – Epidemiology and Biostatistics, Research Centre for Prevention and Health, Glostrup – Rigshospitalet, University of Copenhagen, Glostrup, Denmark Aim of database: The aim of the database is to monitor and improve the treatment and survival of melanoma patients.Study population: All Danish patients with cutaneous melanoma and in situ melanomas must be registered in the Danish Melanoma Database (DMD. In 2014, 2,525 patients with invasive melanoma and 780 with in situ tumors were registered. The coverage is currently 93% compared with the Danish Pathology Register.Main variables: The main variables include demographic, clinical, and pathological characteristics, including Breslow’s tumor thickness, ± ulceration, mitoses, and tumor–node–metastasis stage. Information about the date of diagnosis, treatment, type of surgery, including safety margins, results of lymphoscintigraphy in patients for whom this was indicated (tumors > T1a, results of sentinel node biopsy, pathological evaluation hereof, and follow-up information, including recurrence, nature, and treatment hereof is registered. In case of death, the cause and date

  2. Primary Anorectal Melanoma: An Update

    Directory of Open Access Journals (Sweden)

    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

    2012-01-01

    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.

  3. Congenital uveal melanoma?

    Science.gov (United States)

    Singh, Arun D; Schoenfield, Lynn A; Bastian, Boris C; Aziz, Hassan A; Marino, Meghan J; Biscotti, Charles V

    2016-01-01

    A 3-month-old infant with a white mother and Asian father presented with discoloration and prominence of the left eye since birth. Examination revealed a normal right eye. The left eye had hyperchromic heterochromia and an enlarged cornea (diameter, 13.0 mm) with intraocular pressure of 26 mm Hg. There were multiple areas of subconjunctival nodular pigmentation that extended posteriorly into the superior fornix. Fundus examination showed a large ciliochoroidal pigmented mass extending from 10:30 to 3:00 o'clock position involving the superior half of the choroid and adjacent ciliary body. The eye was enucleated, confirming the diagnosis of diffuse uveal melanoma with extraocular extension. Systemic surveillance (hepatic panel and ultrasonography of the liver) performed every 6 months for 5 years was has been negative for metastases. The tumor was investigated intensively for the panel of genes (BAP1, BRAF, NRAS12, NRAS61, GNAQ, Kit 9,11,13,17,18) implicated in pathogenesis of blue nevus, cutaneous melanoma, and mucosal melanomas with negative results. Moreover, germline BAP1 mutation could not be identified. This case possibly represents as yet unidentified uveal melanocytic proliferation rather than a true variant of uveal melanoma.

  4. Teledermatology: From Prevention to Diagnosis of Nonmelanoma and Melanoma Skin Cancer

    Directory of Open Access Journals (Sweden)

    G. Fabbrocini

    2011-01-01

    Full Text Available Telemedicine is a rapidly developing application of clinical medicine where medical information is transferred through interactive audiovisual media for the purpose of consulting remote medical procedures or examinations, reducing the time of consultation for patients. Teledermatology as an application of telemedicine was developed in 1995: it turns out to be a gradually more ordinary mean of delivering dermatologic healthcare worldwide and will almost certainly have a greater medical function in the future. In particular, teledermatology can aid in the prevention and diagnosis of nonmelanoma and melanoma skin cancer; telemedicine and teledermatology offer the opportunity to make available consultations with experts also by long distance. Overall, patients seem to accept teledermatology, considering it as an excellent mean to obtain healthcare, particularly in those areas with no expert dermatologists available. Clinicians have also generally reported affirmative experiences with teledermatology in the skin cancer field. Further studies focusing on cost effectiveness, patient outcomes, and patient and clinician satisfaction will facilitate to delineate the potential of teledermatology as a mean of prevention and diagnosis of nonmelanoma and melanoma skin cancer.

  5. Cutaneous manifestations of antiphospholipid syndrome: a review of the clinical features, diagnosis and management.

    Science.gov (United States)

    Pinto-Almeida, Teresa; Caetano, Mónica; Sanches, Madalena; Selores, Manuela

    2013-01-01

    Antiphospholipid syndrome is a relatively recent systemic autoimmune disorder defined by thrombotic events and/or obstetric complications in the presence of persistent elevated antiphospholipid antibodies. It\\'s characterized by a wide spectrum of clinical presentations and virtually any organ system or tissue may be affected by the consequences of vascular occlusion. Diagnosis is sometimes difficult and although classification criteria have been published and revised there remain ongoing issues regarding nomenclature, expanding clinical features, laboratory tests and management and much still has to be done. Cutaneous manifestations are common and frequently the first sign of the disease. Although extremely diverse it\\'s important to know which dermatological findings should prompt consideration of antiphospholipid syndrome and the appropriate management for those patients. Much has been debated about when to consider antiphospholipid syndrome and consensus still does not exist, however in spite of being a diagnostic challenge clinicians should know when to look for antiphospholipid antibodies since an early diagnosis is important to prevent further and serious complications. In this article we focus on the cutaneous features that should raise suspicion on the presence of antiphospholipid syndrome and on the complex management of such patients. Many other dermatological signs related to this syndrome have been described in the literature but only occasionally and without consistency or statistic impact and therefore will not be considered here.

  6. Early Diagnosis of Cutaneous Mucormycosis Due to Lichtheimia corymbifera After a Traffic Accident.

    Science.gov (United States)

    Tyll, Tomas; Lyskova, Pavlina; Hubka, Vit; Muller, Martin; Zelenka, Lubomir; Curdova, Martina; Tuckova, Inna; Kolarik, Miroslav; Hamal, Petr

    2016-02-01

    A case report of cutaneous mucormycosis and obstacles to early diagnosis is presented. A 38-year-old male was involved in a car accident that led to amputation of both lower limbs. Subsequently, he developed fungal wound infection of the left lower limb stump. The infection was detected very early, although the diagnosis was difficult because only a small area was affected and histopathological examination was initially negative. The infection was proven by microscopy, culture and histopathology. The isolate was identified by sequencing of the rDNA ITS region gene (internal transcribed spacer region of ribosomal DNA) as Lichtheimia corymbifera. Liposomal amphotericin B and surgery were successful in management of the disease.

  7. Limited value of {sup 18}F-FDG PET/CT and S-100B tumour marker in the detection of liver metastases from uveal melanoma compared to liver metastases from cutaneous melanoma

    Energy Technology Data Exchange (ETDEWEB)

    Strobel, K.; Veit-Haibach, P.; Fischer, D.R.; Steinert, Hans C.; Schulthess, G.K. von [University Hospital Zurich, Division of Nuclear Medicine, Department of Medical Radiology, Zurich (Switzerland); Bode, B. [University Hospital Zurich, Department of Pathology, Zurich (Switzerland); Dummer, R.; Imhof, L.; Goldinger, S. [University Hospital Zurich, Department of Dermatology, Zurich (Switzerland)

    2009-11-15

    The objective of this study was to evaluate the value of {sup 18}F-FDG PET/CT and S-100B tumour marker for the detection of liver metastases from uveal melanoma in comparison to liver metastases from cutaneous melanoma. A retrospective evaluation was conducted of 27 liver metastases in 13 patients with uveal melanoma (UM) (mean age: 56.8, range: 30-77) and 43 liver metastases in 14 patients (mean age: 57.9, range: 40-82) with cutaneous melanoma (CM) regarding size and FDG uptake by measuring the maximum standardized uptake value (SUV{sub max}). S-100B serum tumour markers were available in 20 patients. Cytology, histology, additional morphological imaging and follow-up served as reference standard. In nine patients liver metastases were further evaluated histologically regarding GLUT-1 and S-100 receptor expression and regarding epithelial or spindle cell growth pattern. Of 27 liver metastases in 6 of 13 patients (46%) with UM, 16 (59%) were FDG negative, whereas all liver metastases from CM were positive. Liver metastases from UM showed significantly (p < 0.001) lower SUV{sub max} (mean: 3.5, range: 1.5-13.4) compared with liver metastases from CM (mean: 6.6, range: 2.3-15.3). In four of six (66.7%) patients with UM and liver metastases S-100B was normal and in two (33.3%) increased. All PET-negative liver metastases were detectable by morphological imaging (CT or MRI). S-100B was abnormal in 13 of 14 patients with liver metastases from CM. S-100B values were significantly higher (p = 0.007) in the CM patient group (mean S-100B: 10.9 {mu}g/l, range: 0.1-115 {mu}g/l) compared with the UM patients (mean: 0.2 {mu}g/l, range: 0.0-0.5 {mu}g/l). Histological work-up of the liver metastases showed no obvious difference in GLUT-1 or S-100 expression between UM and CM liver metastases. The minority (36%) of patients with UM had extrahepatic metastases and the majority (86%) of patients with CM had extrahepatic metastases, respectively. There was a close to significant

  8. Targeted next generation sequencing of mucosal melanomas identifies frequent NF1 and RAS mutations.

    Science.gov (United States)

    Cosgarea, Ioana; Ugurel, Selma; Sucker, Antje; Livingstone, Elisabeth; Zimmer, Lisa; Ziemer, Mirjana; Utikal, Jochen; Mohr, Peter; Pfeiffer, Christiane; Pföhler, Claudia; Hillen, Uwe; Horn, Susanne; Schadendorf, Dirk; Griewank, Klaus G; Roesch, Alexander

    2017-06-20

    Mucosal melanoma represents ~1% of all melanomas, frequently having a poor prognosis due to diagnosis at a late stage of disease. Mucosal melanoma differs from cutaneous melanoma not only in terms of poorer clinical outcome but also on the molecular level having e.g. less BRAF and more frequent KIT mutations than cutaneous melanomas. For the majority of mucosal melanomas oncogenic driver mutations remain unknown. In our study, 75 tumor tissues from patients diagnosed with mucosal melanoma were analyzed, applying a targeted next generation sequencing panel covering 29 known recurrently mutated genes in melanoma. NF1 and RAS mutations were identified as the most frequently mutated genes occurring in 18.3% and 16.9% of samples, respectively. Mutations in BRAF were identified in 8.4% and KIT in 7.0% of tumor samples. Our study identifies NF1 as the most frequently occurring driver mutation in mucosal melanoma. RAS alterations, consisting of NRAS and KRAS mutations, were the second most frequent mutation type. BRAF and KIT mutations were rare with frequencies below 10% each. Our data indicate that in mucosal melanomas RAS/NF1 alterations are frequent, implying a significant pathogenetic role for MAPK and potentially PI3K pathway activation in these tumors.

  9. Bronzeamento e risco de melanoma cutâneo: revisão da literatura Suntanning and risk of cutaneous melanoma: a literature review

    Directory of Open Access Journals (Sweden)

    Sonia R P de Souza

    2004-08-01

    Full Text Available Estudos epidemiológicos sugerem a relação entre comportamentos relacionados ao bronzeamento e risco elevado de melanoma. Nesse sentido, realizou-se revisão sobre essa temática que abrangeu o período correspondente aos anos de 1977 a 1998. Foram pesquisadas as bases de dados Medline e Embase (Excerpta Medica. A análise mostrou que entre os jovens, apesar do conhecimento sobre os riscos da exposição excessiva à radiação ultravioleta e sobre as práticas visando à proteção da pele, prevalece o hábito de expor-se intencionalmente ao sol. Esse hábito é alimentado por crenças e atitudes em relação ao bronzeado e estimulado por influência do grupo e de pessoas consideradas "referências". As práticas mais freqüentemente adotadas para bronzear a pele apresentam risco elevado para o desenvolvimento de melanoma. Conclui-se que a forma mais eficaz de prevenir o melanoma é divulgar nos meios de comunicação que a pele bronzeada não é saudável, pois foi danificada pela radiação ultravioleta solar; e iniciar campanhas com ações efetivas para mudar comportamentos, naquilo que os motiva e os alimenta.Epidemiological studies suggest a relationship between suntanning habits and high risk of melanoma. A literature review was carried out for the period between 1977 and 1998 using Medline and Embase (Excerpta Medica databases. The analysis showed that intentional sun exposure is highly prevalent among youths, despite their awareness of the risks involved in excessive exposure to ultraviolet radiation and their knowledge on skin protection measures. Intentional exposure is a habit fostered by certain beliefs and attitudes towards suntanning and stimulated by peer pressure and aesthetic referents.The most common tanning practices involve a high risk of developing melanoma. It was concluded that the most effective means to prevent melanoma is mass media dissemination of the concept that having a tanned skin is not healthy - since it

  10. Up-regulation of Human Leukocyte Antigen G Expression in Primary Cutaneous Malignant Melanoma Associated with Host-vs-tumor Immune Response

    Institute of Scientific and Technical Information of China (English)

    Xianfeng FANG; Xuxin ZHANG; Jiawen LI

    2008-01-01

    Human leukocyte antigen G (HLA-G) is one of the molecules implicated in immunotolerance. To investigate the role of HLA-G in primary cutaneous malignant melanoma (CMM), a series of 47 skin melanocytic lesions were immunohistochemicaily evaluated. The correlation between HLA-G expression and CMM clinicohistopahtologicai data and Bcl-2 expression was also analyzed.HLA-G expression was detected in a variety of cell types. No significant difference in HLA-G expression was observed between malignant and non-malignant melanocytic lesions. HLA-G expres- sion was significantly correlated with the inflammatory infiltration and Bel-2 expression, whereas no significant correlation with ulceration, tumor thickness, clinical stage, histopathologicai subtypes were observed. HLA-G expression may be the result of host immune reaction in tumor microenvi- ronment rather than a malignant feature of CMM.

  11. The measurement of constitutive and facultative skin pigmentation and estimation of sun exposure in Caucasians with basal cell carcinoma and cutaneous malignant melanoma

    DEFF Research Database (Denmark)

    Lock-Andersen, J; Drzewiecki, K T; Wulf, H C

    1998-01-01

    In two identical and simultaneously performed case-control studies of basal cell carcinoma (BCC) and cutaneous malignant melanoma (CMM) with age-matched, sex-matched and residence-matched controls, skin pigmentation was measured objectively by skin reflectance spectroscopy in 145 BCC patients...... by all subjects. There were no statistically significant differences in constitutive skin pigmentation at the buttocks between BCC patients and controls (P = 0.96) or between CMM patients and controls (P = 0.13). Facultative skin pigmentation in ultraviolet-exposed sites was not significantly different...... between BCC patients and controls except that women patients had higher pigmentation at the lateral side of the upper arm. For CMM, men patients had higher pigmentation at the lateral side of the upper arm. Self-estimations of sun exposure did not show differences between patients and controls...

  12. Cost-effectiveness of preoperative SPECT/CT combined with lymphoscintigraphy vs. lymphoscintigraphy for sentinel lymph node excision in patients with cutaneous malignant melanoma

    Energy Technology Data Exchange (ETDEWEB)

    Stoffels, Ingo; Leyh, Julia; Schadendorf, Dirk; Klode, Joachim [University of Duisburg-Essen, Department of Dermatology, Venerology and Allergology, University-Hospital Essen, Essen (Germany); Mueller, Markus [University of Duisburg-Essen, Department of Medical controlling, University-Hospital Essen, Essen (Germany); Geisel, Marie Henrike [University of Duisburg-Essen, Institute for Medical Informatics, Biometry and Epidemiology, University-Hospital Essen, Essen (Germany); Poeppel, Thorsten [University of Duisburg-Essen, Department of Nuclear Medicine, University-Hospital Essen, Essen (Germany)

    2014-09-15

    Malignant melanoma has become a major growing interdisciplinary problem in public health worldwide. Sentinel lymph node excision (SLNE) in conjunction with preoperative SPECT/CT is considered the most sensitive and specific staging test for the detection of micrometastatic melanoma in regional lymph nodes. Among patients with clinically lymph node-negative melanoma, the use of SPECT/CT-aided SLNE compared with SLNE alone has been found to be associated with a higher frequency of metastatic involvement and a higher rate of disease-free survival. The aim of this study was to analyse the cost-effectiveness of SLNE with preoperative SPECT/CT for detecting sentinel lymph nodes versus that of standard SLNE with preoperative lymphoscintigraphy from a single-institution database. Cost-effectiveness analysis of two surgical approaches for SLNE for malignant melanoma at the University Hospital Essen, Skin Cancer Center in Essen, Germany. Between March 2003 and April 2011 464 patients eligible for SLNE were identified. Of these patients, 403 with clinically negative lymph nodes who underwent SLNE with or without preoperative SPECT/CT qualified for subsequent analysis. Between March 2003 and October 2008, 254 patients were operated upon with the standard technique. From November 2008, 149 patients underwent the SPECT/CT technique. Cost analysis showed a mean cost saving of EUR 710.50 when SPECT/CT was added to preoperative imaging. This was achieved by a reduction in operative time (median, Q1;Q3, 40 min, 40;50 min, vs. 45 min, 35;60 min; p = 0.002), hospital stay duration (5 days, 3;8 days, vs. 8 days, 4.5;14.5 days; p < 0.001) and more frequent use of local anaesthesia (90.6 % vs. 70.5 %; p < 0.001). The median cost of SLNE using SPECT/CT was EUR 1,619.7 (Q1;Q3 EUR 1,317.0;2,603.4) and of SLNE without SPECT/CT was EUR 2,330.2 (EUR 1,468.3;4,058.1; p < 0.001), a cost saving of 30.5 %. In patients with cutaneous melanoma, the use of preoperative SPECT/CT-aided SLNE compared

  13. Primary Malignant Melanoma of Pleura: A Case Report and Literature Review.

    Science.gov (United States)

    Agarwal, Poojan; Nambiyar, Kaniyyapan; Manju Kaushal; Bhardwaj, Minakshi

    2016-07-01

    Malignant melanoma is one of the most aggressive and treatment resistant skin cancers. India enjoys a low incidence of melanoma, and age specific incidence rates for cutaneous malignant melanoma (CMM) are being less than 0.5 per 1,000,000. This could be due to under-reporting of melanoma on account of a low index of suspicion by clinicians and pathologists alike. Most common site for origin of primary melanoma is skin, accounting for about 91.2% of all reported primary malignant melanoma cases. Other primary sites are relatively uncommon. Primary pleural melanoma is a very rare tumor and to the best of our knowledge, only seven cases have been reported so far worldwide. We hereby discuss a new case, only second from India. Our patient also had coexistent congenital hairy nevus, an unusual association also noted in two previously reported cases. Excluding primary cutaneous melanoma with pleural metastasis was a diagnostic challenge in this case but multiple cutaneous biopsies together with clinical and findings helped us arrive at this unusual diagnosis. Unfortunately, the patient succumbed to his illness. Diagn. Cytopathol. 2016;44:648-652. © 2016 Wiley Periodicals, Inc.

  14. BILLCD8 - A Multivariable Survival Model as a Simple and Clinically Useful Prognostic Tool to Identify High-risk Cutaneous Melanoma Patients.

    Science.gov (United States)

    Donizy, Piotr; Biecek, Przemyslaw; Halon, Agnieszka; Matkowski, Rafal

    2016-09-01

    To develop a multivariable survival model based on histopathological parameters that would provide the best possible estimate of the risk of death in cutaneous melanoma patients. Breslow thickness and Infiltrating Lymphocytes (BILL(CD8)) is based on two key parameters, namely Breslow thickness and tumor-infiltrating lymphocytes (TILs) shown to be the most important prognostic factors using logistic regression model. The next step was to apply a decision tree method to analyze the impact of the percentage of CD8+ lymphocytes on the risk of cancer death. A patient is given two points if Breslow thickness is >2 mm and one point if TILs are not found in the tumor. The probability of death over a 4-year follow-up is 75% if the patient's score is 3 points; in patients with 0 point score the risk of death is 0%. A significant positive impact of high percentage of CD8+ lymphocytes on the risk of death was shown in the subgroup of melanoma patients with Breslow thickness >2 mm where the risk of death is only 28%. In the case of low percentage of CD8+ lymphocytes in melanomas with Breslow thickness over 2 mm, the risk is as high as 67%. Breslow thickness and TILs, with the evaluation of the CD8+ lymphocytes, may be used for precise prognostic stratification of patients and may help intensify the follow-up, diagnose a relapse sooner and apply proper treatment. Copyright© 2016 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

  15. Differences in tumor thickness between hematoxylin and eosin and Melan-A immunohistochemically stained primary cutaneous melanomas.

    Science.gov (United States)

    Drabeni, Marina; Lopez-Vilaró, Laura; Barranco, Carlos; Trevisan, Giusto; Gallardo, Fernando; Pujol, Ramon M

    2013-02-01

    Tumor thickness (Breslow thickness) represents the main prognostic factor in primary melanoma. Potential differences in melanoma tumor thickness measurements between conventional hematoxylin and eosin (H&E) and Melan-A immunohistochemical staining were evaluated. Ninety-nine excisional biopsies were included in the study. From each sample, 2 consecutive histological sections were stained with H&E and Melan-A, respectively. Tumor thickness was measured from both sections by 2 independent observers. In 59 biopsy specimens (59.6%), higher tumor thickness measurements were recorded in Melan-A-stained than in H&E-stained sections. In 42.4% of such cases (25 biopsies), the observed differences were ≥0.2 mm. After Melan-A evaluation, 33% of in situ melanoma cases were reclassified as invasive melanoma, with thickness measurements ranging from 0.15 to 0.35 mm. In 23 biopsies, identical values were recorded with both techniques, whereas in 17 cases, measurements obtained with H&E staining were slightly higher (from 0.01 to 0.18 mm) than those obtained with Melan-A staining. A high rate of interobserver agreement was noted, and significant intertechnique measurement differences were detected. Significant discrepancies (≥0.2 mm) in thickness measurements between the 2 techniques were mainly attributed to the presence of individual or small clusters of melanocytic cells in the papillary dermis. These melanocytic cells could be easily overlooked in H&E-stained sections, especially in sections showing dense lymphohistiocytic inflammatory infiltrates, numerous melanin-containing histiocytic cells in the upper dermis, or extensive fibrotic changes or regression phenomena. This study confirms the practical interest of immunohistochemical staining with Melan-A in evaluating primary melanoma and, specifically, in situ melanoma cases.

  16. Melanoma cutâneo: características clínicas, epidemiológicas e histopatológicas no Hospital Universitário de Brasília entre janeiro de 1994 e abril de 1999 Cutaneous Melanoma: clinical, epidemiological and histopathological characteristics at the University Hospital of Brasília between January 1994 and April 1999

    Directory of Open Access Journals (Sweden)

    Ana Maria Costa Pinheiro

    2003-04-01

    characteristics of primary cutaneous melanoma, at the University Hospital of Brasília, during a period of five years. MATERIAL AND METHODS: A review was conducted of the data registry concerning primary cutaneous melanoma cases, in the University Hospital of Brasília, diagnosed and treated between January 1994 and April 1999, with a total of 32 cases. The patients were analyzed, characterizing the tumor distribution according to gender, age, skin color, topography, symptomatology, histopathological type, Clark level, Breslow index and presence of metastasis. Data was analyzed by simple statistics and by Chi-square (chi2. RESULTS: A predominance was observed of lesions in the limbs, corresponding to sixteen patients (50.0%. There was the primary nodular form in nine (45% patients, and seventeen (58.6% patients did not have any complaint. According to the presence or absence of metastasis and Clark level, it was found that the patients with a level of invasion up to the subcutaneous layer (Clark V presented a relative risk of 2.94 (1.24cutaneous melanoma at the University Hospital of Brasília, between January 1994 and April 1999, comprised of elderly females (from 61 to 80 years old, Caucasians, whose tumor was located predominantly in the limbs, the nodular type was the most frequent, and the patients did not present symptoms at the time of diagnosis.

  17. Nail apparatus melanoma: a diagnostic opportunity Melanoma do aparelho ungueal: uma oportunidade diagnóstica

    Directory of Open Access Journals (Sweden)

    Ana Maria Carreño

    2013-04-01

    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.

  18. Basic and clinical aspects of malignant melanoma

    Energy Technology Data Exchange (ETDEWEB)

    Nathanson, L. (Health Sciences Center, State Univ. of New York at Stony Brook, Stony Brook, NY (US))

    1987-01-01

    This book contains the following 10 chapters: The role of oncogenes in the pathogenesis of malignant melanoma; Laminin and fibronectin modulate the metastatic activity of melanoma cells; Structure, function and biosynthesis of ganglioside antigens associated with human tumors derived from the neuroectoderm; Epidemiology of ocular melanoma; Malignant melanoma: Prognostic factors; Endocrine influences on the natural history of human malignant melanoma; Psychosocial factors associated with prognostic indicators, progression, psychophysiology, and tumor-host response in cutaneous malignant melanoma; Central nervous system metastases in malignant melanoma; Interferon trials in the management of malignant melanoma and other neoplasms: an overview; and The treatment of malignant melanoma by fast neutrons.

  19. Black Pleural Effusion: A Unique Presentation of Metastatic Melanoma

    Directory of Open Access Journals (Sweden)

    Akansha Chhabra

    2015-05-01

    Full Text Available Metastatic melanoma is a rare form of skin cancer, but one that comes with a high mortality rate. Pulmonary involvement is frequently seen in metastatic melanoma with only 2% of malignant melanoma patients with thorax metastasis presenting with pleural effusions. Herein, we report an extremely rare case of black pleural effusion from thoracic metastasis of cutaneous malignant melanoma. A 74-year-old man with known metastatic melanoma presented with a 1-month history of worsening lower back and hip pain and was found to have extensive osseous metastatic disease and multiple compression fractures. The patient underwent an uneventful kyphoplasty; however, the following day, he became acutely hypoxic and tachypneic with increased oxygen requirements. Radiographic evaluation revealed new bilateral pleural effusions. Bedside thoracentesis revealed a densely exudative, lymphocyte-predominant black effusion. Cytological examination showed numerous neoplastic cells with melanin deposition. A diagnosis of thoracic metastasis of malignant melanoma was established based on the gross and microscopic appearance of the pleural fluid. To the best of our knowledge, this is the first reported case of black pleural effusions secondary to metastatic melanoma in the United States. Despite the rarity of this presentation, it is important to determine the etiology of the black pleural effusion and to keep metastatic melanoma as a differential diagnosis.

  20. Cutaneous CD30-positive lymphoproliferations : clinical and molecular aspects and differential diagnosis

    NARCIS (Netherlands)

    Benner, Marchina Frederika

    2012-01-01

    The studies presented in this thesis focused on cutaneous CD30-positive lymphoproliferations, particularly on primary cutaneous anaplastic large cell lymphoma (C-ALCL), a distinct type of cutaneous T-cell lymphoma (CTCL). In the initial staging of patients with an anaplastic large cell lymphoma firs

  1. Development of an Image Processing System for Automatic Melanoma Diagnosis from Dermoscopic Images: Preliminary Sudy - Original Article

    Directory of Open Access Journals (Sweden)

    M. Emin Yüksel

    2008-12-01

    Full Text Available Objective: Design and implementation of a medical image processing system that will provide decision support to the clinician in the diagnosis of melanoma type skin cancers by performing the analysis of dermoscopic images.Methods: Visual features of pigmented lesions are converted into measurable numerical quantities by employing digital image processing methods and a classification regarding melanoma diagnosis is performed based on these quantitative data.Results: We achieved numerical results showing asymmetry, border and color features of the pigmentary lesions by using segmentation, image histogram, thresholding, convex hull, color clustering, color quantization and distribution methods. Conclusion: The system under development speeds up the decision process of the clinician. In addition, it allows the diagnosis to be based on more objective data.

  2. Clinical characteristics and management of melanoma families

    NARCIS (Netherlands)

    Rhee, Jasper Immanuel van der

    2013-01-01

    Being a member of a melanoma family is a major risk factor for cutaneous malignant melanoma. In this thesis clinical characteristics and management of melanoma families are discussed. In the first part of the thesis clinical and histological characteristics of melanoma (patients) from families with

  3. Clinical characteristics and management of melanoma families

    NARCIS (Netherlands)

    Rhee, Jasper Immanuel van der

    2013-01-01

    Being a member of a melanoma family is a major risk factor for cutaneous malignant melanoma. In this thesis clinical characteristics and management of melanoma families are discussed. In the first part of the thesis clinical and histological characteristics of melanoma (patients) from families with

  4. Sensitive diagnosis of cutaneous leishmaniasis by lesion swab sampling coupled to qPCR

    Science.gov (United States)

    ADAMS, EMILY R.; GOMEZ, MARIA ADELAIDA; SCHESKE, LAURA; RIOS, RUBY; MARQUEZ, RICARDO; COSSIO, ALEXANDRA; ALBERTINI, AUDREY; SCHALLIG, HENK; SARAVIA, NANCY GORE

    2015-01-01

    SUMMARY Variation in clinical accuracy of molecular diagnostic methods for cutaneous leishmaniasis (CL) is commonly observed depending on the sample source, the method of DNA recovery and the molecular test. Few attempts have been made to compare these variables. Two swab and aspirate samples from lesions of patients with suspected CL (n = 105) were evaluated alongside standard diagnosis by microscopic detection of amastigotes or culture of parasites from lesion material. Three DNA extraction methods were compared: Qiagen on swab and aspirate specimens, Isohelix on swabs and Boil/Spin of lesion aspirates. Recovery of Leishmania DNA was evaluated for each sample type by real-time polymerase chain reaction detection of parasitic 18S rDNA, and the diagnostic accuracy of the molecular method determined. Swab sampling combined with Qiagen DNA extraction was the most efficient recovery method for Leishmania DNA, and was the most sensitive (98%; 95% CI: 91–100%) and specific (84%; 95% CI: 64–95%) approach. Aspirated material was less sensitive at 80% (95% CI: 70–88%) and 61% (95% CI: 50–72%) when coupled to Qiagen or Boil-Spin DNA extraction, respectively. Swab sampling of lesions was painless, simple to perform and coupled with standardized DNA extraction enhances the feasibility of molecular diagnosis of CL. PMID:25111885

  5. Cellular Blue Nevus Diagnosed following Excision of Melanoma: A Challenge in Diagnosis

    Directory of Open Access Journals (Sweden)

    Nives Jonjić

    2016-01-01

    Full Text Available A case of a 41-year-old woman with a history of nodular melanoma (NM, associated with an indurated dome-shaped blue-black nodule with a diameter of 1.2 cm in the gluteal region, is presented. Clinical diagnosis of the lesion, present from birth, was blue nevus. Recently, the nodule has been showing a mild enlargement and thus complete resection was performed. Histological analysis revealed a pigmented lesion with an expansive pattern of extension into the dermis and the subcutaneous adipose tissue. The lesion displayed an alveolar pattern as well as a pigmented dendritic cell pattern. The histology was consistent with cellular blue nevus (CBN; however, the history of NM which was excised one year earlier, as well as the clinical information about the slow growing lesion, included a differential diagnosis of CBN, borderline melanocytic tumor, and malignant blue nevus. Additional immunohistochemical (HMB-45, p16, and Ki-67 and molecular (BRAF V600E mutation analyses were performed on both lesions: the CBN-like and the previously excised NM. Along with lesion history and histological analyses, p16 staining and BRAF were useful diagnostic tools for confirming the benign nature of CBN in this case.

  6. Dermoscopic diagnosis of melanoma in a 4D space constructed by active contour extracted features.

    Science.gov (United States)

    Mete, Mutlu; Sirakov, Nikolay Metodiev

    2012-10-01

    Dermoscopy, also known as epiluminescence microscopy, is a major imaging technique used in the assessment of melanoma and other diseases of skin. In this study we propose a computer aided method and tools for fast and automated diagnosis of malignant skin lesions using non-linear classifiers. The method consists of three main stages: (1) skin lesion features extraction from images; (2) features measurement and digitization; and (3) skin lesion binary diagnosis (classification), using the extracted features. A shrinking active contour (S-ACES) extracts color regions boundaries, the number of colors, and lesion's boundary, which is used to calculate the abrupt boundary. Quantification methods for measurements of asymmetry and abrupt endings in skin lesions are elaborated to approach the second stage of the method. The total dermoscopy score (TDS) formula of the ABCD rule is modeled as linear support vector machines (SVM). Further a polynomial SVM classifier is developed. To validate the proposed framework a dataset of 64 lesion images were selected from a collection with a ground truth. The lesions were classified as benign or malignant by the TDS based model and the SVM polynomial classifier. Comparing the results, we showed that the latter model has a better f-measure then the TDS-based model (linear classifier) in the classification of skin lesions into two groups, malignant and benign. Copyright © 2012 Elsevier Ltd. All rights reserved.

  7. Country of origin, age at migration and risk of cutaneous melanoma: a migrant cohort study of 1,100,000 Israeli men.

    Science.gov (United States)

    Levine, Hagai; Afek, Arnon; Shamiss, Ari; Derazne, Estela; Tzur, Dorit; Astman, Nadav; Keinan-Boker, Lital; Mimouni, Daniel; Kark, Jeremy D

    2013-07-15

    Cutaneous melanoma (CM) is a common cancer with increasing incidence in many parts of the world where light-skinned populations live. We conducted a large-scale nationally representative migrant cohort study to assess country of origin and age at migration as predictors of CM, controlling for possible confounders. Data on 1,086,569 Israeli Jewish males, who underwent a general health examination before compulsory military service at ages 16-19 between the years 1967-2005, were linked to Israel National Cancer Registry to obtain incident CM up to 2006. Cox proportional hazards was used to model time to event. Overall, 1562 incident cases were detected during 19.3 million person-years of follow-up. Origin was a strong independent predictor of CM. Incidence was higher for European (hazard ratio [HR] = 4.08, 95% confidence interval [CI]: 3.55-4.67) and Israeli origin (HR = 2.92, 95% CI: 2.25-3.79) compared to N. African/Asian origin, adjusted for year of birth, years of education, residential socio-economic position, rural residence and body surface area (or height). Among those of European origin, the adjusted risk was significantly lower for those who immigrated after the age of 10 years (HR = 0.58, 95% CI: 0.45-0.73) but not for younger ages (HR = 1.02, 95% CI 0.84-1.23) compared to Israeli born. The high rates of CM among men of European origin and the almost twofold lower risk among those immigrating after age 10 provide solid support for the deleterious role of childhood sun exposure as a risk factor for melanoma. These findings will serve in directing public health and research efforts.

  8. 'TB or not TB?' Problems of differential diagnosis of cutaneous mycobacteriosis and tuberculosis--A Case Study and interdisciplinary discussion.

    Science.gov (United States)

    Szmygin-Milanowska, Katarzyna; Grzywa-Celińska, Anna; Zwolska, Zofia; Krawczyk, Paweł; Guz, Leszek; Milanowski, Janusz

    2016-01-01

    The diagnosis of cutaneous tuberculosis poses a serious challenge due to many skin diseases of different etiology resembling the lesions caused by the TB (tuberculosis) bacillus, and difficulties in confirming the disease. The presented case concerns skin lesions in a hobby aquarist stung in the finger of the left hand by a fish. The resulting inflammatory infiltration was to be cutaneous tuberculosis or mycobacteriosis caused by MOTT (Mycobacterium other than tuberculosis). Laboratory, pathomorphologic, genetic and microbiologic tests of samples obtained from the patient, fish and water in the aquarium gave ambiguous results. A multidisciplinary discussion is presented on the difficulties in the differential diagnosis, problems with a clear interpretation of the results of various conducted tests, and possible ways of transmission of the infection, relevant to the described example.

  9. Giant Congenital Melanocytic Naevus with Proliferative Nodules Mimicking Congenital Malignant Melanoma: A Case Report and Review of the Literature of Congenital Melanoma

    Directory of Open Access Journals (Sweden)

    Massimiliano Scalvenzi

    2013-01-01

    Full Text Available Congenital malignant melanoma (CMM is a rare condition that is defined as malignant melanoma recognized at birth. CMM may develop in utero in one of three ways: (1 transmission by metastasis through the placenta from a mother with melanoma; (2 primary melanoma arising within a giant congenital melanocytic naevus (GCMN; (3 primary de novo cutaneous CMM arising in utero. CMM can be confused clinically and histologically with benign proliferative melanocytic lesions such as giant congenital nevi. We describe the case of a patient presenting a GCMN with proliferative nodules, clinically and dermoscopically resembling a CMM, demonstrating the importance of caution in making a diagnosis of MM and highlighting the possibility that benign lesions as GCMN can mimic a malignant melanoma in this age group.

  10. Pathological assessment of tumor biopsy specimen and surgical sentinel lymph node dissection in patients with melanoma.

    Science.gov (United States)

    Nodiţi, Gheorghe; Nica, Cristian C; Petrescu, Horaţiu Pompiliu; Ivan, Codruţ; Crăiniceanu, Zorin Petrişor; Bratu, Tiberiu; Dema, Alis

    2014-01-01

    Actual trends of cutaneous malignant melanoma show a faster increase then other forms of cancer. Early detection and diagnosis, and accurate pathologic interpretation of the biopsy specimen is extremely important for the treatment and prognosis of clinically localized melanoma. The surgical approach to cutaneous melanoma patients with clinically uninvolved regional lymph nodes remains controversial. A retrospective study of melanoma cases was conducted in the "Casa Austria" Department of Plastic and Reconstructive Surgery, Emergency County Hospital, Timisoara, Romania. We have analyzed the medical records of 21 patients that underwent surgical treatment for different stages of melanoma in the period 2008-2012. For histopathological diagnosis of melanoma and the sentinel lymph node(s) status, tissular fragments were routinely processed. For the difficult cases, additional immunohistochemical investigation was done. A positive family history was noted in two cases. The presence of different sizes and localization of pigmented nevi was found in 38% of the cases. Different types of melanoma like superficial spreading melanoma, nodular melanoma or lentigo malignant melanoma and acral lentiginous melanoma was described. The surgical treatment consisted in all cases in wide excision of the primary tumor and prophylactic dissection of sentinel lymph node after lymphoscintigraphy examination. A positive biopsy of the sentinel lymph node was noted in 4.9% of the cases. The surgical treatment combining the wide excision of the primary tumor with respect to safe oncological limits with the prophylactic dissection of sentinel lymph node after lymphoscintigraphy examination had the confirmation done by the pathologic interpretation of the biopsy specimen showing that all the patients had a Breslow index more than 1.5 mm.

  11. Expression of glycoprotein non-metastatic melanoma protein B in cutaneous malignant and benign lesions: a tissue microarray study

    Institute of Scientific and Technical Information of China (English)

    ZHAO Yan; QIAO Zheng-guo; SHAN Shi-jun; SUN Qing-miao; ZHANG Jian-zhong

    2012-01-01

    Background Glycoprotein non-metastatic melanoma protein B (GPNMB) plays an important role in the pathogenesis of inflammatory and malignant diseases.We investigated the expression of GPNMB in benign and malignant skin diseases.Methods Tissue microarray was performed in the skin tissues of 102 cases including malignant melanoma (MM),squamous cell carcinoma (SCC),basal cell carcinoma (BCC),and benign dermatosis.The expression of GPNMB in the tissues was detected by immunohistochemistry.Twenty cases of normal skin and adjacent neoplastic normal skin tissues were selected as controls.Results GPNMB was positively stained in skin malignancies (38/50,76%),which was significantly higher than that in the control and the benign skin tissues (P=0.001 and <0.001 respectively).GPNMB was positively stained in MM (13/15,87%) and SCC (16/20,80%) (P <0.001).Significant higher expression of GPNMB was observed in patients aged ≥65years than those less than 65 years (n=11 and n=9 respectively,P=0.027).No significant difference of the expression rates was observed between normal control and BCC; however,stronger intensity was detected in the latter.Negative or weak expression was observed in the controls.Conclusion Over-expression of GPNMB correlated strongly and might play an important role in the pathogenesis of MM and SCC.

  12. Cutaneous Leishmaniasis in Khyber Pakhtunkhwa Province of Pakistan: Clinical Diversity and Species-Level Diagnosis

    Science.gov (United States)

    Khan, Nazma Habib; Bari, Arfan ul; Hashim, Rizwan; Khan, Inamullah; Muneer, Akhtar; Shah, Akram; Wahid, Sobia; Yardley, Vanessa; O'Neil, Brighid; Sutherland, Colin J.

    2016-01-01

    This study primarily aimed to identify the causative species of cutaneous leishmaniasis (CL) in the Khyber Pakhtunkhwa Province of Pakistan and to distinguish any species-specific variation in clinical manifestation of CL. Diagnostic performance of different techniques for identifying CL was assessed. Isolates of Leishmania spp. were detected by in vitro culture, polymerase chain reaction (PCR) on DNA extracted from dried filter papers and microscopic examination of direct lesion smears from patients visiting three major primary care hospitals in Peshawar. A total of 125 CL patients were evaluated. Many acquired the disease from Peshawar and the neighboring tribal area of Khyber Agency. Military personnel acquired CL while deployed in north and south Waziristan. Leishmania tropica was identified as the predominant infecting organism in this study (89.2%) followed by Leishmania major (6.8%) and, unexpectedly, Leishmania infantum (4.1%). These were the first reported cases of CL caused by L. infantum in Pakistan. PCR diagnosis targeting kinetoplast DNA was the most sensitive diagnostic method, identifying 86.5% of all samples found positive by any other method. Other methods were as follows: ribosomal DNA PCR (78.4%), internal transcribed spacer 2 region PCR (70.3%), culture (67.1%), and microscopy (60.5%). Clinical examination reported 14 atypical forms of CL. Atypical lesions were not significantly associated with the infecting Leishmania species, nor with “dry” or “wet” appearance of lesions. Findings from this study provide a platform for species typing of CL patients in Pakistan, utilizing a combination of in vitro culture and molecular diagnostics. Moreover, the clinical diversity described herein can benefit clinicians in devising differential diagnosis of the disease. PMID:27601518

  13. The Danish Melanoma Database

    DEFF Research Database (Denmark)

    Hölmich, Lisbet Rosenkrantz; Klausen, Siri; Spaun, Eva

    2016-01-01

    AIM OF DATABASE: The aim of the database is to monitor and improve the treatment and survival of melanoma patients. STUDY POPULATION: All Danish patients with cutaneous melanoma and in situ melanomas must be registered in the Danish Melanoma Database (DMD). In 2014, 2,525 patients with invasive......, nature, and treatment hereof is registered. In case of death, the cause and date are included. Currently, all data are entered manually; however, data catchment from the existing registries is planned to be included shortly. DESCRIPTIVE DATA: The DMD is an old research database, but new as a clinical...

  14. [Comparison of direct microscopy, culture and polymerase chain reaction methods for the diagnosis of cutaneous leishmaniasis].

    Science.gov (United States)

    Ertabaklar, Hatice; Özlem Çalışkan, Serçin; Boduç, Erengül; Ertuğ, Sema

    2015-01-01

    Cutaneous leishmaniasis (CL) is an endemic disease especially in Southeastern Anatolia of Turkey and recently shows a trend for spread to other regions of the country including the Aegean region. The diagnosis of CL is based on combined evaluation of epidemiological data with the clinical symptoms and laboratory findings. Direct microscopic examination and culture methods are mainly used in the routine diagnosis of CL, while molecular methods are mainly used for research. The aim of this study was to detect the presence of Leishmania spp. in samples obtained from CL-suspected patients by using direct microscopy, culture and polymerase chain reaction (PCR) methods and to compare the results. A total of 55 patients who were admitted to Parasitology Laboratory of Adnan Menderes University Hospital, Aydin (located at Aegean region in Turkey), between 2012-2014 were included in the study. Smear preparations from the skin lesions of cases were fixed and stained with Giemsa, and the presence of amastigote forms were evaluated by direct microscopy. NNN medium was used for the cultivation of samples. Total genomic DNA of Leishmania from the samples were extracted with a commercial kit (NucleoSpin Tissue(®) Kit, Macherey-Nagel, Germany) and PCR was performed by using 13A and 13B primers to amplify the 116 base pair fragment of Leishmania spp. specific kinetoplast DNA. Amastigotes were observed in 29 (53%) of the 55 samples by direct microscopy, promastigotes were detected among 34 (62%) samples in culture, and parasite-specific amplicons were revealed in 30 (55%) samples by PCR. All assays were positive in 24 patients while in 18 patients all of the tests yielded negative results. Thirty-seven (67%) out of 55 cases were diagnosed as CL when reactivity in at least one of these three methods were considered as positive. Accordingly the positivity rates of the methods were 78.4% (29/37) for direct microscopy, 92% (34/37) for culture and 81.1% (30/37) for PCR in CL

  15. Temporary shielding of hot spots in the drainage areas of cutaneous melanoma improves accuracy of lymphoscintigraphic sentinel lymph node diagnostics

    Energy Technology Data Exchange (ETDEWEB)

    Maza, S.; Valencia, R.; Geworski, L.; Zander, A.; Munz, D.L. [Clinic for Nuclear Medicine, University Hospital Charite, Humboldt University of Berlin, Schumannstrasse 20-21, 10117 Berlin (Germany); Draeger, E.; Winter, H.; Sterry, W. [Clinic for Dermatology, Venereology and Allergology, University Hospital Charite, Humboldt University of Berlin, Berlin (Germany)

    2002-10-01

    Detection of the ''true'' sentinel lymph nodes, permitting correct staging of regional lymph nodes, is essential for management and prognostic assessment in malignant melanoma. In this study, it was prospectively evaluated whether simple temporary shielding of hot spots in lymphatic drainage areas could improve the accuracy of sentinel lymph node diagnostics. In 100 consecutive malignant melanoma patients (45 women, 55 men; age 11-91 years), dynamic and static lymphoscintigraphy in various views was performed after strict intracutaneous application of technetium-99m nanocolloid (40-150 MBq; 0.05 ml/deposit) around the tumour (31 patients) or the biopsy scar (69 patients, safety distance 1 cm). The images were acquired with and without temporary lead shielding of the most prominent hot spots in the drainage area. In 33/100 patients, one or two additional sentinel lymph nodes that showed less tracer accumulation or were smaller (<1.5 cm) were detected after shielding. Four of these patients had metastases in the sentinel lymph nodes; the non-sentinel lymph nodes were tumour negative. In 3/100 patients, hot spots in the drainage area proved to be lymph vessels, lymph vessel intersections or lymph vessel ectasias after temporary shielding; hence, a node interpreted as a non-sentinel lymph node at first glance proved to be the real sentinel lymph node. In two of these patients, lymph node metastasis was histologically confirmed; the non-sentinel lymph nodes were tumour free. In 7/100 patients the exact course of lymph vessels could be mapped after shielding. In one of these patients, two additional sentinel lymph nodes (with metastasis) were detected. Overall, in 43/100 patients the temporary shielding yielded additional information, with sentinel lymph node metastases in 7%. In conclusion, when used in combination with dynamic acquisition in various views, temporary shielding of prominent hot spots in the drainage area of a malignant melanoma of the

  16. Avaliação do perfil epidemiológico e da mortalidade dos pacientes com diagnóstico de melanoma cutâneo primário no município de Florianópolis - SC, Brasil Evaluation of the epidemiological profile and the mortality rate of the patients with primary cutaneous melanoma in Florianopolis - SC, Brazil

    Directory of Open Access Journals (Sweden)

    Rúbia Battisti

    2009-08-01

    Full Text Available FUNDAMENTOS: O melanoma é o câncer cutâneo com maior letalidade. Santa Catarina é o estado brasileiro com maior número de casos desse tumor. OBJETIVOS: Estimar a taxa de mortalidade por melanoma no quinto ano de doença. MÉTODOS: A amostra compreendeu 81 laudos de melanoma primário cutâneo, em 75 pacientes, emitidos em Florianópolis - SC em 2002 e 2003. O protocolo de pesquisa incluiu idade, sexo, cor do paciente e localização anatômica, tipo histológico, grau de invasão, índice de Breslow, infiltrado inflamatório, ulceração, regressão, invasão angiolinfática e estadiamento do tumor. Foi feito contato telefônico com os pacientes para verificar seu status (vivo, morto por melanoma ou morto por outra causa. Para análise estatística, utilizou-se o teste exato de Fisher e a curva de sobrevida de Kaplan-Meier. RESULTADOS: O perfil dos pacientes foi: feminino, branco, 51,3 anos, melanoma invasivo em tronco ou membros, tipo extensivo superficial, Breslow 2,63 mm. A taxa de mortalidade por melanoma cutâneo foi de 7,0%, maior entre homens (11,1%, com Breslow superior a 4,0 mm (66,0%, com ulceração (33,3% e em estádio IV (80,0%. A sobrevida média foi de 56,7 meses. Conclusões: A taxa de mortalidade por melanoma primário cutâneo foi de 7,0%, e a ulceração e o estadiamento final foram os fatores com significância estatística sobre o resultado.BACKGROUND: Melanoma is the cutaneous cancer which has the greatest lethality. Santa Catarina is the Brazilian State that contributes the most to increase this rate. OBJECTIVES: To estimate the mortality rate of melanoma in the fifth year of illness. METHODS: The sample comprises 81 reports of primary cutaneous melanoma, in 75 patients, diagnosed in lorianopolis - SC in 2002 and 2003. The protocol of research includes age, sex, patient's color, anatomical location, histological type, degree of invasion, Breslow index, inflammatory reaction, ulceration, regression, angiolymphatic

  17. Refractory Classical Hodgkin Lymphoma Presenting with Atypical Cutaneous Involvement and Diagnosis of ZZ Phenotype Alpha-1 Antitrypsin Deficiency

    Directory of Open Access Journals (Sweden)

    Mohamad Khawandanah

    2014-01-01

    Full Text Available Cutaneous Hodgkin lymphoma is a rare condition. Specific neoplastic involvement can be primary (confined to the skin or secondary to systemic involvement (metastatic. Cutaneous involvement by HL usually occurs late in the course and is associated with poor prognosis; however in some cases it can exhibit indolent behavior. Skin involvement with nonspecific cutaneous findings may represent a paraneoplastic syndrome. We describe a case of 46-year-old white male patient presented with rash and lymphadenopathy which led to the diagnosis of stage IVE mixed cellularity classical Hodgkin lymphoma with skin involvement. His disease was refractory to multiple lines of chemotherapy including (1 AVD (doxorubicin/bleomycin/dacarbazine, (2 brentuximab, and (3 bendamustine, he later achieved complete remission with (4 GCD (gemcitabine/carboplatin/dexamethasone salvage regimen. Bleomycin was not given secondary to poor pulmonary function tests. His treatment was complicated after AVD with multiple pneumothoraces which unmasked the diagnosis of ZZ phenotype alpha-1 antitrypsin (ATT deficiency. Simultaneous existence of Hodgkin lymphoma and ATT is rarely reported.

  18. Molecular Prognostic Markers in Uveal Melanoma: Expression Profiling and Genomic Studies

    NARCIS (Netherlands)

    W. Gils (Walter)

    2008-01-01

    textabstractUveal Melanomas (UMs) arise from melanocytes. This cell type originates from neural crest cells and thereby uveal melanomas share their origin with pheochromocytomas, neuroblastomas, paragangliomas and cutaneous melanomas, other tumors that develop from neural crest originating cells.

  19. Use of fine needle aspiration cytology in the diagnosis of cutaneous leishmaniasis: a comparison with the conventional scraping method.

    Science.gov (United States)

    Hosseinzadeh, Massood; Omidifar, Navid; Lohrasb, Mohamad Hosein

    2012-04-01

    Cutaneous leishmaniasis is endemic in Iran. Scraping smears are widely used and fine needle aspiration (FNA) cytology is now attracting more attention. Both methods were performed on the clinically suspected cases in our study. Smears were stained using Giemsa. We compared the sensitivity, specificity and some other aspects of these two methods. Of our 400 patients, 346 had specimens that were positive for leishman body, and of these 328 were detected using both methods. However, 42 cases were confirmed positive by FNA cytology and 18 as a result of scraping smears. There was a significant difference between the two methods in the detection of leishman body and microgranuloma, slide background and patient comfort. The sensitivity of FNA cytology was greater even though the specificity was the same. Our study confirmed the advantages of FNA cytology as a reliable method for the diagnosis of cutaneous leishmaniasis.

  20. The Danish Melanoma Database

    DEFF Research Database (Denmark)

    Hölmich, Lisbet Rosenkrantz; Klausen, Siri; Spaun, Eva;

    2016-01-01

    AIM OF DATABASE: The aim of the database is to monitor and improve the treatment and survival of melanoma patients. STUDY POPULATION: All Danish patients with cutaneous melanoma and in situ melanomas must be registered in the Danish Melanoma Database (DMD). In 2014, 2,525 patients with invasive...... melanoma and 780 with in situ tumors were registered. The coverage is currently 93% compared with the Danish Pathology Register. MAIN VARIABLES: The main variables include demographic, clinical, and pathological characteristics, including Breslow's tumor thickness, ± ulceration, mitoses, and tumor...... quality register. The coverage is high, and the performance in the five Danish regions is quite similar due to strong adherence to guidelines provided by the Danish Melanoma Group. The list of monitored indicators is constantly expanding, and annual quality reports are issued. Several important scientific...

  1. Worldwide cutaneous malignant melanoma incidences analyzed by sex, age, and skin type over time (1955–2007): Is HPV infection of androgenic hair follicular melanocytes a risk factor for developing melanoma exclusively in people of European-ancestry?

    Science.gov (United States)

    Merrill, Stephen J.; Subramanian, Madhan; Godar, Dianne E.

    2016-01-01

    ABSTRACT The cutaneous malignant melanoma (CMM) incidence has been increasing in an exponential manner in certain populations around the world for over 7 decades. To help illuminate the etiology, we performed worldwide temporal (1955–2007) CMM incidence analysis by sex, age (0–14, 15–29, 30–49, 50–69, 70–85+), and skin type on 6 continents using data from the International Agency for Research on Cancer. We observe an exponential increase in the CMM incidence over time and an increase of about 2 orders of magnitude between age groups 0–14 and 15–29 exclusively in European-ancestry populations around the world independent of skin type (I–III or III–IV). Other populations like the Chinese (III-IV) had much lower CMM incidences that either remained stable or temporally decreased but did not display a dramatic increase between the youngest age groups. The dramatic increase in the incidence between the youngest age groups found only in European-ancestry populations suggests one of the most important risk factors for CMM may be developing androgenic hair, the occurrence of which appears to correlate with the distribution of CMM over male and female body sites. Besides that potential new risk factor, the increasing CMM incidence with increasing age, known not to be from cumulative UV doses, may be associated with age-related changes to skin, i.e., thinning epidermis causing lower vitamin D3 levels, and hair, i.e., whitening from higher reactive oxygen species. The temporal exponential increasing CMM incidence in European-ancestry populations may be due to Human Papilloma Virus infection of follicular hair melanocytes, found in CMM biopsies. PMID:27588159

  2. Black light visualized solar lentigines on the shoulders and upper back are associated with objectively measured UVR exposure and cutaneous malignant melanoma.

    Science.gov (United States)

    Idorn, Luise Winkel; Datta, Pameli; Heydenreich, Jakob; Philipsen, Peter Alshede; Wulf, Hans Christian

    2015-02-01

    Previous studies on the association of solar lentigines with ultraviolet radiation (UVR) exposure have been based on retrospective questionnaires about UVR exposure. We aimed to investigate the association between solar lentigines and UVR exposure in healthy individuals using objective measurements, and to investigate the association between solar lentigines and cutaneous malignant melanoma (CMM). Forty-eight patients with CMM and 48 controls that matched the patients individually by age, sex, constitutive skin type and occupation participated. Solar lentigines on the shoulders and upper back were counted and graded into 3 categories using black light photographs to show sun damage. Current UVR exposure in healthy controls was assessed by personal electronic UVR dosimeters that measured time-related UVR and by corresponding exposure diaries during a summer season. Sunburn history was assessed by interviews. Among controls, the number of solar lentigines was positively associated with daily hours spent outdoors between noon and 3 pm on holidays (P = 0.027), days at the beach (P = 0.048) and reported number of life sunburns (P < 0.001). Compared with matched controls CMM patients had a higher number of solar lentigines (P = 0.044). There was a positive association between CMM and higher solar lentigines grade; Category III versus Category I (P = 0.002) and Category II versus Category I (P = 0.014). Our findings indicate that solar lentigines in healthy individuals are associated with number of life sunburns, as well as time spent outdoors around noon on holidays and beach trips during a summer season, most likely reflecting past UVR exposure, and that solar lentigines are a risk factor for CMM.

  3. The full blood count as a biomarker of outcome and toxicity in ipilimumab-treated cutaneous metastatic melanoma.

    Science.gov (United States)

    Khoja, Leila; Atenafu, Eshetu G; Templeton, Arnoud; Qye, Ye; Chappell, Mary Anne; Saibil, Sam; Hogg, David; Butler, Marcus O; Joshua, Anthony M

    2016-10-01

    Ipilimumab produces durable responses in some metastatic melanoma patients. Neutrophil, platelet, and eosinophil to lymphocyte ratios (NLR, PLR, and ELR) may be associated with the immune response in cancer thereby acting as biomarkers of toxicity and efficacy in ipilimumab-treated patients. Data were collected on clinical characteristics and lactate dehydrogenase (LDH), NLR, PLR, and ELR at baseline, post cycle 2 and at the end of treatment for 183 patients treated with ipilimumab between 2008 and 2015 at the Princess Margaret Cancer Centre. Associations between clinical characteristics, LDH, NLR, PLR, and ELR with toxicity or survival outcomes of progression-free (PFS) and overall survival (OS) were assessed using univariable and multivariable analysis. Prognostic models of outcome at each time point were determined. Of the 183 patients included, the median age was 58, 85% had M1c disease, 58% were performance status 1, and 64% received ipilimumab as second line therapy. Median follow up was 7.5 months (range: 0.3-49.5), median PFS was 2.8 months (95% confidence intervals (CI): 2.8-3.2), and median OS was 9.6 months (95% CI: 7.9-13.2). Prognostic factors for OS by multivariable analysis were LDH and NLR at all-time points. Prognostic models using LDH (× 2 upper limit of normal) and NLR 4) differentiated patients into high, moderate, and low risk of death prior to or on ipilimumab treatment (P < 0.0001 for each model). No factors were associated with toxicity. Prognostic models based on NLR and LDH values at baseline and on treatment differentiate patients into good, intermediate, and poor prognostic groups and may be relevant in patient management.

  4. Pregnancy and early-stage melanoma

    NARCIS (Netherlands)

    Daryanani, D; Plukker, JT; De Hullu, JA; Kuiper, H; Nap, RE; Hoekstra, HJ

    2003-01-01

    BACKGROUND. Cutaneous melanomas are aggressive tumors with an unpredictable biologic behavior. It has been suggested that women who present with melanoma during pregnancy have a worse prognosis due to more aggressive behavior of the melanoma. The objective of the current study was to evaluate the lo

  5. Trends in the diagnosis and clinical features of melanoma in situ (MIS) in US men and women: A prospective, observational study.

    Science.gov (United States)

    Wei, Erin X; Qureshi, Abrar A; Han, Jiali; Li, Tricia Y; Cho, Eunyoung; Lin, Jennifer Y; Li, Wen-Qing

    2016-10-01

    The incidence of melanoma in situ (MIS) is increasing, but little is known about its clinical and epidemiologic features. We sought to determine trends in diagnosis and clinical features of MIS. Incident cases of melanoma were collected prospectively from the Nurses' Health Study (1976-2010) and Health Professionals Follow-up Study (1986-2010). MIS incidence increased from 2 to 42 per 100,000 person-year among women, and from 11 to 73 per 100,000 person-year among men, exceeding the rate of increase of invasive melanomas. Melanoma mortality initially increased during the follow-up period then plateaued. Men were more likely than women to develop in situ melanomas on the upper half of the body (P MIS (P MIS (P < .001). This is a strictly descriptive study without examination into mechanisms. We found epidemiologic and clinical differences for in situ and invasive melanomas, which support further examination into the variations in etiologic pathways. The lack of improvement in mortality despite the increase in detection of in situ relative to invasive lesions further highlights the need to improve invasive melanoma-specific clinical screening features. Copyright © 2016 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  6. Expert review remains important in the histopathological diagnosis of cutaneous melanocytic lesions

    NARCIS (Netherlands)

    van Dijk, M. C. R. F.; Aben, K. K. H.; van Hees, F.; Klaasen, A.; Blokx, W. A. M.; Kiemeney, L. A. L. M.; Ruiter, D. J.

    2008-01-01

    Aims: To assess the type of problems encountered in diagnosing melanocytic lesions and to evaluate the contribution of expert review. Methods and results: Data from 1887 lesions submitted for consultation to one of the expert pathologists of the Dutch Melanoma Working Group Pathology Panel between 1

  7. A Fast-Track Referral System for Skin Lesions Suspicious of Melanoma

    DEFF Research Database (Denmark)

    Jarjis, Reem Dina; Hansen, Lone Bak; Matzen, Steen Henrik

    2016-01-01

    Introduction. To minimize delay between presentation, diagnosis, and treatment of cutaneous melanoma (CM), a national fast-track referral system (FTRS) was implemented in Denmark. The aim of this study was to analyze the referral patterns to our department of skin lesions suspicious of melanoma i...... melanocytic skin lesions will increase diagnostic accuracy, leading to larger capacity in secondary care for the required treatment of malignant skin lesions.......Introduction. To minimize delay between presentation, diagnosis, and treatment of cutaneous melanoma (CM), a national fast-track referral system (FTRS) was implemented in Denmark. The aim of this study was to analyze the referral patterns to our department of skin lesions suspicious of melanoma....... A total of 556 patients were registered as referred to the center in the FTRS for skin lesions suspicious of melanoma. Among these, a total of 312 patients (56.1%) were diagnosed with CM. Additionally, 41 (7.4%) of the referred patients were diagnosed with in situ melanoma.  Conclusion. In total, 353 (63...

  8. The presentation, pathology, and current management strategies of cutaneous metastasis

    Directory of Open Access Journals (Sweden)

    Christina Yin Bin Wong

    2013-01-01

    Full Text Available Skin metastases are rare in the routine clinical practice of dermatology, but are of major clinical significance because they usually indicate advanced disease. We reviewed the literature on skin metastasis regarding recent trends in clinical presentation and diagnosis of the most common cutaneous lesions. An extensive literature review was conducted using PubMed from May 26, 2011 to July 16, 2013 relating cutaneous metastases. Articles chosen for reference were queried with the following prompts: "Cutaneous metastases", "clinical presentation", "histological features", and "immunohistochemistry". Further searches included "treatment" and "management" options for "metastatic breast", "metastatic colorectal", "metastatic melanoma", "metastatic lung", and "hematologic cancers." We also reviewed the literature on the current management of melanoma as a model for all cutaneous metastatic disease. Our own clinical findings are presented and compared to the literature. Additionally, we highlight the most useful immunohistochemical studies that aid in diagnoses. Several novel therapies and combination therapies such as electrochemotherapy, vemurafenib, and imiquimod will be discussed for palliative treatment of cancers that have been found to improve cutaneous lesions. We review these notable findings and developments regarding skin metastases for the general dermatologist.

  9. Prognostic factors of melanoma patients with satellite or in-transit metastasis at the time of stage III diagnosis.

    Directory of Open Access Journals (Sweden)

    Benjamin Weide

    Full Text Available BACKGROUND: Prognosis of patients with loco-regional skin metastases has not been analyzed in detail and the presence or absence of concurrent lymph node metastasis represents the only established prognostic factor thus far. Most studies were limited to patients already presenting with skin lesions at the time of initial diagnosis. We aimed to analyze the impact of a broad penal of prognostic factors in patients with skin metastases at the time of first metastatic spread, including patients with synchronous lesions already present at the time of initial diagnosis, stage I/II patients with loco-regional recurrence and patients initially presenting with skin metastasis but unknown primary melanoma. PATIENTS AND METHODS: We investigated disease-specific survival of 380 patients treated at our department between 1996 and 2010 using Kaplan Meier survival probabilities and Cox-proportional hazard analysis. RESULTS: Five-year survival probability was 60.1% for patients with skin metastases only and 36.3% for those with synchronous nodal metastases. The number of involved nodes and a tumor thickness of at least 3 mm had independent negative impact on prognosis. A strong relationship was identified between the risk of death and the number of involved nodes. Neither ulceration nor the timing of the first occurrence of metastases as either in stage I/II patients, at the time of excision of the primary melanoma or initially in patients with unknown primary tumor, had additional effects on survival. CONCLUSION: Lymph node involvement was confirmed as the most important prognostic factor for melanoma patients with loco-regional skin metastasis including those with unknown primary tumor and stage I/II patients with skin recurrence. Consideration of the tumor thickness and of the number of involved lymph nodes instead of the exclusive differentiation into presence vs. absence of nodal disease may allow a more accurate prediction of prognosis for patients with

  10. Melanoma cutáneo facial con gánglio centinela en región parotídea: Revisión de la literatura Cutaneous melanoma of the face with sentinel node in parotid region: Revision of the literature

    Directory of Open Access Journals (Sweden)

    R. del Rosario Regalado

    2007-02-01

    Full Text Available Introducción. La parótida es primer escalón ganglionar en la diseminación regional de los melanomas cutáneos de región frontal, orbitaria y nasal. Aunque la linfografía se ha convertido en una prueba diagnóstica estándar en el estudio del melanoma, no está exenta de inconvenientes. Material y método. Presentamos el caso de un paciente con melanoma frontal y ganglios centinela parotídeos y discutimos las particularidades, ventajas y desventajas de la técnica en dicha región. Conclusiones. Aunque se ha demostrado que la afectación del ganglio centinela es el factor predictor más importante de recurrencia y supervivencia, creemos que es una técnica en estudio cuyo efecto en la supervivencia debe ser demostrado frente a la alternativa de seguimiento clínico y que por tanto debe indicarse en casos seleccionados con mayor probabilidad de metástasis.Introduction. The parotid gland is the first lymph node echelon in the regional dissemination of frontal, orbital and nasal cutaneous melanomas. Although the lymphoscintigraphy has been become a standard diagnostic technique for studying melanomas, it is not exempt of inconveniences. Material and methods. We present the case of a patient with frontal melanoma and sentinel nodes in the parotid region, and we discuss the peculiarities, advantages and disadvantages of using this technique in this region. Conclusions. Although it has been proved that an affected sentinel lymph node is the most important prognostic factor for recurrence and survival, we believe that this is a technique under study, and that its influence on survival should be demonstrated with regard to the alternative of clinical monitoring. It should therefore be indicated in specific cases with greater probabilities of metastases.

  11. Jejuno-jejunal invagination due to intestinal melanoma

    Institute of Scientific and Technical Information of China (English)

    Giuseppe Resta; Gianfranco Azzena; Savino Occhionorelli; Gabriele Anania; Federico Messina; Damiano de Tullio; Gloria Ferrocci; Federico Zanzi; Davide Pellegrini; Rocco Stano; Giorgio Cavallesco

    2007-01-01

    Cutaneous melanoma is one of the most studied neoplastic lesions in biology and clinical oncology. It has been well documented that this type of neoplasm presents a high metastatic rate, and is able to involve nearly every tissue. Non-cutaneous melanoma represents an unusual pattern of melanoma, and the small intestine is an uncommon anatomic localization. Herein we report an extremely rare clinical case of a young woman affected by a bleeding jejunal melanoma, whose early clinical presentation was an intestinal invagination.

  12. Sensitivity and Specificity of Nucleic Acid Sequence-Based Amplification Method (NASBA for Diagnosis of Cutaneous Leishmaniasis

    Directory of Open Access Journals (Sweden)

    Niazi, A

    2014-05-01

    Full Text Available Background and Objective: Employing advanced diagnostics for molecular identification of the Lishmania parasite is has a more sensitivity and specificity in comparison to the microscopic methods. RT- PCR is also introduced as one of the best known techniques for diagnosis of this parasite; however, the method is not widely used due to its expensive equipments and the time requested.the application of NASBA method is shown high efficient for diagnosis of live parasite. The aim of this study is comparison sensivity and specificity between NASBA isothermal amplification and RT-PCR for molecular detection of lishmania major. Material and Methods: 28 skin biopsy from Oscar of patients was prepared and total RNA was extracted. Then, the using of specific primers designed for 18srRNA region, this region was amplified using NASBA isothemal amplification. The RNA amplicons were produced in less than 90 minutes and then identified via electrophoresed agaros gel after staining with Syber Gold flourecent probes for the purpose increasing sensitivity and specificity Result: In this study, NASBA and RT-PCR method are sensitivity 81%, specificity of 51% and 100% respectively for detection of Leishmania parasites inscars Conclusion: NASBA isothermal method can be applied with high sensitivity and specificity for the identification of cutaneous leishmaniasis, this method can be fed with live microorganisms and response to treatment in patients examined. Keywords: Cutaneous Leishmanisis, NASBA, 18S rRNA

  13. Expression of MMP-2 and MMP-9 in Cutaneous Malignant Melanoma and its Significance%MMP-2和MMP-9在皮肤恶性黑色素瘤中的表达及意义

    Institute of Scientific and Technical Information of China (English)

    宋宁静; 王晓楠; 陈佳; 吴正升; 章楚光

    2011-01-01

    目的 研究明胶酶(MMP-2和MMP-9)在皮肤黑色素瘤和色素痣组织中的蛋白表达及其意义.方法 应用免疫组织化学S-P法检测90例皮肤黑色素瘤和43例皮肤色素痣组织MMP-2和MMP-9的表达情况,分析它们与患者临床病理特征的关系.结果 皮肤黑色素瘤组织MMP-2和MMP-9蛋白表达阳性率分别为50.0%和55.6%,显著高于色素痣的阳性率27.9%和25.6%(P<0.05和P<0.01);黑色素瘤MMP-2和MMP-9蛋白表达均与肿瘤的浸润深度和淋巴结转移呈正相关(均P<0.05).结论 皮肤恶性黑色素瘤MMP-2和MMP-9表达状况与肿瘤侵袭、转移呈密切相关,提示MMP-2和MMP-9可能在黑色素瘤发生发展过程中发挥了重要作用.%Objective To investigate the expression of MMP-2 and MMP-9 protein in cutaneous melanoma and its significance.Methods The expression of MMP-2 and MMP-9 protein was detected in 90 cases of melanoma and 47 cases of nevus by using streptavidin-peroxidase technique. Their correlations with the clinicopathological features were analyzed. Results The positive rates of MMP-2 and MMP-9 protein in the melanomas were 50.0% and 55.6% ,which were significantly higher than those in the nevus. Both t MMP-2 and MMP-9 protein was positively correlated to the depth of tumour invasion and the lymph node metastasis of melanoma( All P < 0.05). Conclusion The expression of MMP-2 and MMP-9 is closely correlated to the tumout invasion and metastasis. The result suggests that MMP-2 and MMP-9 might play an important role in the cutaneous melanoma development and progression.

  14. Cutaneous histiocytosis X. The presence of S-100 protein and its use in diagnosis.

    Science.gov (United States)

    Rowden, G; Connelly, E M; Winkelmann, R K

    1983-07-01

    The cellular localization of glial S-100 protein was investigated in paraffin-embedded sections of cutaneous histiocytosis X and in a variety of cutaneous infiltrative disorders, including juvenile xanthogranuloma, necrobiotic xanthogranuloma, papular xanthoma, eruptive histiocytoma, and reticulohistiocytosis. Immunoperoxidase staining with a rabbit anti-calf brain-S-100 antibody demonstrated strong and consistent activity in atypical histiocytes in all histiocytosis X specimens. No detectable S-100 protein was demonstrated in either histiocytes or giant cells in the non-X histiocytic disorders investigated. Positive controls were included within both groups of disorders in respect to melanocyte, epidermal Langerhans' cell, and dermal Schwann's cell staining. These findings are interpreted as evidence for diversity in the mononuclear phagocyte system and demonstrate the practicality of such a simple test in diagnostic problems involving infiltrative histiocytic disorders of the skin.

  15. Cutaneous sarcoidosis.

    Science.gov (United States)

    Wilson, N J; King, C M

    1998-11-01

    Sarcoidosis is a multi-organ granulomatous disorder of unknown cause. Skin sarcoidosis occurs in about 25% of patients with systemic disease and may also arise in isolation. A wide range of clinical presentations of cutaneous sarcoidosis is recognised. The diagnosis rests on the presence of non-caseating granulomas on skin biopsy and the exclusion of other granulomatous skin disease. The treatment and overall prognosis of cutaneous sarcoidosis is primarily dependent on the degree of systemic involvement. In patients with aggressive disease limited to the skin immunosuppressive therapy may be indicated.

  16. [The role of sentinel lymph node biopsy in the diagnosis and prognosis of malignant melanoma].

    Science.gov (United States)

    Mangas, C; Paradelo, C; Rex, J; Ferrándiz, C

    2008-06-01

    Sentinel lymph node biopsy was introduced into the management of cancer patients 20 years ago. Most hospitals now currently use the technique as a routine diagnostic tool in patients with localized malignant melanoma. However, the technique is complex and numerous details need to be determined and assessed to provide reliable diagnostic and prognostic information. In addition, the introduction of immunohistochemical and molecular techniques in the last decade has extended the information provided by the study of sentinel lymph nodes and created valuable opportunities for investigating the pathogenesis of this type of cancer. The aim of this review is to offer the reader a detailed analysis of the most important studies in the literature and the factors that should currently be considered in determining the indication for sentinel lymph node biopsy, performing the procedure correctly, and interpreting the findings in patients with malignant melanoma.

  17. Feasibility Study of Optical Spectroscopy as a Medical Tool for Diagnosis of Skin Lesions

    OpenAIRE

    Asad Saf; Sheikh Ziauddin; Alexander Horsch; Mahzad Ziai; Victor Castaneda; Tobias Lasser; Nassir Navab

    2016-01-01

    Skin cancer is one of the most frequently en-countered types of cancer in the Western world. According to the Skin Cancer Foundation Statistics, one in every five Americans develops skin cancer during his/her lifetime. Today, the incurability of advanced cutaneous melanoma raises the importance of its early detection. Since the differentiation of early melanoma from other pigmented skin lesions is not a trivial task, even for experienced dermatologists, computer aided diagnosis could become a...

  18. Malignant Melanoma

    Directory of Open Access Journals (Sweden)

    Eshini Perera

    2013-12-01

    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.

  19. Are all melanomas dangerous?

    DEFF Research Database (Denmark)

    Nørgaard, Carsten; Glud, Martin; Gniadecki, Robert

    2011-01-01

    summarizes the most recent epidemiological findings regarding the incidence of cutaneous malignant melanoma, mortality, Breslow thickness and clinical stage. Studies published between 2005 and 2010 with more than 2,000 test subjects were included in this review. These studies all report an increase...

  20. A Rare Thyroid Metastasis from Uveal Melanoma and Response to Immunotherapy Agents.

    Science.gov (United States)

    Collins, Dearbhaile Catherine; Yela, Ruben; Horgan, Noel; Power, Derek Gerard

    2016-01-01

    Thyroid metastasis is a rare occurrence with cutaneous melanoma and even more uncommon with uveal melanoma. The management of such metastasis is uncertain due to its infrequency and, in the era of immunotherapy, the effect of these novel drugs on uncommon metastasis, such as to the thyroid, is unknown. We report the rare case of a thyroid metastasis in a patient diagnosed with ocular melanoma initially managed with enucleation. Metastatic disease developed in the lung and thyroid gland. The case patient received the immunotherapy ipilimumab with stable disease in the thyroid and progressive disease elsewhere. The patient was then further treated with a second immunotherapy agent, pembrolizumab, and remains with stable disease one year later. We discuss the current literature on thyroid metastases from all causes and the optimal known management strategies. Furthermore, we provide an original report on the response of this disease to the novel immunomodulators, ipilimumab, and pembrolizumab with stable disease four years after initial diagnosis of ocular melanoma.

  1. Cutaneous larva migrans in Hospital Kuala Lumpur, Malaysia: rate of correct diagnosis made by the referring primary care doctors.

    Science.gov (United States)

    Yap, Felix Boon-Bin

    2011-07-01

    A retrospective study was undertaken to determine the clinical features of cutaneous larva migrans (CLM) seen in the Department of Dermatology, Hospital Kuala Lumpur (Kuala Lumpur, Malaysia) and to assess the rate of correct diagnosis made by the referring primary care doctors. Clinical records of all 31 patients with CLM seen between January 2006 and June 2010 were retrieved. The majority of patients were male. The mean age was 32.2 years. Pruritus was reported in 83.9% of cases and serpiginous tracts in 100%. The mean lesion count was 4.4 and the mean duration of disease before presentation was 3.1 weeks. The majority of skin lesions were on the buttock and lower extremities. Only 45.2% of patients had the correct diagnosis made by the referring primary care doctors. Older age of patients and lower number of lesions were associated with a higher rate of correct diagnosis. The low rate of correct diagnosis made by the referring primary care doctors to the dermatologists in this study warrants the need for education of not only primary care doctors but also future primary care providers, consisting of medical students, house officers and junior medical officers.

  2. Cutaneous zygomycosis.

    Science.gov (United States)

    Bonifaz, Alexandro; Vázquez-González, Denisse; Tirado-Sánchez, Andrés; Ponce-Olivera, Rosa María

    2012-01-01

    Cutaneous zygomycosis is a fungal infection caused by zygomycetes that affects the skin. It occurs in uncontrolled diabetic patients and immunosuppressed individuals. It has 2 clinical forms: primary cutaneous zygomycosis and secondary cutaneous zygomycosis. The first is characterized by necrotic lesions and the fungus is usually inoculated by trauma. If diagnosed early, it generally has a good prognosis. Secondary zygomycosis is usually a complication and extension of the rhinocerebral variety that starts as a palpebral fistula and progresses to a necrotic lesion with a poor prognosis. The diagnosis is made by identification of the fungus by direct KOH examination, culture, and biopsy. Treatment for the primary disease is surgical debridement plus amphotericin B. The secondary type is treated with amphotericin B and/or posaconazole.

  3. Anti-Protective Antigen IgG Enzyme-Linked Immunosorbent Assay for Diagnosis of Cutaneous Anthrax in India

    Science.gov (United States)

    Ghosh, N.

    2012-01-01

    Anthrax caused by Bacillus anthracis is a public health problem in several developing countries whose main source of income is farming. Anthrax is a disease of herbivorous animals, and humans can be infected by handling infected animals or contaminated animal products. Specific diagnostic tests are unavailable in India for the detection and confirmation of cutaneous anthrax in humans. Here, we describe the development of an enzyme-linked immunosorbent assay (ELISA) for detection of serum antibodies against Bacillus anthracis protective antigen in the Indian population. A total of 405 serum samples collected from different groups were tested by the developed ELISA. The assay provided a specificity of 99.41% (95% confidence interval [CI], 97.89 to 99.93) and a sensitivity of 100% (CI, 94.4 to 100) using a cutoff value of 0.29 ELISA unit (EU). The positive predictive value (PPV) and negative predictive value (NPV) of the assay were 97% and 100%, respectively. The efficiency and J index for the reliability of the assay were 99.5% and 0.994, respectively. The assay can be a very useful tool for surveillance as well as for diagnosis of cutaneous anthrax cases in India. PMID:22718130

  4. Esophageal melanomas harbor frequent NRAS mutations unlike melanomas of other mucosal sites.

    Science.gov (United States)

    Sekine, Shigeki; Nakanishi, Yukihiro; Ogawa, Reiko; Kouda, Satoko; Kanai, Yae

    2009-05-01

    Mucosal melanomas have genetic alterations distinct from those in cutaneous melanomas. For example, NRAS- and BRAF-activating mutations occur frequently in cutaneous melanomas, but not in mucosal melanomas. We examined 16 esophageal melanomas for genetic alterations in NRAS, BRAF, and KIT to determine whether they exhibit genetic features common to melanomas arising from other mucosal sites. A sequencing analysis identified NRAS mutations in six cases; notably, four of these mutations were located in exon 1, an uncommon mutation site in cutaneous and other mucosal melanomas. BRAF and KIT mutations were found in one case each. Immunohistochemistry showed KIT expression in four cases, including the tumor with a KIT mutation and two other intramucosal tumors. The low frequency of BRAF mutations and the presence of a KIT mutation-positive case are findings similar to those of mucosal melanomas of other sites, but the prevalence of NRAS mutations was even higher than that of cutaneous melanomas. The present study implies that esophageal melanomas have genetic alterations unique from those observed in other mucosal melanomas.

  5. Non-immediate Cutaneous Reactions to Beta-Lactams: Approach to Diagnosis.

    Science.gov (United States)

    Romano, Antonino; Valluzzi, Rocco Luigi; Caruso, Cristiano; Maggioletti, Michela; Gaeta, Francesco

    2017-04-01

    Non-immediate cutaneous reactions (i.e., occurring at least 1 h after the initial drug administration), particularly maculopapular exanthemas and urticarial eruptions, are common during beta-lactam treatments. A T cell-mediated pathogenic mechanism has been demonstrated in some cutaneous reactions, such as maculopapular exanthema, fixed drug eruption, acute generalized exanthematous pustulosis, and drug-induced hypersensitivity syndrome. In the diagnostic work-up, patch testing is useful, together with delayed-reading intradermal testing. Patch tests are a simple and safe diagnostic tool, which in the case of severe reactions should be used as the first line of investigation. However, patch tests are less sensitive than intradermal tests, which are preferable in subjects with mild reactions. Lymphocyte transformation or activation tests and enzyme-linked immunosorbent spot assays can be used as complementary tests. In selected cases of mild or moderate reactions, displaying negative results in the aforesaid allergy tests, a graded challenge with the implicated beta-lactam can be performed.

  6. Brain metastasis is predetermined in early stages of cutaneous melanoma by CD44v6 expression through epigenetic regulation of the spliceosome.

    Science.gov (United States)

    Marzese, Diego M; Liu, Michelle; Huynh, Jamie L; Hirose, Hajime; Donovan, Nicholas C; Huynh, Kelly T; Kiyohara, Eiji; Chong, Kelly; Cheng, David; Tanaka, Ryo; Wang, Jinhua; Morton, Donald L; Barkhoudarian, Garni; Kelly, Daniel F; Hoon, Dave S B

    2015-01-01

    Melanoma brain metastasis (MBM) is frequent and has a very poor prognosis with no current predictive factors or therapeutic molecular targets. Our study unravels the molecular alterations of cell-surface glycoprotein CD44 variants during melanoma progression to MBM. High expression of CD44 splicing variant 6 (CD44v6) in primary melanoma (PRM) and regional lymph node metastases from AJCC Stage IIIC patients significantly predicts MBM development. The expression of CD44v6 also enhances the migration of MBM cells by hyaluronic acid and hepatocyte growth factor exposure. Additionally, CD44v6-positive MBM migration is reduced by blocking with a CD44v6-specific monoclonal antibody or knocking down CD44v6 by siRNA. ESRP1 and ESRP2 splicing factors correlate with CD44v6 expression in PRM, and ESRP1 knockdown significantly decreases CD44v6 expression. However, an epigenetic silencing of ESRP1 is observed in metastatic melanoma, specifically in MBM. In advanced melanomas, CD44v6 expression correlates with PTBP1 and U2AF2 splicing factors, and PTBP1 knockdown significantly decreases CD44v6 expression. Overall, these findings open a new avenue for understanding the high affinity of melanoma to progress to MBM, suggesting CD44v6 as a potential MBM-specific factor with theranostic utility for stratifying patients.

  7. Molecular diagnosis of Leishmania mexicana in a cutaneous leishmaniasis case in Sinaloa, Mexico.

    Science.gov (United States)

    Ochoa-Diaz, Yssete O; Lopez-Moreno, Carmina Y; Rendon-Maldonado, Jose G; Lopez-Moreno, Hector S

    2012-01-01

    Leishmaniasis has been considered endemic in Sinaloa, Mexico, since 1994. Despite that Leishmania mexicana is the main etiological agent of cutaneous leishmaniasis (CL) in other regions of Mexico, the species causing CL in patients from Sinaloa state has not been previously established, although Leishmania braziliensis has been found in the neighboring southern state, Nayarit. L. braziliensis is also associated with mucocutaneous leishmaniasis, which is a more complicated clinical variant. Due to the implications on individual and public health, the objective of this report was to identify the Leishmania species present in Sinaloa, Mexico. Using the first internal transcribed spacer (ITS-1) polymerase chain reaction-restriction fragment length polymorphism, we identified L. mexicana in a CL patient from Sinaloa and confirmed the extended distribution of this parasite in Mexico.

  8. Shave Biopsy Is a Safe and Accurate Method for the Initial Evaluation of Melanoma

    Science.gov (United States)

    Zager, Jonathan S; Hochwald, Steven N; Marzban, Suroosh S; Francois, Rony; Law, Kimberly M; Davis, Ashley H; Messina, Jane L; Vincek, Vladimir; Mitchell, Christina; Church, Ann; Copeland, Edward M; Sondak, Vernon K; Grobmyer, Stephen R

    2015-01-01

    BACKGROUND Shave biopsy of cutaneous lesions is simple, efficient, and commonly used clinically. However, this technique has been criticized for its potential to hamper accurate diagnosis and microstaging of melanoma, thereby complicating treatment decision-making. STUDY DESIGN We retrospectively analyzed a consecutive series of patients referred to the University of Florida Shands Cancer Center or to the Moffitt Cancer Center for treatment of primary cutaneous melanoma, initially diagnosed on shave biopsy to have Breslow depth biopsy in T-staging and the potential impact on definitive surgical treatment and outcomes. RESULTS Six hundred patients undergoing shave biopsy were diagnosed with melanoma from extremity (42%), trunk (37%), and head or neck (21%). Mean (± SEM) Breslow thickness was 0.73 ± 0.02 mm; 6.2% of lesions were ulcerated. At the time of wide excision, residual melanoma was found in 133 (22%), resulting in T-stage upstaging for 18 patients (3%). Recommendations for additional wide excision or sentinel lymph node biopsy changed in 12 of 600 (2%) and 8 of 600 patients (1.3%), respectively. Locoregional recurrence occurred in 10 (1.7%) patients and distant recurrence in 4 (0.7%) patients. CONCLUSIONS These data challenge the surgical dogma that full-thickness excisional biopsy of suspicious cutaneous lesions is the only method that can lead to accurate diagnosis. Data obtained on shave biopsy of melanoma are reliable and accurate in the overwhelming majority of cases (97%). The use of shave biopsy does not complicate or compromise management of the overwhelming majority of patients with malignant melanoma. PMID:21463767

  9. Bronchial malignant melanoma.

    Science.gov (United States)

    Weshler, Z; Sulkes, A; Kopolovitch, J; Leviatan, A; Shifrin, E

    1980-01-01

    We describe a case of malignant melanoma presenting initially as an endobronchial lesion located in the left main bronchus causing total atelectasis. This resolved with radiation therapy. Widespread metastases developed shortly thereafter. The differential diagnosis of primary and metastatic bronchial malignant melanoma is discussed. Other isolated case reports are reviewed.

  10. Primary pulmonary/pleural melanoma in a 13 year-old presenting as pleural effusion.

    Science.gov (United States)

    Baniak, Nick; Podberezin, Mark; Kanthan, Selliah C; Kanthan, Rani

    2017-02-01

    Melanoma in children, adolescents, and young adults is uncommon and reported almost exclusively as cutaneous melanoma. Melanoma presenting as a pleural effusion is very rare in adults and not reported in the pediatric population. Additionally, primary pulmonary melanoma is overall very rare and undocumented in pediatric patients. Furthermore, the distinction between a primary pulmonary/pleural melanoma versus a regressed cutaneous melanoma with pulmonary/pleural metastases remains extremely challenging. We discuss a case of a previously healthy 13-year-old girl that presented with a left-sided pleural effusion. Investigations revealed a large mediastinal mass, left-sided pleural and pulmonary nodules, a sacral mass, and bone marrow infiltration. The neoplasm was subsequently diagnosed by morphology and immunocytochemistry with histological correlation as malignant melanoma. As no mucosal, eye, or cutaneous lesions were identified, we deliberate the likelihood of a regressed cutaneous melanoma with metastases versus primary pulmonary/pleural melanoma with pleural effusion and discuss its diagnostic approach.

  11. Evaluation of the polymerase chain reaction in the diagnosis of cutaneous leishmaniasis due to Leishmania major: a comparison with direct microscopy of smears and sections from lesions

    DEFF Research Database (Denmark)

    Andresen, K; Gaafar, A; El-Hassan, A M

    1996-01-01

    We have compared the sensitivity of the polymerase chain reaction (PCR) as a diagnostic tool against conventional microscopical diagnostic techniques in patients with cutaneous leishmaniasis from the Sudan. Twenty-eight patients were diagnosed according to clinical criteria followed by microscopi......We have compared the sensitivity of the polymerase chain reaction (PCR) as a diagnostic tool against conventional microscopical diagnostic techniques in patients with cutaneous leishmaniasis from the Sudan. Twenty-eight patients were diagnosed according to clinical criteria followed......%, respectively. The PCR should be considered as a valuable and sensitive diagnostic tool in the diagnosis of cutaneous leishmaniasis; it has the added advantage of identification of the species of Leishmania causing the lesion....

  12. Angles and geometric shapes, but not lines, in melanocytic lesions may be helpful in the clinical diagnosis of melanoma.

    Science.gov (United States)

    Betti, R; Cerri, A; Vergani, R; Agape, E; Menni, S

    2015-07-01

    Geometric shapes have been suggested to be found in malignant melanomas. We have observed a number of melanomas presenting with linear and incomplete angulated figures. To verify the assumption that geometric shapes, a linear border and/or incomplete angulated figures may indicate a potential melanoma. Patients with surgically removed melanocytic lesions were admitted to the study. We evaluated the presence of a sharp linear demarcation, the presence of contiguous lines resulting in the formation of angle/s and the presence of complete geometric figure. We distinguished the obtained results into melanoma and benign melanocytic naevi. A total of 471 melanomas and 1979 melanocytic naevi were collected. Linear borders, angles and geometric figures were observed in 42 melanomas and in 75 benign melanocytic naevi. Angles with incomplete geometric configuration were observed in 21 melanomas and in 37 benign naevi (21/471 vs. 37/1979, 4.24% vs. 1.87%; P geometrical figures in 12 melanomas and 17 naevi (12/471 vs. 17/1979, 2.54% vs. 0.85%; P geometrical configurations might indicate a suspect melanoma. Only sharp linear demarcation of the lesion do not seem to be significantly associated with melanoma suspicion. © 2014 European Academy of Dermatology and Venereology.

  13. Increasing Incidence of Melanoma among Middle-Aged Adults: An Epidemiologic Study in Olmsted County, Minnesota

    Science.gov (United States)

    Lowe, Garrett C.; Saavedra, Alexandra; Reed, Kurtis B.; Velazquez, Ana I.; Dronca, Roxana S.; Markovic, Svetomir N.; Lohse, Christine M.; Brewer, Jerry D.

    2015-01-01

    Objective To identify changes in incidence of cutaneous melanoma over time in the fastest-growing segment of the US population, middle-aged adults. Patients and Methods Using the Rochester Epidemiology Project resource, we identified patients aged 40 to 60 years who had a first lifetime diagnosis of melanoma between January 1, 1970, and December 31, 2009, in Olmsted County, Minnesota. Incidence of melanoma and overall and disease-specific survival rates were compared by age, sex, year of diagnosis, and stage of disease. Results From 1970 through 2009, age- and sex-adjusted incidence increased significantly over time (P<.001) from 7.9 to 60.0 per 100,000 person-years, with a 24-fold increase in women and a 4.5-fold increase in men. Although not significant (P=.06), incidence of melanoma increased with age. Overall and disease-specific survival improved over time, with hazard ratios of 0.94 (P<.001) and 0.93 (P<.001) for each 1-year increase in year of diagnosis, respectively. Each 1-year increase in age at diagnosis was associated with increased risk of death from any cause (hazard ratio, 1.07; P=.01) but was not significantly associated with disease-specific death. Sex was not significantly associated with death from any cause or death from disease. No patient with malignant melanoma in situ died from disease. Patients with stage II, III, and IV disease were over 14 times more likely to die from disease compared with patients with stage 0 or I disease (P<.001). Conclusion The incidence of cutaneous melanoma among middle-aged adults increased over the past 4 decades, especially in middle-aged women, while mortality decreased. PMID:24388022

  14. Assessment of Optical Coherence Tomography Imaging in the Diagnosis of Non-Melanoma Skin Cancer and Benign Lesions Versus Normal Skin:

    DEFF Research Database (Denmark)

    Mogensen, Mette; Jørgensen, Thomas Martini; Nürnberg, Birgit Meincke;

    2009-01-01

    BACKGROUND Optical coherence tomography (OCT) is an optical imaging technique that may be useful in diagnosis of non-melanoma skin cancer (NMSC). OBJECTIVES To describe OCT features in NMSC such as actinic keratosis (AK) and basal cell carcinoma (BCC) and in benign lesions and to assess the diagn......BACKGROUND Optical coherence tomography (OCT) is an optical imaging technique that may be useful in diagnosis of non-melanoma skin cancer (NMSC). OBJECTIVES To describe OCT features in NMSC such as actinic keratosis (AK) and basal cell carcinoma (BCC) and in benign lesions and to assess...... the diagnostic accuracy of OCT in differentiating NMSC from benign lesions and normal skin. METHODS AND MATERIALS OCT and polarization-sensitive (PS) OCT from 104 patients were studied. Observer-blinded evaluation of OCT images from 64 BCCs, 1 baso-squamous carcinoma, 39 AKs, two malignant melanomas, nine benign......-defined layering in OCT and PS-OCT images and dark lobules in BCC. Discrimination of AK from BCC had an error rate of 50% to 52%. CONCLUSION OCT features in NMSC are identified, but AK and BCC cannot be differentiated. OCT diagnosis is less accurate than clinical diagnosis, but high accuracy in distinguishing...

  15. [The laboratory diagnosis and epidemiology of cutaneous leishmaniasis in Paraná State, southern Brazil].

    Science.gov (United States)

    Silveira, T G; Arraes, S M; Bertolini, D A; Teodoro, U; Lonardoni, M V; Roberto, A C; Ramos, M; Nerilo Sobrinho, A; Ishikawa, E; Shaw, J

    1999-01-01

    Between 1986 and 1997 a total of 1418 patients were examined at the Clinical Analysis Teaching and Research Laboratory of Maringá State University (LEPAC/UEM) for cutaneous leishmaniasis by direct examination of stained smears made from the lesions, the Montenegro skin test and the indirect immunofluorescent antibody test. Nine hundred and fifty five patients (67.3%) were positive for at least one of the three tests and of these 804 (84.2%) were considered to have contracted the disease in Paraná State; 665 (69.6%) were between 15 and 49 years old; 658 (68.9%) were males; 523 (54.8%) sought medical advice during the first three months of their infections and 74 (7.7%) had mucosal lesions. Of the 83 counties of Paraná State, where the patients had most probably acquired their infections, 44.7% were from the counties of São Jorge do Ivaí (10.2%), Doutor Camargo (9.8%), Terra Boa (7.3%), Maringá (7.3%), Jussara (6.0%) and Cianorte (4.5%). Seventy seven strains of Leishmania (Viannia) braziliensis were isolated and 63.6% of these strains belong to serodema 1.

  16. Prognostic significance of hematological profiles in melanoma patients.

    Science.gov (United States)

    Gandini, Sara; Ferrucci, Pier Francesco; Botteri, Edoardo; Tosti, Giulio; Barberis, Massimo; Pala, Laura; Battaglia, Angelo; Clerici, Alessandra; Spadola, Giuseppe; Cocorocchio, Emilia; Martinoli, Chiara

    2016-10-01

    Cancer-related inflammation may play an important role in disease progression and patient outcome, and could be easily monitored through indirect parameters routinely evaluated at diagnosis. Here, we investigated if peripheral blood cells and the ratios of neutrophils to lymphocytes (NLR) and of lymphocytes to monocytes (LMR) as surrogate markers of cancer related inflammation are associated with disease progression and survival of melanoma patients at any stage of the disease. Records of 1,182 melanoma patients included in an Institutional tumor registry in the period 2000-2010, were reviewed. Among them, 584 patients with a cutaneous or unknown primary melanoma and available pre-operative blood tests were analyzed. Survival was estimated with the Kaplan-Meier method, and analyzed using Log-rank test, Cox regression and multivariate Cox proportional hazard models. We found that patients presenting with distant metastases had higher leukocytes, neutrophils and monocytes, and lower lymphocytes compared to Stage I-III patients. Furthermore, at a single-patient level, hematological profiles changed on disease progression from regional to distant metastatic, with significantly increased circulating leukocytes, neutrophils and monocytes, and decreased lymphocytes. Peripheral blood cell counts were not associated with survival of patients with a localized or regionally metastasized melanoma. Instead, in Stage IV patients, leukocytes (p = 0.001), neutrophils (p = 0.0002), monocytes (p = 0.002), NLR (p melanoma. © 2016 UICC.

  17. Consistency and distribution of reflectance confocal microscopy features for diagnosis of cutaneous T cell lymphoma

    Science.gov (United States)

    Lange-Asschenfeldt, Susanne; Babilli, Jasmin; Beyer, Marc; Ríus-Diaz, Francisca; González, Salvador; Stockfleth, Eggert; Ulrich, Martina

    2012-01-01

    Reflectance confocal microscopy (RCM) represents a noninvasive imaging technique that has previously been used for characterization of mycosis fungoides (MF) in a pilot study. We aimed to test the applicability of RCM for diagnosis and differential diagnosis of MF in a clinical study. A total of 39 test sites of 15 patients with a biopsy-proven diagnosis of either MF, parapsoriasis, Sézary syndrome, or lymphomatoid papulosis were analyzed for presence and absence of RCM features of MF. Cochran and Chi2 analysis were applied to test the concordance between investigators and the distribution of RCM features, respectively. For selected parameters, the Cochran analysis showed good concordance between investigators. Inter-observer reproducibility was highest for junctional atypical lymphocytes, architectural disarray, and spongiosis. Similarly, Chi2 analysis demonstrated that selected features were present at particularly high frequency in individual skin diseases, with values ranging from 73% to 100% of all examined cases.

  18. Synchronous anorectal melanoma

    Institute of Scientific and Technical Information of China (English)

    Drinko Balicevic; Karla Tomic; Miroslav Bekavac-Beslin; Igor Kovacevic; August Mijic; Mladen Belicza; Bozo Kruslin

    2006-01-01

    Anorectal melanoma is a very rare tumor with poor prognosis. Rectal bleeding is the most frequent symptom and surgical treatment ranges from local excision to radical abdominoperineal resection. We report a case of a 75-years-old male patient who presented with a history of recurrent rectal bleeding, and whose histopathological diagnosis was melanoma. Macroscopically, we found two distinct tumors in anorectal region, 0.5 cm and 1.5 cm from dentate line. The first one was pedunculated, on a thin stalk, measuring 1 cm in greatest diameter, and the second one was sessile and nodular measuring up to 2.8 cm in largest diameter. Microscopic examination and immunohistochemical analysis of both tumors confirmed the diagnosis of melanoma. This case represents multiple synchronous primary melanoma of the anorectal region, with a possibility that one of the lesions is primary melanoma and the second one is a satellite lesion.

  19. Development and validation of PCR-based assays for diagnosis of American cutaneous leishmaniasis and identification of the parasite species.

    Science.gov (United States)

    Graça, Grazielle Cardoso da; Volpini, Angela Cristina; Romero, Gustavo Adolfo Sierra; Oliveira Neto, Manoel Paes de; Hueb, Marcia; Porrozzi, Renato; Boité, Mariana Côrtes; Cupolillo, Elisa

    2012-08-01

    In this study, PCR assays targeting different Leishmania heat-shock protein 70 gene (hsp70) regions, producing fragments ranging in size from 230-390 bp were developed and evaluated to determine their potential as a tool for the specific molecular diagnosis of cutaneous leishmaniasis (CL). A total of 70 Leishmania strains were analysed, including seven reference strains (RS) and 63 previously typed strains. Analysis of the RS indicated a specific region of 234 bp in the hsp70 gene as a valid target that was highly sensitive for detection of Leishmania species DNA with capacity of distinguishing all analyzed species, after polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). This PCR assay was compared with other PCR targets used for the molecular diagnosis of leishmaniasis: hsp70 (1400-bp region), internal transcribed spacer (ITS)1 and glucose-6-phosphate dehydrogenase (G6pd). A good agreement among the methods was observed concerning the Leishmania species identification. Moreover, to evaluate the potential for molecular diagnosis, we compared the PCR targets hsp70-234 bp, ITS1, G6pd and mkDNA using a panel of 99 DNA samples from tissue fragments collected from patients with confirmed CL. Both PCR-hsp70-234 bp and PCR-ITS1 detected Leishmania DNA in more than 70% of the samples. However, using hsp70-234 bp PCR-RFLP, identification of all of the Leishmania species associated with CL in Brazil can be achieved employing a simpler and cheaper electrophoresis protocol.

  20. Development and validation of PCR-based assays for diagnosis of American cutaneous leishmaniasis and identificatio nof the parasite species

    Directory of Open Access Journals (Sweden)

    Grazielle Cardoso da Graça

    2012-08-01

    Full Text Available In this study, PCR assays targeting different Leishmania heat-shock protein 70 gene (hsp70 regions, producing fragments ranging in size from 230-390 bp were developed and evaluated to determine their potential as a tool for the specific molecular diagnosis of cutaneous leishmaniasis (CL. A total of 70 Leishmania strains were analysed, including seven reference strains (RS and 63 previously typed strains. Analysis of the RS indicated a specific region of 234 bp in the hsp70 gene as a valid target that was highly sensitive for detection of Leishmania species DNA with capacity of distinguishing all analyzed species, after polymerase chain reaction-restriction fragment length polymorfism (PCR-RFLP. This PCR assay was compared with other PCR targets used for the molecular diagnosis of leishmaniasis: hsp70 (1400-bp region, internal transcribed spacer (ITS1 and glucose-6-phosphate dehydrogenase (G6pd. A good agreement among the methods was observed concerning the Leishmania species identification. Moreover, to evaluate the potential for molecular diagnosis, we compared the PCR targets hsp70-234 bp, ITS1, G6pd and mkDNA using a panel of 99 DNA samples from tissue fragments collected from patients with confirmed CL. Both PCR-hsp70-234 bp and PCR-ITS1 detected Leishmania DNA in more than 70% of the samples. However, using hsp70-234 bp PCR-RFLP, identification of all of the Leishmania species associated with CL in Brazil can be achieved employing a simpler and cheaper electrophoresis protocol.

  1. Immunotherapy of metastatic melanoma by reversal of immune suppression

    Energy Technology Data Exchange (ETDEWEB)

    Biggs, M.W.; Eiselein, J.E.

    1997-01-01

    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.

  2. Non-Invasive Cytology Brush PCR for the Diagnosis and Causative Species Identification of American Cutaneous Leishmaniasis in Peru

    Science.gov (United States)

    Alba, Milena; Adaui, Vanessa; Arevalo, Jorge; Low, Donald E.; Llanos-Cuentas, Alejandro; Boggild, Andrea K.

    2012-01-01

    Background Traditional methods of detecting Leishmania from cutaneous lesions involve invasive diagnostic procedures, such as scrapings, which cause discomfort, require technical expertise, and carry risks of invasive procedures. We compared the performance of 2 novel, molecular-based non-invasive methods for the diagnosis of cutaneous leishmaniasis (CL). Methods Consecutive patients presenting to the Leishmania Clinic at the Hospital Nacional Cayetano Heredia were enrolled. PCR was performed on filter paper lesion impressions (FPLIs), cytology brushes, and lancets for detection of Leishmania DNA. Smears from lesion scrapings and leishmanin skin test were also performed. Outcome measures were sensitivity and specificity. Composite reference standard was any 2 of 5 tests positive. Species identification was performed by PCR assays of positive specimens. Results Ninety patients with 129 lesions were enrolled, 117 of which fulfilled reference criteria for a diagnosis of CL. Of these 117 lesions, 113 were positive by PCR of lancets used for lesion scrapings versus 116 by PCR of FPLIs (p = 0.930) or 116 by PCR of cytology brushes (p = 0.930). Sensitivity and specificity of PCR on lancets were 96.6% [95% CI 93.3–99.9%] and 100%, respectively. Sensitivity and specificity of FPLI PCR were 99.1% [95% CI 97.4–100%] and 100%, respectively. Sensitivity and specificity of cytology brush PCR were 99.1% [95% CI 97.4–100%] and 100%, respectively. Giemsa-stained lesion smear and leishmanin skin test had inferior sensitivities at 47.9% [95% CI 38.9–57.0%] and 82.3% [95% CI 73.9–90.7%], respectively, compared to PCR of invasive or non-invasive specimens (p<0.001). Conclusions Cytology brush PCR constitutes a sensitive and specific alternative to traditional diagnostic assays performed on invasive specimens such as lesion scrapings. It performs comparatively to non-invasive FPLI PCR. This novel, rapid, and well-tolerated method has the potential for widespread use in

  3. Epidermotropic metastatic melanoma with perilesional depigmentation in an Indian male

    Directory of Open Access Journals (Sweden)

    Bhavana Doshi

    2013-01-01

    Full Text Available Melanoma is a rare form of cutaneous malignancy encountered in the dark skin population. Epidermotropic metastatic melanoma is a rare form of cutaneous metastatic melanoma which can mimic primary melanoma on histopathology. Hence its differentiation is of immense prognostic importance. The occurrence of rim of depigmentation around the primary cutaneous melanoma has previously been reported to portend a bad prognosis. The occurrence of vitiligo like lesions in patients with metastatic melanoma in comparison has a better prognosis. However the occurrence of depigmentation around the secondaries is rare and its importance is not well known. Hence we wish to report a case of epidermotropic metastatic melanoma with perilesional depigmentation in a 78 year old Indian male.

  4. Basal cell carcinoma in oculo-cutaneous albinism

    Directory of Open Access Journals (Sweden)

    Ajay Kumar

    2016-06-01

    Full Text Available The basal cell carcinoma is the most common skin tumour especially affecting the white individuals worldwide. The exact incidence of basal cell carcinoma is not known from India but non melanoma skin cancers comprises about 1-2% of cutaneous tumour in India. The most common skin tumour is squamous cell carcinoma in albinism and the incidence of basal cell carcinoma is less. Hereby, we report a peculiar case of basal cell carcinoma in albinism to highlights the importance of early recognition and diagnosis of suspected lesions by performing histopathological examination in unusual circumstances. [Int J Res Med Sci 2016; 4(6.000: 2452-2454

  5. Evaluation of a direct immunofluorescent antibody (difma test using Leishmania genus - specific monoclonal antibody in the routine diagnosis of cutaneous leishmaniasis

    Directory of Open Access Journals (Sweden)

    Martha E. Chico

    1995-06-01

    Full Text Available A direct immunofluorescent antibody (DIFMA test using a Leishmania genus- specific monoclonal antibody was evaluated in the routine diagnosis of cutaneous leishmaniasis (CL in Ecuador. This test was compared with the standard diagnostic techniques of scrapings, culture and histology. Diagnostic samples were taken from a total of 90 active dermal ulcers from patients from areas of Ecuador known to be endemic for cutaneous leishmaniasis. DIFMA was positive in all lesions. It was shown to be significantly superior to standard diagnostic methods either alone or in combination. The sensitivity of DIFMA did not diminish with chronicity of lesions. This test proved to be extremely useful in the routine diagnosis of CL because it is highly sensitive, is easy to use and produces rapid results.

  6. Melanoma of unknown origin: a case series.

    LENUS (Irish Health Repository)

    Kelly, J

    2010-12-01

    The natural history of metastatic melanoma involving lymph nodes, in the absence of a known primary site (cutaneous, ocular or mucosal) has, to date, been poorly defined; and the optimal management of this rare subtype of disease is therefore unclear. Melanomas of unknown primary site (MUP) are estimated to comprise between 3.7 and 6% of all melanomas (Anbari et al. in Cancer 79:1861-1821, 1997).

  7. Initial misdiagnosis of melanoma located on the foot is associated with poorer prognosis.

    Science.gov (United States)

    Sondermann, Wiebke; Zimmer, Lisa; Schadendorf, Dirk; Roesch, Alexander; Klode, Joachim; Dissemond, Joachim

    2016-07-01

    Acral melanoma has been reported to be associated with poorer outcomes than melanoma occurring on other cutaneous sites. It has been suggested that part of this disparity in outcomes may be related to delay in diagnosis. Therefore, we have analyzed the rate of misdiagnoses in patients with melanoma located on the foot and have characterized the influence on the clinical course and survival of the patients. A prospective, computerized melanoma database at the Skin Cancer Center of the University Hospital Essen, Germany was used to identify patients with histologically confirmed melanoma located on the foot between 2002 and July 2013 for subsequent analysis. A cohort of 151 patients diagnosed with primary melanoma located on the foot was identified. One hundred seven patients qualified for subsequent analysis. Forty-two patients were male (39.3%) and 65 (60.7%) were female; the mean age at first diagnosis was 61.6 years (median 66 years). The youngest patient was 19 years, the oldest 88 years old.Of the 107 patients analyzed, 32 (30%) were initially misdiagnosed. Misdiagnoses included chronic wounds, nevi, hematoma, fungal infections, warts, and paronychia. Misdiagnosis caused a median delay in diagnosis of 9 months. The 5-year disease-free survival rate (47.8% vs 72.7%) and the 5-year overall survival rate (63.5% vs 88.4%) were statistically significant lower in the misdiagnosis cohort.The awareness of potentially overlooked melanoma located on the foot has to increase among physicians.To improve early detection and, thus, the prognosis of patients with melanoma located on the foot, taking a biopsy from any suspicious lesion should be taken into consideration as soon as possible.

  8. Laser induced autofluorescence for diagnosis of non-melanoma skin cancer

    Science.gov (United States)

    Drakaki, E.; Makropoulou, M.; Serafetinides, A. A.; Merlemis, N.; Kalatzis, I.; Sianoudis, I. A.; Batsi, O.; Christofidou, E.; Stratigos, A. J.; Katsambas, A. D.; Antoniou, Ch.

    2015-01-01

    Non melanoma skin cancer is one of the most frequent malignant tumors among humans. A non-invasive technique, with high sensitivity and high specificity, would be the most suitable method for basal cell carcinoma (BCC) or other malignancies diagnostics, instead of the well established biopsy and histopathology examination. In the last decades, a non-invasive, spectroscopic diagnostic method was introduced, the laser induced fluorescence (LIF), which could generate an image contrast between different states of skin tissue. The noninvasiveness consists in that this biophotonic method do not require tissue sample excision, what is necessary in histopathology characterization and biochemical analysis of the skin tissue samples, which is worldwide used as an evaluation gold standard. The object of this study is to establish the possibilities of a relatively portable system for laser induced skin autofluorescence to differentiate malignant from nonmalignant skin lesions. Unstained human skin samples, excised from humans undergoing biopsy examination, were irradiated with a Nd:YAG-3ω laser (λ=355 nm, 6 ns), used as an excitation source for the autofluorescence measurements. A portable fiber-based spectrometer was used to record fluorescence spectra of the sites of interest. The ex vivo results, obtained with this spectroscopic technique, were correlated with the histopathology results. After the analysis of the fluorescence spectra of almost 60 skin tissue areas, we developed an algorithm to distinguish different types of malignant lesions, including inflammatory areas. Optimization of the data analysis and potential use of LIF spectroscopy with 355 nm Nd:YAG laser excitation of tissue autofluorescence for clinical applications are discussed.

  9. Fatty Acid Synthase and Acetyl-CoA Carboxylase Are Expressed in Nodal Metastatic Melanoma But Not in Benign Intracapsular Nodal Nevi.

    Science.gov (United States)

    Saab, Jad; Santos-Zabala, Maria Laureana; Loda, Massimo; Stack, Edward C; Hollmann, Travis J

    2017-06-13

    Melanoma is a potentially lethal form of skin cancer for which the current standard therapy is complete surgical removal of the primary tumor followed by sentinel lymph node biopsy when indicated. Histologic identification of metastatic melanoma in a sentinel node has significant prognostic and therapeutic implications, routinely guiding further surgical management with regional lymphadenectomy. While melanocytes in a lymph node can be identified by routine histopathologic and immunohistochemical examination, the distinction between nodal nevus cells and melanoma can be morphologically problematic. Previous studies have shown that malignant melanoma can over-express metabolic genes such as fatty acid synthase (FASN) and acetyl-CoA carboxylase (ACC). This immunohistochemical study aims to compare the utility of FASN and ACC in differentiating sentinel lymph nodes with metastatic melanomas from those with benign nodal nevi in patients with cutaneous melanoma. Using antibodies against FASN and ACC, 13 sentinel lymph nodes from 13 patients with metastatic melanoma and 14 lymph nodes harboring benign intracapsular nevi from 14 patients with cutaneous malignant melanoma were examined. A diagnosis of nodal melanoma was based on cytologic atypia and histologic comparison with the primary melanoma. All nodal nevi were intracapsular and not trabecular. Immunohistochemistry for Melan-A, S100, human melanoma black 45 (HMB45), FASN, and ACC were performed. The percentage of melanocytes staining with HMB45, FASN, and ACC was determined and graded in 25% increments; staining intensity was graded as weak, moderate, or strong. All metastatic melanomas tested had at least 25% tumor cell staining for both FASN and ACC. Greater than 75% of the tumor cells stained with FAS in 7/13 cases and for ACC in 5/12 cases. Intensity of staining was variable; strong staining for FASN and ACC was observed in 69% and 50% of metastatic melanoma, respectively. HMB45 was negative in 40% of nodal

  10. [ Spectrum of oncogene mutations is different in melanoma subtypes].

    Science.gov (United States)

    Mazurenko, N N; Tsyganova, I V; Lushnikova, A A; Ponkratova, D A; Anurova, O A; Cheremushkin, E A; Mikhailova, I N; Demidov, L V

    2015-01-01

    Melanoma is the most lethal malignancy of skin, which is comprised of clinically relevant molecular subsets defined by specific "driver" mutations in BRAF, NRAS, and KIT genes. Recently, the better results in melanoma treatment were obtained with the mutation-specific inhibitors that have been developed for clinical use and target only patients with particular tumor genotypes. The aim of the study was to characterize the spectrum of "driver" mutations in melanoma subtypes from 137 patients with skin melanoma and 14 patients with mucosal melanoma. In total 151 melanoma cases, the frequency of BRAF, NRAS, KIT, PDGFRA, and KRAS mutations was 55.0, 10.6, 4.0, 0.7, and 0.7%, respectively. BRAF mutations were found in 69% of cutaneous melanoma without UV exposure and in 43% of cutaneous melanoma with chronic UV exposure (p=0.045), rarely in acral and mucosal melanomas. Most of melanomas containing BRAF mutations, V600E (92%) and V600K (6.0%) were potentially sensitive to inhibitors vemurafenib and dabrafenib. NRAS mutations were more common in cutaneous melanoma with chronic UV exposure (26.0%), in acral and mucosal melanomas; the dominant mutations being Q61R/K/L (87.5%). KIT mutations were found in cutaneous melanoma with chronic UV exposure (8.7%) and mucosal one (28.6%), but not in acral melanoma. Most of KIT mutations were identified in exon 11; these tumors being sensitive to tyrosine kinase inhibitors. This is the first monitoring of BRAF, NRAS, KIT, PDGFRA, and KRAS hotspot mutations in different subtypes of melanoma for Russian population. On the base of data obtained, one can suppose that at the molecular level melanomas are heterogeneous tumors that should be tested for "driver" mutations in the each case for evaluation of the potential sensitivity to target therapy. The obtained results were used for treatment of melanoma patients.

  11. Naevus Lipomatosus Cutaneous Superficialis

    Directory of Open Access Journals (Sweden)

    Ramanan C

    2001-01-01

    Full Text Available Naevus lipomatosus cutaneous superficialis (NLCS in an eighteen year old female is reported. She had asymptomatic nodules and plaques on her lower back since birth. The diagnosis was confirmed by histopathology

  12. Acral lentiginous melanoma - a skin cancer with unfavourable prognostic features. A study of the German Central Malignant Melanoma Registry (CMMR) in 2050 patients.

    Science.gov (United States)

    Teramoto, Y; Keim, U; Gesierich, A; Schuler, G; Fiedler, E; Tüting, T; Ulrich, C; Wollina, U; Hassel, J C; Gutzmer, R; Goerdt, S; Zouboulis, C; Leiter, U; Eigentler, T K; Garbe, C

    2017-07-14

    Acral lentiginous melanoma (ALM) is one of the four major subtypes in cutaneous melanoma (CM). Although ALM has a poorer prognosis than other CM subtypes, the prognostic factors of ALM have been verified only in small-sized cohorts because of the low incidence of ALM worldwide. To investigate clinical characteristics of ALM and to evaluate their prognostic values based on a large dataset from the Central Malignant Melanoma Registry (CMMR) of the German Dermatologic Society. The Kaplan-Meier method was used to estimate the potential influence of clinical and histological parameters on ALM disease-specific survival (DSS) curves, which were compared using log-rank test. A cox proportional hazards model was used to identify independent prognostic factors for DSS. 2,050 ALM patients were identified from 58,949 CM patients recorded by CMMR with follow-up data. In multivariate analyses, age (p=0.006), ulceration (p = 0.013), tumour thickness (p < 0.001) and tumour spread (p < 0.001) turned out to be significant prognostic factors for DSS in ALM whereas gender, nevus association and level of invasion were not independent factors. Acral lentiginous melanoma has the same prognostic factors as the other subtypes of melanoma. Unfavourable prognosis probably derives from the delay of diagnosis in comparison to other melanoma subtypes. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  13. Attempts to enhance light microscopic diagnosis of cutaneous T-cell lymphoma (mycosis fungoides).

    Science.gov (United States)

    Lefeber, W P; Robinson, J K; Clendenning, W E; Dunn, J L; Colton, T

    1981-07-01

    Precise pathologic criteria for the diagnosis of mycosis fungoides (MF) remain controversial. With the use of a specific counting technique and defined criteria for cell types, we attempted to differentiate between a series of slides from patients with eczematous dermatitis, large plaque parapsoriasis, and atypical dermatitis with features that suggest MF, the plaque stage of MF, and the tumor stage of MF. This could not be done on the basis of cellular density in e defined field in the papillary dermis or on the basis of the percentage of atypical lymphocytes in the fields counted. Furthermore, individual investigator variance was shown to be highly significant despite efforts to minimize this factor.

  14. Cutaneous Manifestations in Dermatomyositis: Key Clinical and Serological Features-a Comprehensive Review.

    Science.gov (United States)

    Muro, Yoshinao; Sugiura, Kazumitsu; Akiyama, Masashi

    2016-12-01

    Dermatomyositis (DM) is a common idiopathic inflammatory myopathy. The pathogenesis is considered to be microangiopathy affecting skin and muscle. The cutaneous manifestations of DM are the most important aspect of this disease, and their correct evaluation is important for early diagnosis. The skin signs are various: Some are pathognomonic or highly characteristic, and others are compatible with DM. Recently, DM has been categorized into several disease subsets based on the various autoantibodies present in patients. Sometimes, characteristic cutaneous manifestations are strongly associated with the presence of specific autoantibodies. For example, anti-Mi-2 antibody is associated with the classic features of DM, including heliotrope rash, Gottron's papules, the V-neck sign, the shawl sign, cuticular overgrowth, and photosensitivity. Frequent cutaneous features in anti-transcriptional intermediary factor 1 gamma (TIF1γ)-positive patients are diffuse photoerythema, including "dusky red face," while skin ulcerations, palmar papules (inverse Gottron), diffuse hair loss, panniculitis, and oral pain and/or ulcers are sometimes associated with anti-melanoma differentiation-associated gene 5 product (MDA5) antibody. Here, we review important cutaneous manifestations seen in patients with DM, and we examine the relationship between the skin changes and myositis-associated autoantibodies. Correct evaluation of cutaneous manifestations and myositis-associated autoantibodies should help the clinician in the early diagnosis of DM, for a quick recognition of cutaneous signs that may be the symptom of onset before muscle inflammation.

  15. Genetic alterations and markers of melanoma

    Directory of Open Access Journals (Sweden)

    N. N. Mazurenko

    2014-01-01

    Full Text Available Melanoma remains the most deadly form of malignant skin disease with high risk of metastases. Metastatic melanoma is prognostic highly unfavorable and resistant to traditional chemotherapy and biologic treatment. There is a great progress in understanding of the molecular mechanisms underlying melanoma initiation and progression. The external (ultraviolet irradiation and internal (genetic factors are involved in melanoma genesis. 5–14 % of melanoma cases occur in familial context due to genetic predisposition risk factors. Among them rare germinal mutations in the cell cycle genes regulators CDKN2A and CDK4 and in the master gene of melanocyte homeostasis MITF, as well as single nucleotide polymorphisms of several low-penetrated genes, namely MC1R, have been identified. The main cell signaling pathways and oncogene driver mutations are involved in melanoma pathogenesis. RAS / RAF / MEK / ERK cascade is hyperactivated in 75 % of cutaneous melanoma cases. Activation of PI3K / AKT / mTOR signaling pathway is important for melanoma progression. Recent studies revealed that melanomas are genetically and phenotypically heterogeneous tumors. Spectrum of chromosomal alterations and activating mutations corresponding to tumor molecular portraits varies in melanomas of different location. Most of cutaneous melanomas contain BRAF (50 % or NRAS (20 % mutations, and NRAS mutations occur on chronically sun-exposed skin. Activating KIT mutations have been reported in approximately 20–30 % of certain subtypes of melanoma, including acral and mucosal, and melanoma that develop on photodamaged skin. Cutaneous metastatic melanoma derive from preexisting nevi in 25 % of cases, molecular mechanisms of nevi malignization are discussed. Deepsequencing approaches of melanoma samples of different melanoma types highlighted new melanoma driver genes, that are damaged due to tumorigenic effects of ultraviolet: PPP6C, RAC1, SNX31, TACC1 and STK19. The

  16. You never know when your last day will come and your trip will be over--existential expressions from a melanoma diagnosis.

    Science.gov (United States)

    Hajdarevic, Senada; Rasmussen, Birgit H; Hörnsten, Åsa

    2014-08-01

    The aim of this study was to further explore expressions of existential experiences by patients diagnosed with malignant melanoma (MM). Semi-structured interviews were performed consecutively after diagnosis among 30 patients with MM. The methodological approach was inspired by Gadamer's hermeneutic philosophy. The analysis of expressions of existential experiences after having been diagnosed with malignant melanoma revealed that it is an existential process that people go through, beginning with feelings of suddenly becoming groundless at the time of the diagnosis, including being empty and in a vacuum, being in chaos and uncertainty and being confronted with one's own death. Next theme searching for solid ground included striving to understand what lies ahead, striving to find a balance in life - fighting, hoping, going on living and striving to prioritize family. The last theme creating islands of solid ground when living with cancer included understanding what is meaningful in life, living in the moment - seizing the day and keeping watch on the body. On being diagnosed with malignant melanoma, people go through a process where many questions emerge, including an existential turmoil, which health professionals should be aware of to provide these patients with sufficient support. Copyright © 2014 Elsevier Ltd. All rights reserved.

  17. Melanoma of the oral mucosa. Clinical cases and review of the literature.

    Science.gov (United States)

    González-García, Raúl; Naval-Gías, Luis; Martos, Pedro L; Nam-Cha, Syong Hyun; Rodríguez-Campo, Francisco J; Muñoz-Guerra, Mario F; Sastre-Pérez, Jesús

    2005-01-01

    The appearance of primary melanomas of the oral mucosa is uncommon. The aggressiveness of this entity and the absence of any standardized treatment protocol make the prognostic unfortunate. The difficulty to obtain free surgical margins, the elevated tendency to invade in depth and the early haematogenous metastasis have been referred as features which may explain its bad prognosis, even in comparison with cutaneous melanoma. However, no large clinical series exist and actually, clinical cases are the main source of information. Due to the absence of any treatment modality which may substantially increase long-term survival, we suggest the use of resective surgery with wide margins and early diagnosis by means of biopsy for suspicious melanotic-pigmented lesions. In this work we present 2 new cases of primary melanoma of the oral mucosa, with a follow-up period of 72 and 12 months respectively, and we make a review of the literature in relation with this rare entity.

  18. Multiple Cutaneous (pre)-Malignancies

    NARCIS (Netherlands)

    R.J.T. van der Leest (Robert)

    2015-01-01

    markdownabstract__Abstract__ The three most common cutaneous malignancies are derived from melanocytes and keratinocytes (ordered in decreasing aggressiveness): melanoma, squamous cell carcinoma (SCC) and basal cell carcinoma (BCC). This thesis focuses only on these three types of cancer and their

  19. Assessment of Optical Coherence Tomography Imaging in the Diagnosis of Non-Melanoma Skin Cancer and Benign Lesions Versus Normal Skin:

    DEFF Research Database (Denmark)

    Mogensen, Mette; Jørgensen, Thomas Martini; Nürnberg, Birgit Meincke

    2009-01-01

    BACKGROUND Optical coherence tomography (OCT) is an optical imaging technique that may be useful in diagnosis of non-melanoma skin cancer (NMSC). OBJECTIVES To describe OCT features in NMSC such as actinic keratosis (AK) and basal cell carcinoma (BCC) and in benign lesions and to assess...... the diagnostic accuracy of OCT in differentiating NMSC from benign lesions and normal skin. METHODS AND MATERIALS OCT and polarization-sensitive (PS) OCT from 104 patients were studied. Observer-blinded evaluation of OCT images from 64 BCCs, 1 baso-squamous carcinoma, 39 AKs, two malignant melanomas, nine benign...... lesions, and 105 OCT images from perilesional skin was performed; 50 OCT images of NMSC and 50 PS-OCT images of normal skin were evaluated twice. RESULTS Sensitivity was 79% to 94% and specificity 85% to 96% in differentiating normal skin from lesions. Important features were absence of well...

  20. Updates in Therapy for Advanced Melanoma.

    Science.gov (United States)

    Singh, Bhavana P; Salama, April K S

    2016-01-15

    Cutaneous melanoma is one of the most aggressive forms of skin cancer, and is correlated with a large proportion of skin cancer-related deaths. Therapy for cutaneous melanoma has advanced greatly through careful identification of therapeutic targets and the development of novel immunotherapeutic approaches. The identification of BRAF as well as other driver mutations, have allowed for a specialized approach to treatment. In addition, immune checkpoint inhibition has dramatically changed the treatment landscape over the past 5-10 years. The successful targeting of CTLA-4, as well as PD-1/PD-L1, has been translated into meaningful clinical benefit for patients, with multiple other potential agents in development. Systemic therapy for cutaneous melanoma is becoming more nuanced and often takes a multifaceted strategy. This review aims to discuss the benefits and limitations of current therapies in systemic melanoma treatment as well as areas of future development.

  1. Cutaneous and Mucosal Lichen Planus: A Comprehensive Review of Clinical Subtypes, Risk Factors, Diagnosis, and Prognosis

    Directory of Open Access Journals (Sweden)

    Farzam Gorouhi

    2014-01-01

    Full Text Available Lichen planus (LP is a chronic inflammatory disorder that most often affects middle-aged adults. LP can involve the skin or mucous membranes including the oral, vulvovaginal, esophageal, laryngeal, and conjunctival mucosa. It has different variants based on the morphology of the lesions and the site of involvement. The literature suggests that certain presentations of the disease such as esophageal or ophthalmological involvement are underdiagnosed. The burden of the disease is higher in some variants including hypertrophic LP and erosive oral LP, which may have a more chronic pattern. LP can significantly affect the quality of life of patients as well. Drugs or contact allergens can cause lichenoid reactions as the main differential diagnosis of LP. LP is a T-cell mediated immunologic disease but the responsible antigen remains unidentified. In this paper, we review the history, epidemiology, and clinical subtypes of LP. We also review the histopathologic aspects of the disease, differential diagnoses, immunopathogenesis, and the clinical and genetic correlations.

  2. Combination of 3D skin surface texture features and 2D ABCD features for improved melanoma diagnosis.

    Science.gov (United States)

    Ding, Yi; John, Nigel W; Smith, Lyndon; Sun, Jiuai; Smith, Melvyn

    2015-10-01

    Two-dimensional asymmetry, border irregularity, colour variegation and diameter (ABCD) features are important indicators currently used for computer-assisted diagnosis of malignant melanoma (MM); however, they often prove to be insufficient to make a convincing diagnosis. Previous work has demonstrated that 3D skin surface normal features in the form of tilt and slant pattern disruptions are promising new features independent from the existing 2D ABCD features. This work investigates that whether improved lesion classification can be achieved by combining the 3D features with the 2D ABCD features. Experiments using a nonlinear support vector machine classifier show that many combinations of the 2D ABCD features and the 3D features can give substantially better classification accuracy than using (1) single features and (2) many combinations of the 2D ABCD features. The best 2D and 3D feature combination includes the overall 3D skin surface disruption, the asymmetry and all the three colour channel features. It gives an overall 87.8 % successful classification, which is better than the best single feature with 78.0 % and the best 2D feature combination with 83.1 %. These demonstrate that (1) the 3D features have additive values to improve the existing lesion classification and (2) combining the 3D feature with all the 2D features does not lead to the best lesion classification. The two ABCD features not selected by the best 2D and 3D combination, namely (1) the border feature and (2) the diameter feature, were also studied in separate experiments. It found that inclusion of either feature in the 2D and 3D combination can successfully classify 3 out of 4 lesion groups. The only one group not accurately classified by either feature can be classified satisfactorily by the other. In both cases, they have shown better classification performances than those without the 3D feature in the combinations. This further demonstrates that (1) the 3D feature can be used to

  3. Diagnostic Inaccuracy of Smart Phone Applications for Melanoma Detection

    Science.gov (United States)

    Wolf, Joel; Moreau, Jacqui; Akilov, Oleg; Patton, Timothy; English, Joseph C; Ho, Jon; Ferris, Laura Korb

    2013-01-01

    Objective To measure the performance of smart phone applications which evaluate photographs of skin lesions and provide the user feedback as to their likelihood of malignancy. Design Case-control diagnostic accuracy study Setting Academic dermatology department Participants Digital clinical images of pigmented cutaneous lesions (60 melanoma cases and 128 benign lesion controls), all with histologic diagnosis rendered by a board-certified dermatopathologist, obtained prior to biopsy in patients undergoing lesion removal as part of routine care. Main Outcome Measures Sensitivity, specificity, and positive and negative predictive values of four smart phone applications designed to aid non-clinician users in determining if their skin lesion is benign or malignant. Results Sensitivity of the four tested applications ranged from 6.8% to 98.1%. Specificity ranged from 30.4% to 93.7%. Positive predictive value ranged from 33.3% to 42.1%, and negative predictive value ranged from 65.4% to 97.0%. The highest sensitivity for melanoma diagnosis was observed for an application that sends the image directly to a board-certified dermatologist for analysis and the lowest sensitivity was observed for applications that use automated algorithms to analyze images. Conclusions The performance of smart phone applications in assessing melanoma risk is highly variable, and 3 out of 4 smart phone applications incorrectly classified 30% or more of melanomas as unconcerning. Reliance on these applications, which are not subject to regulatory oversight, in lieu of medical consultation, has the potential to delay the diagnosis of melanoma and to harm users. PMID:23325302

  4. Current guidelines in melanoma treatment. Melanoma Working Group of Gent and Bordet.

    Science.gov (United States)

    Brochez, L; Verhaeghe, E; Sales, F; Del Marmol, V; Deraemaecker, R; Vossaert, K; Naeyaert, J M

    2000-01-01

    This article focuses on the actual management of cutaneous melanoma, dealing both with established, internationally well-accepted standard procedures and interventions which are still being investigated. It wants to offer a global picture to the dermatologist of what is currently available in the therapeutic arsenal against melanoma.

  5. Molecular pathogenesis of cutaneous melanocytic neoplasms.

    Science.gov (United States)

    Ibrahim, Nageatte; Haluska, Frank G

    2009-01-01

    Melanoma is the deadliest form of skin cancer without an effective treatment. An understanding of the genetic basis of melanoma has recently shed light on some of the mechanisms of melanomagenesis. This review explores the major genes involved in familial and sporadic cutaneous melanoma with an emphasis on CDKN2A, CDK4, MC1R, and MAPK pathway targets (e.g., RAS and BRAF), apoptosis regulators (e.g., BCL-2, AKT, and APAF-1), and the tumor-suppressor genes TP53 and PTEN. New directions for therapeutics based on our current knowledge of the genes implicated in melanoma are also discussed.

  6. High accuracy of family history of melanoma in Danish melanoma cases

    DEFF Research Database (Denmark)

    Wadt, Karin A W; Drzewiecki, Krzysztof T; Gerdes, Anne-Marie

    2015-01-01

    The incidence of melanoma in Denmark has immensely increased over the last 10 years making Denmark a high risk country for melanoma. In the last two decades multiple public campaigns have sought to increase the awareness of melanoma. Family history of melanoma is a known major risk factor...... but previous studies have shown that self-reported family history of melanoma is highly inaccurate. These studies are 15 years old and we wanted to examine if a higher awareness of melanoma has increased the accuracy of self-reported family history of melanoma. We examined the family history of 181 melanoma...... probands who reported 199 cases of melanoma in relatives, of which 135 cases where in first degree relatives. We confirmed the diagnosis of melanoma in 77% of all relatives, and in 83% of first degree relatives. In 181 probands we validated the negative family history of melanoma in 748 first degree...

  7. Detection of DNA from Leishmania (Viannia: accuracy of polymerase chain reaction for the diagnosis of cutaneous leishmaniasis.

    Directory of Open Access Journals (Sweden)

    Herintha Coeto Neitzke-Abreu

    Full Text Available Cutaneous leishmaniasis (CL can occur in skin and mucosa, causing disfiguring lesions. The laboratory diagnosis of CL involves immunological methods and optical detection of the parasite, al of which have limitations. There is a need for more effective diagnostic methods for CL which wil allow treatment to be initiated more promptly in order to help prevent the development of severe forms of mucosal disease, and to estimate the prognosis of the infection. The polymerase chain reaction (PCR has been widely used to diagnose CL, because of its higher sensitivity. This study estimated the accuracy and compared PCRs of samples from lesion scarification (PCR-L and blood sample-enriched leukocytes (PCR-B with three conventional diagnostic techniques: parasite direct search (DS, Montenegro skin test (MST, and indirect immunofluorescence reaction (IIF. The study included 276 patients under suspicion of CL. We conducted a cross-sectional study, in which patients were selected by convenience sampling. We used MP3H/MP1L primers to generate a Leishmania (Viannia (minicircle kDNA fragment of 70-bp. Of 106 patients with CL, 83.87%, 51.67%, 64.52%, 85.71%, or 96.10% tested positive by PCR-L, PCR-B, DS, IIF, or MST, respectively. Five patients tested positive only by PCR-L, and two other patients only by PCR-B. PCR-L is indicated for use in patients with chronic lesions or Leishmania reinfection, which may progress to mucosal lesion. PCR-B is indicated for use in patients with negative results in conventional tests or for patients with no apparent lesion. PCR is not only useful in diagnosing CL but also helps to identify the infecting species.

  8. COX-1 and COX-2 expression in canine cutaneous, oral and ocular melanocytic tumours.

    Science.gov (United States)

    Pires, I; Garcia, A; Prada, J; Queiroga, F L

    2010-01-01

    In order to evaluate the potential value of non-steroidal anti-inflammatory drugs (NSAIDs) in the treatment of canine malignant melanoma, expression of cyclooxygenase (COX)-1 and COX-2 was determined in 20 cutaneous, nine oral and two ocular malignant melanomas, and in nine cutaneous melanocytomas. Almost all tumours expressed COX-1, but COX-2 expression was restricted to the malignant tumours being found in 11 of the 20 cutaneous malignant melanomas, all oral malignant melanomas and in one of two ocular malignant melanomas. COX-1 expression did not differ significantly between benign and malignant skin lesions, but COX-2 expression was significantly greater in cutaneous malignant melanoma compared with melanocytoma (P=0.047). COX-2 labelling was particularly intense in the more highly malignant oral tumours. The results of the study suggest that NSAIDs, particularly COX-2 inhibitors, may be useful in the treatment of canine malignant melanoma.

  9. Progress in the studies of etiology, epidemiology and pathogenesis of ocular melanomas.

    Science.gov (United States)

    Hu, Danning; McCormick, Steven A

    2011-03-01

    Our population-based epidemiological studies demonstrated that the epidemiological aspects of ocular melanomas are different from those in cutaneous melanoma. The incidences of conjunctival melanoma increased in the past decades and was higher in the South (greater sun exposure), which is consistent with the occurrence of cutaneous melanoma. On the contrary, incidences of uveal melanoma are in the opposite direction of cutaneous melanomas. This indicates that solar radiation does not cause an increase of incidences of melanoma in ocular tissues (uveal melanoma) that are not exposed to solar radiation. Solar radiation increases the incidence of melanoma only in tissues exposed to said radiation, such as in conjunctival and eyelid melanomas. Uveal melanoma incidences in light-pigmented individuals are much greater than in dark-pigmented individuals. This result cannot be attributed to a melanin photo-screening effect, and is possibly related to melanin's biophysical and biochemical effects. The difference in incidences between light- and dark-pigmented individuals in conjunctival melanomas, as well as in vulvar and vaginal melanomas, are much lower than that in the uveal and cutaneous melanomas. This difference may be related to the different histological structures in these melanomas; conjunctival and vaginal melanomas occur in the mucous membrane, whereas cutaneous melanomas occur in the skin. Recent molecular biological studies indicate that each type of melanoma has its own molecular changes which are different from the others. Therefore, independent studies are required for each type of melanoma to discover their own etiology and pathogenesis, and to develop relevant novel prevention and treatment procedures.

  10. Cutaneous mucormycosis*

    Science.gov (United States)

    Castrejón-Pérez, Ana Daniela; Welsh, Esperanza C.; Miranda, Ivett; Ocampo-Candiani, Jorge; Welsh, Oliverio

    2017-01-01

    Cutaneous mucormycosis is an emerging fungal infection caused by opportunistic fungi of the phylum Glomeromycota. It is frequent in poorly controlled diabetic patients and individuals with immunosuppression. It is usually acquired by direct inoculation through trauma. The clinical presentation is nonspecific, but an indurated plaque that rapidly evolves to necrosis is a common finding. Diagnosis should be confirmed by demonstration of the etiological agent and new molecular diagnostic tools have recently been described. It is an invasive life-threatening disease and in order to improve survival, a prompt diagnosis and multidisciplinary management should be provided. The treatment of choice is amphotericin B, but new azoles, such as posaconazole and isavuconazole, must be considered.

  11. Short-term clinical outcome of carbon ion radiotherapy for cutaneous malignant melanoma%碳离子束治疗皮肤恶性黑色素瘤的近期疗效

    Institute of Scientific and Technical Information of China (English)

    蔡宏懿; 肖国青; 张晓文; 王小虎; 高力英; 张红; 冉俊涛; 张秋宁; 李强; 刘志强; 赵林

    2010-01-01

    Objective To evaluate the toxicity and efficacy of carbon ion radiotherapy for cutaneous malignant melanoma. Methods Form December 2006 to May 2009, 13 patients with superficial malignant melanoma were treated with carbon ion radiotherapy in the Institute of Modern Physics, Chinese Academy of Sciences. The total dose was 60 -66 GyE in 6 -12 fractions within 6 -12 days. The disease was Stage Ⅱ_a in 2, Ⅱ_b in 3, Ⅱ_c in 5, and Ⅲ_c in 3 patients. The toxicities were assessed according to the Radiation Therapy Oncology Group (RTOG) criteria, and the efficacy was evaluated with WHO criteria. Results The median follow-up time was 13.5 months (range, 1 -25 months) and the follow-up rate was 100%. Of the 13 patients, 10(77%) achieved complete remission (CR), and 3(23%) partial remission (PR). The overall response rate (RR) was 100%, and the median survival time was 21.3 months (95% CI, 18. 1 -24.5 months). The grade 0, 1,2 and 3 skin reaction occurred in 3, 6, 2 and 2 patients, respectively. The hematologic toxicities were mild. Conclusions Carbon ion radiotherapy is a safe and effective treatment for cutaneous malignant melanoma.%目的 评价碳离子(~(12)C~(6+))束对皮肤恶性黑色素瘤放射治疗的近期疗效和副反应.方法 13例皮肤恶性黑色素瘤患者分6批接受~(12)C~(6+)束放射治疗,其中Ⅱ_a期2例,Ⅱ_b期3例,Ⅱ_c期5例,Ⅲ_c期3例.照射总剂量60~66 GyE分6~12 d,单次剂量2.2~4.4 GyE,1次/d,连续治疗.采用RTOG标准和WHO近期疗效标准分别评价副反应和近期疗效.结果 中位随访时间为13.5个月(1~25个月),随访率为100%.13例患者中完全缓解10例,部分缓解3例,有效率为100%,中位生存时间为21.3个月(95%可信区间为18.1~24.5个月).皮肤反应0级3例,1级6例,2级2例,3级2例.血液系统副反应治疗前后无明显改变.结论 ~(12)C~(6+)束治疗皮肤恶性黑色素瘤近期疗效好,且并发症轻.

  12. Laboratory diagnosis, clinical manifestations, epidemiological situation and public health importance of cutaneous leishmaniasis in Shushtar County, Southwestern Iran

    Institute of Scientific and Technical Information of China (English)

    Hamid Kassiri; Ali kassiri; Masoud Lotfi; Parvaneh Farajifard; Elnaz Kassiri

    2014-01-01

    Objective:To investigate as a descriptive and cross sectional study on epidemiology, the laboratory diagnosis and clinical manifestation ofCutaneousLeishmaniasis(CL) inShushtar County.Methods:The investigation was carried out on referrals from different districts of ShushtarCounty and was diagnosed based on their ulcer clinical manifestations withCL using laboratory method.This study was actively developed over the period of2008 to2010.Surface of a clean slide was pressed on to the scraped part of the lesions and moved along to produce a smear on the slide.The slides were fixed with methanol, stained with standardGiemsa, and examined carefully under high magnification for an hour or more to look for amastigotes by a trained person.Two smears were prepared and examined from each patient and data were collected using different correlative patients characteristics to analyze information.The essential records including residential area, type and location of lesion, age, sex, the number of ulcers, season, and the history of traveling to endemic areas for this disease were carefully gathered. Results:Parasites presumed to beLeishmania major (L. major) based on the existence of a large vacuole in the cytoplasm.Totally206 patients were referred to the central laboratory and their manifestation lesions were clinically examined.Of these,64 cases(31.1%) were female and142 cases(68.9%) were male.The findings documented that the rate of incidence ofCL was in fall61 cases(29/6%) and winter80 cases(38/8%), which is one of the most important characteristics of zoonoticCL.Sixty-eight cases(33%) had ulcers on hands,63 cases(30.6%) on feet and30 cases (14.6%) on hands and feet.A total of120 patients(58.3%) had only one ulcer.But70 cases(34%) had2 ulcers.The highest incidence was found among patients with two age groups of20-29 years old(43.2%) and10-19 years old(18%).The most cases resided in rural areas with164 cases(79.6%). Conclusions:Analyzing of the composed results revealed

  13. Tyrosinase expression in malignant melanoma, desmoplastic melanoma, and peripheral nerve tumors

    DEFF Research Database (Denmark)

    Boyle, Jenny L; Haupt, Helen M; Stern, Jere B

    2002-01-01

    CONTEXT: Pathologists may encounter problems in the differential diagnosis of malignant melanoma, spindle and epithelioid neoplasms of peripheral nerves, and fibrohistiocytic tumors. Tyrosinase has been demonstrated to be a sensitive marker for melanoma. OBJECTIVE: To determine the specificity of...

  14. ITS1 PCR-RFLP Diagnosis and Characterization of Leishmania in Clinical Samples and Strains from Cases of Human Cutaneous Leishmaniasis in States of the Mexican Southeast

    Directory of Open Access Journals (Sweden)

    Amalia Monroy-Ostria

    2014-01-01

    Full Text Available American cutaneous leishmaniasis includes a spectrum of clinical forms localized cutaneous, diffuse cutaneous, and mucocutaneous leishmaniasis which can be caused by different strains of Leishmania belonging to the L. mexicana or L. braziliensis complexes which may coexist in the same endemic area. We evaluated the PCR-RFLP assay of the ITS1 genes for direct identification of Leishmania species in 163 clinical samples and 21 Mexican isolates of Leishmania. In relation to the Mexican isolates of Leishmania 52% displayed a pattern similar to the L. (L. mexicana, 5% showed a mixed pattern compatible with L. (L. mexicana and L. (V. braziliensis, eight with L. (L. amazonensis and L. (L. mexicana, and one to L. (V. braziliensis. Most of the clinical samples, 109/116 (94%, gave a pattern similar to that of the L. mexicana, two clinical samples gave similar patterns to that of Leishmania braziliensis, and 5 samples gave patterns that suggest a coinfection of L. (L. mexicana and L. (V. braziliensis or L. (L. mexicana and L. (L. amazonensis. The ITS1 PCR-RFLP assay is a multipurpose tool for diagnosis of Leishmania from clinical samples and enables determination of the infecting species of New World Leishmania in the field in relatively short time and low cost.

  15. Surgical management of primary and recurrent melanoma.

    Science.gov (United States)

    Farma, Jeffrey M; Kulkarni, Nandini; Hsu, Cary

    2015-04-01

    Melanoma accounts for less than 2% of skin cancer cases but causes most skin cancer-related deaths. Surgery continues to be the cornerstone of treatment of melanoma and surgical principles are guided by data derived from clinical research. This article examines the evolution of surgical techniques for the diagnosis and treatment of primary and locally recurrent melanoma.

  16. Malignant melanoma of the foot and ankle.

    Science.gov (United States)

    John, K J; Hayes, D W; Green, D R; Dickerson, J

    2000-04-01

    Malignant melanoma is a serious and devastating skin disease that podiatrists may be called upon to treat. It is pertinent that delays in diagnosis and treatment of malignant melanoma be avoided. Some of the topics discussed in this article are causes, clinical features, classification, and treatment of malignant melanoma, focusing on the foot and ankle.

  17. Prospective study of melanoma in the Paris Region in 2004

    Energy Technology Data Exchange (ETDEWEB)

    Souques, M.; Baccard, M.; Barrazza, V.; Havard, S.; Verrier, A.; Wechsler, J. [Prevention et Epidemiologie des Tumeurs en Region Ile de France (PETRI), Domus Medica, 75 - Paris (France)

    2006-07-01

    Introduction: Melanoma remains an important public health problem because of its increasing incidence and its responsibility for the deaths of young individuals. A first study was carried out by the P.E.T.R.I. association in 1994 to estimate the incidence of melanoma in the Paris region. A second one was carried out in 2004, with the same methodology, to estimate the increase of melanoma incidence in the Paris region and the main clinical and histological characteristics of these cancers, comparing to 1994 data. Methodology: Every pathologist of the region has been contacted to fill a questionnaire for each primary cutaneous melanoma excised between January 1. and December 31. 2004, from patients living in the Paris region (departments 75, 77, 91, 92, 93, 94, 95). The information requested included melanoma characteristics (localisation, type, Breslow thickness, Clark level, regression signs, pre existence of a nevus) and demographic data (age, sex, zip code of residence). Results: 98 % of pathologists in the region agree to participate in the study. They send 1453 questionnaires, among them 160 were excluded (double, non cutaneous melanoma, secondary lesion, non resident in the region, diagnoses out of the inclusion dates, biopsy followed by exeresis). The analyse included 1293 lesions in 1269 patients. More than 2/3 of diagnoses were confirmed by 2 laboratories and 10 laboratories (on 98) reported 86 % of the diagnoses. Incidence:The crude incidence of melanoma in the Paris region during 2004 was 11.4 cases per 100 000 inhabitants, by sex:11.1 per 100 000 males and 12.4 cases per 100 000 females. The sex ratio men/women was 0.82. The crude incidence of invasive melanoma (Clark 2 to 5) was 8,9 cases per 100 000 inhabitants, 9,2 per 100 000 women and 8,6 per 100 000 men, with a sex ratio men/women of 0,93. Demographic characteristics: Melanoma diagnosis was more often in women (54.9 %) than in men (45.1 %). The patients mean age was 59.3 years (S.D.: 17.3). The

  18. [Cutaneous leishmaniasis].

    Science.gov (United States)

    Enk, C D; Gardlo, K; Hochberg, M; Ingber, A; Ruzicka, T

    2003-06-01

    Leishmaniasis is a vector-borne disease caused by an obligate intracellular protozoa, Leishmania, which resides in macrophages. The parasite is transmitted by an infected female sandfly. The incidence of cutaneous leishmaniasis approaches 2 million new cases per year with 90% of the cases occurring in the "Old World", while the "New World" accounts for the rest. Infection may be restricted to the skin with development of characteristic ulcers, or may affect the mucous membranes in its mucocutaneous form. The clinical diagnosis is verified by the presence of amastigotes in slit-skin smears. Therapeutic modalities include systemic treatments such as the pentavalent antimony compound sodium stibogluconate, liposomal formulations of amphotericin B, oral ketoconazole or itraconazole, as well as topical paromomycin sulphate, local heat, freezing with liquid nitrogen, or photodynamic therapy. An effective vaccine is not available.

  19. Melanoma genetics

    DEFF Research Database (Denmark)

    Read, Jazlyn; Wadt, Karin A W; Hayward, Nicholas K

    2016-01-01

    Approximately 10% of melanoma cases report a relative affected with melanoma, and a positive family history is associated with an increased risk of developing melanoma. Although the majority of genetic alterations associated with melanoma development are somatic, the underlying presence...... of heritable melanoma risk genes is an important component of disease occurrence. Susceptibility for some families is due to mutation in one of the known high penetrance melanoma predisposition genes: CDKN2A, CDK4, BAP1, POT1, ACD, TERF2IP and TERT. However, despite such mutations being implicated...... in a combined total of approximately 50% of familial melanoma cases, the underlying genetic basis is unexplained for the remainder of high-density melanoma families. Aside from the possibility of extremely rare mutations in a few additional high penetrance genes yet to be discovered, this suggests a likely...

  20. Whole-genome landscapes of major melanoma subtypes.

    Science.gov (United States)

    Hayward, Nicholas K; Wilmott, James S; Waddell, Nicola; Johansson, Peter A; Field, Matthew A; Nones, Katia; Patch, Ann-Marie; Kakavand, Hojabr; Alexandrov, Ludmil B; Burke, Hazel; Jakrot, Valerie; Kazakoff, Stephen; Holmes, Oliver; Leonard, Conrad; Sabarinathan, Radhakrishnan; Mularoni, Loris; Wood, Scott; Xu, Qinying; Waddell, Nick; Tembe, Varsha; Pupo, Gulietta M; De Paoli-Iseppi, Ricardo; Vilain, Ricardo E; Shang, Ping; Lau, Loretta M S; Dagg, Rebecca A; Schramm, Sarah-Jane; Pritchard, Antonia; Dutton-Regester, Ken; Newell, Felicity; Fitzgerald, Anna; Shang, Catherine A; Grimmond, Sean M; Pickett, Hilda A; Yang, Jean Y; Stretch, Jonathan R; Behren, Andreas; Kefford, Richard F; Hersey, Peter; Long, Georgina V; Cebon, Jonathan; Shackleton, Mark; Spillane, Andrew J; Saw, Robyn P M; López-Bigas, Núria; Pearson, John V; Thompson, John F; Scolyer, Richard A; Mann, Graham J

    2017-05-11

    Melanoma of the skin is a common cancer only in Europeans, whereas it arises in internal body surfaces (mucosal sites) and on the hands and feet (acral sites) in people throughout the world. Here we report analysis of whole-genome sequences from cutaneous, acral and mucosal subtypes of melanoma. The heavily mutated landscape of coding and non-coding mutations in cutaneous melanoma resolved novel signatures of mutagenesis attributable to ultraviolet radiation. However, acral and mucosal melanomas were dominated by structural changes and mutation signatures of unknown aetiology, not previously identified in melanoma. The number of genes affected by recurrent mutations disrupting non-coding sequences was similar to that affected by recurrent mutations to coding sequences. Significantly mutated genes included BRAF, CDKN2A, NRAS and TP53 in cutaneous melanoma, BRAF, NRAS and NF1 in acral melanoma and SF3B1 in mucosal melanoma. Mutations affecting the TERT promoter were the most frequent of all; however, neither they nor ATRX mutations, which correlate with alternative telomere lengthening, were associated with greater telomere length. Most melanomas had potentially actionable mutations, most in components of the mitogen-activated protein kinase and phosphoinositol kinase pathways. The whole-genome mutation landscape of melanoma reveals diverse carcinogenic processes across its subtypes, some unrelated to sun exposure, and extends potential involvement of the non-coding genome in its pathogenesis.

  1. Antiangiogenic Metargidin Peptide (AMEP) Gene Therapy in Disseminated Melanoma

    DEFF Research Database (Denmark)

    Spanggaard, Iben; Gehl, Julie

    2015-01-01

    Gene delivery by electroporation is an efficient method for transfecting genes into various tissues including tumors. Here we present the treatment protocol used in a phase 1 study on gene electrotransfer of plasmid DNA encoding an antiangiogenic peptide into cutaneous melanoma.......Gene delivery by electroporation is an efficient method for transfecting genes into various tissues including tumors. Here we present the treatment protocol used in a phase 1 study on gene electrotransfer of plasmid DNA encoding an antiangiogenic peptide into cutaneous melanoma....

  2. Primary malignant melanoma of the liver:One case report and literature review

    Institute of Scientific and Technical Information of China (English)

    Dongfang Huang; Jinsheng Wu; Guofeng Chen; Jianhuai Zhang

    2016-01-01

    Objective Primary malignant melanomas of the liver are exceedingly rare. Only 19 cases have been reported in the literature worldwide. In this report, we describe our pathological findings and review the literature in order to improve our understanding of the disease and prevent misdiagnosis, as wel as provide evidence for its treatment and prognosis. Methods We present a case of an isolated malignant melanoma of the liver in a 61-year-old male Chi-nese patient. Results Comprehensive dermatological and ophthalmological examinations did not reveal any evidence of a primary cutaneous or ocular lesion. Similarly, serial physical examinations, auxiliary examinations, and bone scans did not demonstrate any other lesions in the brain, respiratory tract, and gastrointestinal tract. Microscopic examination of the resected specimen revealed malignant melanoma, which was confirmed by immunohistochemical staining for S-100 protein (+), ki67 (30%+), EMA (+), CD10 (+), and HMB-45 (++). Conclusion Primary malignant melanoma may occur in the liver, and should be considered when the histopathological appearance is atypical of other hepatic neoplasms. The diagnostic criteria for hepatic malignant melanoma depend mainly on the clinical, radiographic, and histopathological findings. Pathomor-phology and immumohistochemical staining can be utilized to confirm the diagnosis.

  3. Coffee, tea and melanoma risk

    DEFF Research Database (Denmark)

    Caini, Saverio; Masala, Giovanna; Saieva, Calogero

    2017-01-01

    In vitro and animal studies suggest that bioactive constituents of coffee and tea may have anticarcinogenic effects against cutaneous melanoma; however, epidemiological evidence is limited to date. We examined the relationships between coffee (total, caffeinated or decaffeinated) and tea consumpt......In vitro and animal studies suggest that bioactive constituents of coffee and tea may have anticarcinogenic effects against cutaneous melanoma; however, epidemiological evidence is limited to date. We examined the relationships between coffee (total, caffeinated or decaffeinated) and tea...... consumption and risk of melanoma in the European Prospective Investigation into Cancer and Nutrition (EPIC). EPIC is a multicentre prospective study that enrolled over 500,000 participants aged 25-70 years from ten European countries in 1992-2000. Information on coffee and tea drinking was collected...... at baseline using validated country-specific dietary questionnaires. We used adjusted Cox proportional hazards regression models to calculate hazard ratios (HR) and 95% confidence intervals (95% CI) for the associations between coffee and tea consumption and melanoma risk. Overall, 2,712 melanoma cases were...

  4. Current Research and Development of Chemotherapeutic Agents for Melanoma

    Directory of Open Access Journals (Sweden)

    Kyaw Minn Hsan

    2010-04-01

    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.

  5. A prospective population-based study, aiming to support decision-making in a follow-up programme for patients with cutaneous malignant melanoma, based on patterns of recurrence

    DEFF Research Database (Denmark)

    Maroti, Marianne; Ulff, Eva; Lyth, Johan;

    2016-01-01

    to characteristics of the primary tumour. Metastases developed in 421 of the 2,910 patients with primary cutaneous MM in Stage I and II of the disease. Thirty-five percent of all recurrences were detected during the first year. Time to first metastasis to the skin and lymph nodes was almost identical. The vast...... majority of the recurrences were diagnosed at sites that were easily recognised by the patient and relatives; self-examination may therefore be a worthwhile approach. Our findings further indicate that the follow-up programme should focus on the first three years after diagnosis....... to administer successful treatment for early disseminated disease, it may be of interest to engage MM patients and/or relatives in self-control. The aim of the present study was to analyse both the time to, and the location of, the first metastatic lesion in order to provide help for the patient, relatives...

  6. MicroRNA miR-125b induces senescence in human melanoma cells

    DEFF Research Database (Denmark)

    Glud, Martin; Manfé, Valentina; Biskup, Edyta

    2011-01-01

    in malignant melanoma producing lymph node micrometastases than in nonmetastasizing tumors. To get further insight into the functional role of miR-125b, we assessed whether its overexpression or silencing affects apoptosis, proliferation, or senescence in melanoma cell lines. We showed that overexpression...... in an early cutaneous malignant melanoma can contribute to the increased metastatic capability of this tumor....

  7. Inverse association between atopy and melanoma: A case-control study

    NARCIS (Netherlands)

    Marasigan, V. (Vivien); M.-A. Morren (Marie-Anne); J. Lambert; Medaer, K. (Karen); Fieuws, S. (Steffen); T.E.C. Nijsten (Tamar); Garmyn, M. (Marjan)

    2017-01-01

    textabstractHeightened cutaneous immune surveillance in atopic patients may inhibit development of melanoma. The aim of this study was to analyse the association between atopy and melanoma (development and outcome). A total of 188 cases of melanoma and 596 healthy controls were interviewed by teleph

  8. Synchronous melanomas arising within nevus spilus*

    Science.gov (United States)

    de Brito, Maria Helena Toda Sanches; Dionísio, Cecília Silva Nunes de Moura; Fernandes, Cândida Margarida Branco Martins; Ferreira, Joana Cintia Monteiro; Rosa, Maria Joaninha Madalena de Palma Mendonça da Costa; Garcia, Maria Manuela Antunes Pecegueiro da Silva

    2017-01-01

    Nevus spilus is a melanocytic cutaneous lesion consisting of a light brown background macule with numerous superimposed darker maculopapular speckles. Melanoma arising from a nevus spilus is rare, with less than 40 cases reported to date. The absolute risk for malignant transformation is not well defined, lacking a standardized management approach. We report a new case of melanoma arising from nevus spilus, with the additional peculiarity of multifocality. We offer our recommendations for the management of the condition. PMID:28225967

  9. Cutaneous histoplasmosis in renal transplant recipients.

    Science.gov (United States)

    Sun, N Z; Augustine, J J; Gerstenblith, M R

    2014-10-01

    Cutaneous histoplasmosis is a rare entity, although it can be seen in a substantial portion of renal transplant recipients with disseminated disease. The prognosis of disseminated disease is worse than isolated cutaneous involvement, and significant delays in diagnosis are reported. We reviewed reports of cutaneous histoplasmosis with and without dissemination in the setting of renal transplantation to examine incidence, timing of diagnosis, clinical features, and prognosis. Remarkable morphologic variability and the non-specific appearance of skin findings suggest that tissue culture is required for definitive diagnosis. Cutaneous lesions represent an easily accessible source for early diagnosis.

  10. Primary localization and tumor thickness as prognostic factors of survival in patients with mucosal melanoma.

    Directory of Open Access Journals (Sweden)

    Tarun Mehra

    Full Text Available Data on survival with mucosal melanoma and on prognostic factors of are scarce. It is still unclear if the disease course allows for mucosal melanoma to be treated as primary cutaneous melanoma or if differences in overall survival patterns require adapted therapeutic approaches. Furthermore, this investigation is the first to present 10-year survival rates for mucosal melanomas of different anatomical localizations.116 cases from Sep 10 1984 until Feb 15 2011 retrieved from the Comprehensive Cancer Center and of the Central Register of the German Dermatologic Society databases in Tübingen were included in our analysis. We recorded anatomical location and tumor thickness, and estimated overall survival at 2, 5 and 10 years and the mean overall survival time. Survival times were analyzed with the Kaplan-Meier method. The log-rank test was used to compare survival times by localizations and by T-stages.We found a median overall survival time of 80.9 months, with an overall 2-year survival of 71.7%, 5-year survival of 55.8% and 10-year survival of 38.3%. The 10-year survival rates for patients with T1, T2, T3 or T4 stage tumors were 100.0%, 77.9%, 66.3% and 10.6% respectively. 10-year survival of patients with melanomas of the vulva was 64.5% in comparison to 22.3% of patients with non-vulva mucosal melanomas.Survival times differed significantly between patients with melanomas of the vulva compared to the rest (p = 0.0006. It also depends on T-stage at the time of diagnosis (p < 0.0001.

  11. MDA-9 and GRP78 as potential diagnostic biomarkers for early detection of melanoma metastasis.

    Science.gov (United States)

    Guan, Ming; Chen, Xiaofan; Ma, Yingyu; Tang, Lihua; Guan, Lei; Ren, Xuefeng; Yu, Bo; Zhang, Wei; Su, Bing

    2015-04-01

    Metastatic melanoma, the primary cause of skin cancer-related death, warrants new diagnostic and therapeutic approaches that target the regulatory machinery at molecular level. The heterogeneity and complexity of melanoma result in the difficulty to find biomarkers and targets for early detection and treatment. Here, we investigated metastasis-associated proteins by comparing the proteomic profiles of primary cutaneous melanomas to their matched lymph node metastases, which minimizes heterogeneity among samples from different patients. Results of two-dimensional gel electrophoresis (2-DE) followed by proteomic analysis revealed eight differentially expressed proteins. Among them, seven proteins (α-enolase, cofilin-1, LDH, m-β-actin, Nm23, GRP78, and MDA-9) showed increased and one (annexin A2) showed decreased expression in metastatic lymph node tissues than in primary melanomas. MDA-9 and GRP78 were the most highly expressed proteins in lymph node metastases, which was validated by immunohistochemical staining. Moreover, exosomes from serum samples of metastatic melanoma patients contained higher levels of MDA-9 and GRP78 than those of patients without metastases, indicating the potential of MDA-9 and GRP78 to be biomarkers for early detection of metastasis. Further, small interfering RNA (siRNA)-mediated knockdown confirmed a functional role for MDA-9 and GRP78 to promote cell invasion in the A375 cells. Finally, we showed that GRP78 co-localized with MDA-9 in 293T cells. Taken together, our findings support MDA-9, co-expressed with GRP78, as a melanoma protein associated with lymph node metastasis. Investigating how MDA-9 and GRP78 interact to contribute to melanoma metastasis and disease progression could reveal new potential avenues of targeted therapy and/or useful biomarkers for diagnosis and prognosis.

  12. Immunohistochemical diagnosis of malignant melanoma of the conjunctiva and uvea: comparison of the novel antibody against melan-A with S100 protein and HMB-45

    DEFF Research Database (Denmark)

    Heegaard, Steffen; Jensen, O.A.; Prause, J.U.

    2000-01-01

    ophthalmology, A103, conjunctiva, gp100, HMB-45, malignant melanoma, MART-1, melan-A, S100, uvea......ophthalmology, A103, conjunctiva, gp100, HMB-45, malignant melanoma, MART-1, melan-A, S100, uvea...

  13. Near-infrared autofluorescence imaging of cutaneous melanins and human skin in vivo

    Science.gov (United States)

    Han, Xiao; Lui, Harvey; McLean, David I.; Zeng, Haishan

    2009-03-01

    In recent years, near-infrared (NIR) autofluorescence imaging has been explored as a novel technique for tissue evaluation and diagnosis. We present an NIR fluorescence imaging system optimized for the dermatologic clinical setting, with particular utility for the direct characterization of cutaneous melanins in vivo. A 785-nm diode laser is coupled into a ring light guide to uniformly illuminate the skin. A bandpass filter is used to purify the laser light for fluorescence excitation, while a long-pass filter is used to block the main laser wavelength but pass the spontaneous components for NIR reflectance imaging. A computer-controlled filter holder is used to switch these two filters to select between reflectance and fluorescence imaging modes. Both the reflectance and fluorescence photons are collected by an NIR-sensitive charge-coupled device (CCD) camera to form the respective images. Preliminary results show that cutaneous melanin in pigmented skin disorders emits higher NIR autofluorescence than surrounding normal tissue. This confirmed our previous findings from NIR fluorescence spectroscopy study of cutaneous melanins and provides a new approach to directly image the distributions of cutaneous melanins in the skin. In-vivo NIR autofluorescence images may be useful for clinical evaluation and diagnosis of pigmented skin lesions, including melanoma.

  14. Vitamin D and melanoma and non-melanoma skin cancer risk and prognosis: a comprehensive review and meta-analysis.

    Science.gov (United States)

    Caini, Saverio; Boniol, Mathieu; Tosti, Giulio; Magi, Serena; Medri, Matelda; Stanganelli, Ignazio; Palli, Domenico; Assedi, Melania; Marmol, Veronique Del; Gandini, Sara

    2014-10-01

    Vitamin D is formed mainly in the skin upon exposure to sunlight and can as well be taken orally with food or through supplements. While sun exposure is a known risk factor for skin cancer development, vitamin D exerts anti-proliferative and pro-apoptotic effects on melanocytes and keratinocytes in vitro. To clarify the role of vitamin D in skin carcinogenesis, we performed a review of the literature and meta-analysis to evaluate the association of vitamin D serum levels and dietary intake with cutaneous melanoma (CM) and non-melanoma skin cancer (NMSC) risk and melanoma prognostic factors. Twenty papers were included for an overall 1420 CM and 2317 NMSC. The summary relative risks (SRRs) from random effects models for the association of highest versus lowest vitamin D serum levels was 1.46 (95% confidence interval (CI) 0.60-3.53) and 1.64 (95% CI 1.02-2.65) for CM and NMSC, respectively. The SRR for the highest versus lowest quintile of vitamin D intake was 0.86 (95% CI 0.63-1.13) for CM and 1.03 (95% CI 0.95-1.13) for NMSC. Data were suggestive of an inverse association between vitamin D blood levels and CM thickness at diagnosis. Further research is needed to investigate the effect of vitamin D on skin cancer risk in populations with different exposure to sunlight and dietary habits, and to evaluate whether vitamin D supplementation is effective in improving CM survival.

  15. Cutaneous neoplastic lesions of equids in the central United States and Canada: 3,351 biopsy specimens from 3,272 equids (2000-2010).

    Science.gov (United States)

    Schaffer, Paula A; Wobeser, Bruce; Martin, Laura E R; Dennis, Michelle M; Duncan, Colleen G

    2013-01-01

    To identify epidemiological trends in cutaneous neoplasms affecting equids in central North America and compare them with previously reported trends. Retrospective case series. 3,351 cutaneous biopsy specimens from 3,272 equids with a neoplastic diagnosis. Diagnostic reports from 2 diagnostic laboratories (Colorado State University and Prairie Diagnostic Services Inc) were reviewed for frequency of specific lesions and epidemiological trends. Variables included in analyses (if known) were age, sex, breed, geographic location, date of diagnosis, location of neoplasm on the body, and presence or absence of ulceration. Sarcoid, squamous cell carcinoma (SCC), and melanoma were the 3 most common tumors diagnosed. Tumors associated with UV radiation (SCC, SCC in situ, hemangioma, hemangiosarcoma) were 2.3 (95% confidence interval [CI], 1.8 to 3.0) times as common in biopsy specimens received by Colorado State University than in specimens received by Prairie Diagnostic Services Inc. Appaloosa horses and American Paint horses, respectively, were 7.2 (95% CI, 5.6 to 9.2) and 4.4 (95% CI, 3.6 to 5.4) times as likely as other breeds to have tumors associated with UV radiation. Thoroughbreds were predisposed to cutaneous lymphoma, whereas Arabians were more likely to have melanomas. Draft and pony breeds were 3.1 (95% CI, 1.9 to 5.1) times as likely as other breeds to have benign soft tissue tumors. Morgans and pony breeds more commonly had basal cell tumors. Tumors in the perianal region were significantly more likely to be SCC or melanoma while tumors on the limbs were more likely to be giant cell tumor of soft parts. Signalment, anatomic location of the mass, and geographic location of the horse can be used to help equine practitioners formulate differential diagnoses for cutaneous masses. Further research is necessary to identify the biological basis for the development of many equine cutaneous neoplasms.

  16. Recombinant Interleukin-15 in Treating Patients With Advanced Melanoma, Kidney Cancer, Non-small Cell Lung Cancer, or Squamous Cell Head and Neck Cancer

    Science.gov (United States)

    2017-09-14

    Head and Neck Squamous Cell Carcinoma; Recurrent Head and Neck Carcinoma; Recurrent Non-Small Cell Lung Carcinoma; Recurrent Renal Cell Carcinoma; Recurrent Skin Carcinoma; Stage III Renal Cell Cancer; Stage IIIA Cutaneous Melanoma AJCC v7; Stage IIIA Non-Small Cell Lung Cancer AJCC v7; Stage IIIB Cutaneous Melanoma AJCC v7; Stage IIIB Non-Small Cell Lung Cancer AJCC v7; Stage IIIC Cutaneous Melanoma AJCC v7; Stage IV Cutaneous Melanoma AJCC v6 and v7; Stage IV Non-Small Cell Lung Cancer AJCC v7; Stage IV Renal Cell Cancer

  17. Primary gastric melanoma: A case report

    Institute of Scientific and Technical Information of China (English)

    Emmanuel Eustathios Lagoudianakis; Michael Genetzakis; Dimitrios Konstantinos Tsekouras; Artemisia Papadima; Georgia Kafiri; Konstantinos Toutouzas; Vaggelogiannis Katergiannakis; Andreas Manouras

    2006-01-01

    Melanoma accounts for 1-3 per cent of all malignant tumors. Except cutaneous, other less common melanomas include, among others, those in the GI tract.However, their primary or secondary nature is often difficult to establish. Referring to the stomach, scattered cases of primary melanomas have been reported in the literature.We report a case of a man with an ulcerated submucosal mass at the antrum of the stomach, manifested with dull upper abdominal pain, nausea, vomiting,fatigue and anemia. This lesion was histologically proved to be melanoma. A detailed clinical and laboratory investigation revealed no primary site elsewhere.To our knowledge, very few cases of primary gastric melanoma have been reported. Our case is the fourth ever published and the first located at the antrum of the stomach. The debate upon the primitive nature of such lesions still persists. Thus, specific diagnostic criteria have been proposed.

  18. Evaluation of a direct immunofluorescent antibody (difma test using Leishmania genus - specific monoclonal antibody in the routine diagnosis of cutaneous leishmaniasis

    Directory of Open Access Journals (Sweden)

    Martha E. Chico

    1995-06-01

    Full Text Available A direct immunofluorescent antibody (DIFMA test using a Leishmania genus- specific monoclonal antibody was evaluated in the routine diagnosis of cutaneous leishmaniasis (CL in Ecuador. This test was compared with the standard diagnostic techniques of scrapings, culture and histology. Diagnostic samples were taken from a total of 90 active dermal ulcers from patients from areas of Ecuador known to be endemic for cutaneous leishmaniasis. DIFMA was positive in all lesions. It was shown to be significantly superior to standard diagnostic methods either alone or in combination. The sensitivity of DIFMA did not diminish with chronicity of lesions. This test proved to be extremely useful in the routine diagnosis of CL because it is highly sensitive, is easy to use and produces rapid results.O método de imunofluorescência direta (DIFMA, com anticorpos monoclonais gênero- específicos para Leishmania, foi avaliado na rotina diagnostica da leishmaniose cutânea no Equador. O método foi comparado com técnicas diagnosticas de rotina: o esfregaço, a cultura e o exame histopatolôgico. As amostras para o diagnóstico foram obtidas de um total de 90 lesões cutâneas ativas, de doentes das ãreas do Equador, endêmicas para leishmaniose cutânea. O DIFMA foi positivo em todas as lesões, com resultados significativamente superior aos métodos diagnósticos de rotina, isolado ou em combinação. A sensibilidade do DFIMA não diminui em lesões crônicas. O método mostra-se muito útil no diagnóstico de leishmaniose cutânea, pela sua sensibilidade, rapidez e facilidade de execução.

  19. The role of sensory nerve conduction study of the palmar cutaneous nerve in the diagnosis of carpal tunnel syndrome in patients with polyneuropathy

    Directory of Open Access Journals (Sweden)

    Ayse Tokcaer

    2007-01-01

    Full Text Available Background: Conventional methods in the diagnosis of carpal tunnel syndrome (CTS in patients with polyneuropathy (PNP are insufficient. Aims: We suggest that the comparison of the conduction of the median nerve with that of the neighboring peripheral nerves may be more beneficial in the diagnosis of entrapment neuropathy. Setting and Design: The median nerve sensory conduction in healthy volunteers, in cases of CTS, PNP cases without CTS and in cases of PNP in whom clinical findings point to CTS, were compared by palmar cutaneous nerve (PCN sensory conduction. Materials and Methods: Comparative parameters were difference of PCN-1st digits′ nerve conduction velocities (NCV, PCN/1st digit NCVs ratio, difference of 5th-2nd digits′ NCVs and 5th/2nd digits′ NCVs ratio. Statistical Analysis: The statistical analysis was performed by the SPSS package for statistics. Student t test and receiver operating characteristic were used. Results: Although the ratio of PCN-1st digit did not differ significantly between the control group and the polyneuropathy group, there was a significant difference between CTS and PNP+CTS groups and the control group ( P < 0.001 and P < 0.001, respectively. The ratio of PCN-1st digit nerve conduction velocity was also significantly different between polyneuropathy and PNP+CTS groups ( P < 0.001. Conclusion: To diagnose CTS on a background of polyneuropathy in mild cases in which sensory conduction is preserved, the ratio of sensory nerve conduction velocities of the palmar cutaneous nerve and the median nerve 1st digit-wrist segment may be a criterion.

  20. Dermoscopy, Confocal Microscopy and other Non-invasive Tools for the Diagnosis of Non-Melanoma Skin Cancers and Other Skin Conditions.

    Science.gov (United States)

    Malvehy, Josep; Pellacani, Giovanni

    2017-07-05

    Non-melanoma skin cancer (NMSC), including basal cell and squamous cell carcinomas, is the most common form of neoplasm. The incidence of NMSC is increasing worldwide. The cure rate is high with early detection and appropriate treatment. Visual examination is the first screening tool used by clinicians, but it is sometimes not sufficient to discriminate benign from malignant lesions. Skin biopsy with histopathology is the gold standard for differential diagnosis; however, this procedure is invasive and occasionally painful. Repeated tissue sampling is not possible in patients with several suspicious lesions and various clinical presentations that are challenging to identify. There are several medical imaging tools for non-invasive in-depth skin examination that can be used to guide clinical diagnosis: dermoscopy, confocal microscopy, cross-polarized light and fluorescence photography, optical coherence tomography and high-frequency ultrasound. These tools are discussed along with their clinical applications. These techniques provide valuable morphological information for better identification, confident diagnosis and treatment monitoring of NMSC.

  1. 皮肤原发恶性黑色素瘤127例细胞增殖活性与生存预后相关性%Correlation between tumor cell prolieration and prognosis of primary cutaneous malignant melanoma in 127 patients

    Institute of Scientific and Technical Information of China (English)

    王燕; 薛卫成; 斯璐; 崔传亮; 陆爱萍; 曹登峰; 郭军; 李忠武

    2013-01-01

    目的 分析皮肤原发恶性黑色素瘤中细胞增殖活性与其他临床病理学参数的关系及预后意义,并筛选黑色素瘤的独立预后因素.方法 收集北京肿瘤医院资料完整的皮肤原发恶性黑色素瘤127例,采用免疫组织化学EnVision法检测肿瘤的Ki-67表达,参照第7版美国癌症联合会推荐的“热点”法计数肿瘤细胞的核分裂象,分析Ki-67表达水平、核分裂象数与其他临床病理参数的相关性,并结合随访资料对所有参数(包括TNM分期、Clark分级等)进行生存分析,筛选出影响患者生存预后的因素.结果 Ki-67表达水平与坏死、Breslow厚度相关(P<0.05),核分裂象数与Clark分级及Ki-67表达水平相关(P<0.05);单因素分析显示Ki-67表达水平(P=0.043)、核分裂象数(P =0.030)和TNM分期(P<0.001)可以影响黑色素瘤患者总生存,而多因素分析显示只有TNM分期(P <0.001)是影响总生存的独立预后因素.结论 初诊时TNM分期是影响皮肤原发黑色素瘤患者预后的最重要因素,Ki-67表达水平与核分裂象数是皮肤原发黑色素瘤重要的临床病理学参数.%Objective To investigate the correlations among Ki-67 expression,mitosis and other clinicopathological parameters of primary cutaneous malignant melanoma,and search for prognostic factors of malignant melanoma.Methods Totally 127 cases of primary cutaneous malignant melanoma were collected from Beijing Cancer Hospital.Immunohistochemical study for Ki-67 was performed,and the mitosis was calculated referring to “ hot spot” method recommended by the seventh edition of the American Joint Committee on Cancer (AJCC) melanoma staging system.The correlations of Ki-67 expression,mitosis and other clinicopathological parameters were analyzed,and the survival analysis of all these risk factors including TNM and Clark level was conducted based on follow up data.Results The expression level of Ki-67 was associated with necrosis and

  2. BRAF基因突变与皮肤黑色素瘤临床病理特征关系的meta分析%Relationship between BRAF mutations and clinicopathological features in cutaneous melanoma: a meta-analysis

    Institute of Scientific and Technical Information of China (English)

    杨猛; 邝晓聪; 潘延斌; 谭美乐; 卢斌珠; 卢坚; 程秋梅; 李建民

    2013-01-01

    目的 探讨BRAF突变频率以及该突变与皮肤黑色素瘤(CM)临床病理特征的关系.方法 使用Pubmed、Embase、维普、清华同方等数据库检索2013年4月以前相关文献,按纳入排除标准筛选文献,采用Revman5.0软件进行统计分析.结果 涉及BRAF突变有9项研究,共1134例患者.CM患者BRAF突变率为47.3%.50岁以上患者BRAF突变OR =2.30,95% CI为1.36 ~3.91;浅表扩散性黑色素瘤(SSM)B RAF突变OR =2.11,95%CI为1.64~2.71;病灶在躯干时BRAF基因突变OR=2.35,95% CI为1.71~3.21;浸润深度小于1mm时BRAF突变OR=1.56,95% CI为1.08 ~2.25.结论 BRAF基因突变易发生于年龄50岁以上、SSM、病灶在躯干及浸润深度小于1mm的患者,而与性别无关.%Objective To explore the frequencies of BRAF mutations and the relationship between BRAF mutations and clinicopathological features of cutaneous melanoma (CM).Methods Pubmed,Embase,VIP,CNKI and other databases were utilized to search the relative articles and literatures were screened according to inclusion and excluding criteria and the meta-analysis was conducted by RevmanS.0 software.Results Nine researches about BRAF mutations were enrolled in this study including 1134 patients.BRAF mutation rate of CM was 47.3%.As for patients over 50 years old,the OR of BRAF mutations was 2.30 (95% CI:1.36-3.91; the OR of BRAF mutations for superficial spreading melanoma (SSM) was 2.11 (95% CI:1.64-2.71) ; the OR of BRAF mutations for lesions in the trunk was 2.35 (95% CI:1.71-3.21) ; the OR of BRAF mutations for invasion depth less than 1 mm was 1.56 (95% CI:1.08-2.25).Conclusion BRAF mutations are more frequent in patients over 50 years old,in SSM and in patients whose lesions locate in the truck and invasion depth less than 1 mm,but have no relationship with sex.

  3. Diagnosis of cutaneous T-cell lymphoma detecting T-cell receptor gamma chain gene monoclonality by denaturing gradient gel electrophoresis.

    Science.gov (United States)

    Lapière, K; Dhaene, K; Matthieu, L; Hübner, R; Lambert, J; Van Marck, E

    1999-04-01

    Cutaneous T-cell lymphomas represent a group of malignant lymphoproliferative disorders characterised by the occurrence of a monoclonal population of T-lymphocytes. Diagnosis of early stages of this disease is a difficult challenge for both the dermatologist and the dermatopathologist. With the aid of the polymerase chain reaction it is possible to amplify specific regions of the T-cell receptor gamma gene. The amplification products can then be separated by denaturing gradient gel electrophoresis in order to detect a monoclonal population of T-lymphocytes in the infiltrate. We studied 4 patients with the clinicopathologic diagnosis of mycosis fungoides and 2 patients diagnosed as large plaque parapsoriasis. A monoclonal population was detected in 3 of the 4 mycosis fungoides cases and in 1 of the patients with large plaque parapsoriasis. This indicates that our analysis can help us establishing a diagnosis, and it can also help us to identify patients with a possible early stage of the disease, which clinically or histologically is not yet recognised as such.

  4. The different psychological profiles of subjects attending melanoma screening campaigns and those delaying diagnosis: an aid for designing preventive campaigns?

    Science.gov (United States)

    Forghieri, Matilde; Longo, Caterina; Galeazzi, Gian Maria; Rigatelli, Marco; Seidenari, Stefania; Pellacani, Giovanni

    2010-01-01

    Patient delay in seeking medical attention for melanoma (MM) constitutes one of the main challenges in designing prevention campaigns. No conclusive studies exploring psychological aspects of those patients, using standardized psychometric instruments, are currently available. We hypothesized that the attitude toward illness of subjects attending the melanoma screening day (EMD) would differ from patients diagnosed with MM following the usual clinical pathways. Five psychometric tests, assessing attitude toward illness, were administered both to EMD and MM groups, this latter further divided into two subgroups (good and bad detectors, GD and BD) considering the histo-clinical characteristics of the lesion. The Mann-Whitney U Test and Pearson Chi Square test were used to compare EMD patients with the other groups and to compare psychometric scores between GD and BD. BD and GD groups showed significant differences. Interestingly, the BD group was characterized by higher scores in Temperament and Character Inventory Fearful subscale, Multidimensional Health Locus of Control Powerful Others scale and Illness Behaviour Questionnaire General Hypochondriasis, Affective Disturbance and Irritability subscales. BD patients tend to react in a phobic manner to medical recommendations and they appear to favour external and more assertive help, which would suggest choosing a more direct approach in proposing a prevention campaign. Although this is a pilot study and further studies are needed, it gives new insight to build up more effective prevention campaigns for those patients.

  5. Prognostic stratification of ulcerated melanoma

    DEFF Research Database (Denmark)

    Bønnelykke-Behrndtz, Marie L; Schmidt, Henrik; Christensen, Ib J

    2014-01-01

    OBJECTIVES: For patients with melanoma, ulceration is an important prognostic marker and interestingly also a predictive marker for the response of adjuvant interferon. A consensual definition and accurate assessment of ulceration are therefore crucial for proper staging and clinical management. We...... stratification of ulcerated lesions. METHODS: From H&E-stained sections, the status (presence vs absence), extent (percentage of the total tumor length), and type (infiltrative vs attenuative) of ulceration and epidermal involvement were evaluated from 385 patients with cutaneous melanoma. RESULTS: The presence...... of ulceration (hazard ratio [HR], 1.83), an attenuative type of ulceration (HR, 3.02), and excessive ulceration (HR, 3.57) were independent predictors of poor melanoma-specific survival. Further subdivision of minimal/moderate ulceration showed independent prognostic value only for lesions with epidermal...

  6. Diversified β-2-adrenergic Receptor Expression and Action in Melanoma Cells.

    Science.gov (United States)

    Janik, Marcelina Elżbieta; Szlęzak, Dominika; Surman, Magdalena; Gołas, Aniela; Lityńska, Anna; Przybyło, Małgorzata

    2017-06-01

    Growing evidence links stress hormones with development and progression of various cancer types. The aim of this study was to assess susceptibility of cutaneous and uveal melanoma cells to adrenaline (AD). The expression of β-2-adrenergic receptor in primary cutaneous (FM-55-P), primary uveal (92-1, Mel202) and metastatic cutaneous (A375) melanoma cells was estimated at mRNA, protein and cell surface levels. The impact of AD on cell proliferation and migration was also studied. The expression of β-2-adrenergic receptor was cell line-dependent. Adrenaline treatment caused a slight stimulation of melanoma cell proliferation and activation of matrix metalloproteinases. Adrenaline-treated uveal melanoma cells showed an increased migration rate, whereas, in cutaneous melanoma cells, no changes or even lower migration speed were observed. Melanoma cell susceptibility to AD varies depending on origin and progression stage. Metastatic cutaneous melanoma cells were found to be less responsive to AD than primary cutaneous and uveal melanoma cells. Copyright© 2017, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

  7. Adjuvant Therapy: Melanoma

    Directory of Open Access Journals (Sweden)

    Diwakar Davar

    2011-01-01

    Full Text Available With an incidence that is increasing at 2–5% per year, cutaneous melanoma is an international scourge that disproportionately targets young individuals. Despite much research, the treatment of advanced disease is still quite challenging. Immunotherapy with high-dose interferon-α2b or interleukin-2 benefits a select group of patients in the adjuvant and metastatic settings, respectively, with significant attendant toxicity. Advances in the biology of malignant melanoma and the role of immunomodulatory therapy have produced advances that have stunned the field. In this paper, we review the data for the use of interferon-α2b in various dosing ranges, vaccine therapy, and the role of radiotherapy in the adjuvant setting for malignant melanoma. Recent trials in the metastatic setting using anticytoxic T-lymphocyte antigen-4 (anti-CTLA-4 monoclonal antibody therapy and BRAF inhibitor therapy have demonstrated clear benefit with prolongation of survival. Trials investigating combinations of these novel agents with existing immunomodulators are at present underway.

  8. Cutaneous mucormycosis.

    Science.gov (United States)

    Skiada, Anna; Petrikkos, George

    2013-01-01

    Mucormycosis is an invasive fungal infection caused by fungi of the order Mucorales, mainly affecting immunocompromised patients. Cutaneous mucormycosis is the third most common clinical form of the disease, after pulmonary and rhino-cerebral. The usual factors predisposing to this infection are hematological malignancies and diabetes mellitus, but a significant proportion of patients are immunocompetent. The agents of mucormycosis are ubiquitous in nature and are transmitted to the skin by direct inoculation, as a result of various types of trauma. These include needle sticks, stings and bites by animals, motor vehicle accidents, natural disasters, and burn injuries. The typical presentation of mucormycosis is the necrotic eschar, but it can present with various other signs. The infection can be locally invasive and penetrate into the adjacent fat, muscle, fascia, and bone, or become disseminated. Diagnosis is difficult because of the nonspecific findings of mucormycosis. Biopsy and culture should be performed. The treatment of mucormycosis is multimodal and consists of surgical debridement, use of antifungal drugs (amphotericin B and posaconazole), and reversal of underlying risk factors, when possible. Mortality rates, although lower than in other forms of the disease, are significant, ranging from 4% to 10% when the infection is localized.

  9. Primary Dermal Melanoma in a Patient with a History of Multiple Malignancies: A Case Report with Molecular Characterization

    Directory of Open Access Journals (Sweden)

    Germana Sini

    2013-07-01

    Full Text Available Introduction: Primary dermal melanoma (PDM is a recently described clinical entity accounting for less than 1% of all melanomas. Histologically, it is located in the dermis or subcutaneous tissue, and it shows no connections with the overlying epidermis. The differential diagnosis is principally made along with that of metastatic cutaneous melanoma. Case Report: A 72-year-old Caucasian woman with a history of multiple cancers (metachronous bilateral breast cancer, meningioma, clear cell renal cell carcinoma, uterine fibromatosis and intestinal adenomatous polyposis, came to our attention with a nodular lesion on her back. After removal of the lesion, the histology report indicated malignant PDM or metastatic malignant melanoma. The clinical and instrumental evaluation of the patient did not reveal any other primary tumour, suggesting the primitive nature of the lesion. The absence of an epithelial component argued for a histological diagnosis of PDM. Subsequently, the patient underwent a wide surgical excision with sentinel node biopsy, which was positive for metastatic melanoma. Finally, the mutational status was studied in the main genes that regulate proliferation, apoptosis and cellular senescence. No pathogenetic mutations in CDKN2A, BRAF, NRAS, KRAS, cKIT, TP53 and PTEN genes were observed. This suggests that alternative pathways and low-frequency alterations may be involved. Conclusions: The differential diagnosis between PDM and isolated metastatic melanoma depends on the negativity of imaging studies and clinical findings for other primary lesions. This distinction is important because 5-year survival rates in such cases are higher than in metastatic cases (80-100 vs. 5-20%, respectively.

  10. Gender Differences in Melanoma Progression and Survival

    NARCIS (Netherlands)

    A. Joosse (Arjen)

    2014-01-01

    markdownabstract__Abstract__ Cutaneous melanoma is developing into a major public health problem worldwide. Incidence differs greatly across the world with high incidence rates in the Unites states, Europe and especially in Australia and New Zealand, but relatively low incidence rates in Central an

  11. The biology of melanoma prognostic factors.

    NARCIS (Netherlands)

    Spatz, A.; Stock, N.; Batist, G.; Kempen, L.C.L.T. van

    2010-01-01

    Cutaneous melanoma still represents a paradox among all solid tumors. It is the cancer for which the best prognostic markers ever identified in solid tumors are available, yet there is very little understanding of their biological significance. This review focuses on recent biological data that shed

  12. Refining criteria for diagnosis of cutaneous infections caused by herpes viruses through correlation of morphology with molecular pathology

    Directory of Open Access Journals (Sweden)

    Böer Almut

    2006-01-01

    Full Text Available BACKGROUND: Infections of the skin by herpes viruses do not always present themselves in typical fashion. Early diagnosis, however, is crucial for appropriate treatment. Polymerase chain reaction (PCR allows diagnosis and differential diagnosis of herpes virus infections, but the method is not yet available in large parts of the world, where diagnosis is made based on morphology alone. AIM: To refine criteria for the diagnosis of herpes virus infections of the skin by way of correlation of clinical and histopathologic findings with results of PCR studies. METHODS: We studied 75 clinically diagnosed patients of "zoster," "varicella," and "herpes simplex", to correlate clinical and histopathological findings with results of PCR studies on paraffin embedded biopsy specimens. RESULTS: Clinical suspicion of infection by herpes viruses was confirmed by histopathology in 37% of the cases and by PCR studies in 65% of the cases. Zoster was frequently misdiagnosed as infection with herpes simplex viruses (30%. When diagnostic signs of herpes virus infection were encountered histopathologically, PCR confirmed the diagnosis in 94%. By way of correlation with results of PCR studies, initial lesions of herpes virus infections could be identified to have a distinctive histopathological pattern. Herpetic folliculitis appeared to be a rather common finding in zoster, it occurring in 28% of the cases. CONCLUSION: We conclude that correlation of clinical and histopathological features with results of PCR studies on one and the same paraffin embedded specimen permits identification of characteristic morphologic patterns and helps to refine criteria for diagnosis both clinically and histopathologically.

  13. Dermoscopic clues in the diagnosis of amelanotic and hypomelanotic malignant melanoma Pistas dermatoscópicas no diagnóstico de melanoma maligno amelanótico e hipomelanótico

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    Raquel Bissacotti Steglich

    2012-12-01

    Full Text Available The clinical identification of amelanotic malignant melanoma (AMM and hypomelanotic malignant melanoma (HMM becomes difficult due to the lack of pigmentation and to the diverse clinical presentations. Dermoscopy is very useful in these cases, increasing the level of suspicion of malignancy. We report 4 cases of amelanotic malignant melanoma and hypomelanotic malignant melanoma with characteristic dermoscopic findings. Dermoscopy under polarized light demonstrates vascular polymorphism, globules and milky-red areas, in addition to chrysalis and multiple blue-gray dots.A identificação clínica de melanoma maligno amelanótico e hipomelanótico torna-se difícil devido à falta de pigmentação e às diversas apresentações desse tipo de tumor. A dermatoscopia é muito útil nestes casos, aumentando o grau de suspeição de malignidade. Relatamos 4 casos de melanoma maligno amelanótico e melanoma maligno hipomelanótico com achados dermatoscópicos característicos. A dermatoscopia com luz polarizada demonstra polimorfismo vascular, glóbulos e áreas vermelholeitosas, assim como crisálides e múltiplos pontos azul-acinzentados.

  14. Morphogenesis of early stage melanoma

    Science.gov (United States)

    Chatelain, Clément; Amar, Martine Ben

    2015-08-01

    Melanoma early detection is possible by simple skin examination and can insure a high survival probability when successful. However it requires efficient methods for identifying malignant lesions from common moles. This paper provides an overview first of the biological and physical mechanisms controlling melanoma early evolution, and then of the clinical tools available today for detecting melanoma in vivo at an early stage. It highlights the lack of diagnosis methods rationally linking macroscopic observables to the microscopic properties of the tissue, which define the malignancy of the tumor. The possible inputs of multiscale models for improving these methods are shortly discussed.

  15. IN-VIVO DIAGNOSIS OF CHEMICALLY INDUCED MELANOMA IN AN ANIMAL MODEL USING UV-VISIBLE AND NIR ELASTIC SCATTERING SPECTROSCOPY: PRELIMINARY TESTING.

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    C. A' AMAR; R. LEY; ET AL

    2001-01-01

    Elastic light scattering spectroscopy (ESS) has the potential to provide spectra that contain both morphological and chromophore information from tissue. We report on a preliminary study of this technique, with the hope of developing a method for diagnosis of highly-pigmented skin lesions, commonly associated with skin cancer. Four opossums were treated with dimethylbenz(a)anthracene to induce both malignant melanoma and benign pigmented lesions. Skin lesions were examined in vivo using both UV-visible and near infrared (NIR) ESS, with wavelength ranges of 330-900 nm and 900-1700 nm, respectively. Both portable systems used identical fiber-optic probe geometry throughout all of the measurements. The core diameters for illuminating and collecting fibers were 400 and 200 {micro}m, respectively, with center-to-center separation of 350 {micro}m. The probe was placed in optical contact with the tissue under investigation. Biopsies from lesions were analyzed by two standard histopathological procedures. Taking into account only the biopsied lesions, UV-visible ESS showed distinct spectral correlation for 11/13 lesions. The NIR-ESS correlated well with 12/13 lesions correctly. The results of these experiments showed that UV-visible and NIR-ESS have the potential to classify benign and malignant skin lesions, with encouraging agreement to that provided by standard histopathological examination. These initial results show potential for ESS based diagnosis of pigmented skin lesions, but further trials are required in order to substantiate the technique.

  16. Genus-specific kinetoplast-DNA PCR and parasite culture for the diagnosis of localised cutaneous leishmaniasis: applications for clinical trials under field conditions in Brazil

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    Julia Ampuero

    2009-11-01

    Full Text Available The positivities of two methods for the diagnosis of localised cutaneous leishmaniasis (CL were estimated in 280 patients enrolled in a clinical trial. The trial was conducted in an endemic area of Leishmania (Viannia braziliensis and trial participants were patients with skin ulcers and positive leishmanin skin tests. Patients underwent aspirative skin punctures of the ulcerated lesions and lymph nodes for in vitro cultures, which were processed under field conditions at the local health centre. Skin lesion biopsies were tested at a reference laboratory using kinetoplastid DNA (kDNA-PCR to detect DNA. The median time required to obtain a positive culture from the skin samples was seven days and the contamination rate of the samples was 1.8%. The positivities of the cultures from skin lesions, kDNA-PCR and the combination of the two methods were 78.2% (95% CI: 73-82.6%, 89.3% (95% CI: 85.1-92.4% and 97.1% (95% CI: 94.5-98.5%. We conclude that parasite culture is a feasible method for the detection of Leishmania in field conditions and that the combination of culture and PCR has a potential role for the diagnosis of CL in candidates for clinical trials.

  17. Genus-specific kinetoplast-DNA PCR and parasite culture for the diagnosis of localised cutaneous leishmaniasis: applications for clinical trials under field conditions in Brazil.

    Science.gov (United States)

    Ampuero, Julia; Rios, Alexandre Pereira; Carranza-Tamayo, César Omar; Romero, Gustavo Adolfo Sierra

    2009-11-01

    The positivities of two methods for the diagnosis of localised cutaneous leishmaniasis (CL) were estimated in 280 patients enrolled in a clinical trial. The trial was conducted in an endemic area of Leishmania (Viannia) braziliensis and trial participants were patients with skin ulcers and positive leishmanin skin tests. Patients underwent aspirative skin punctures of the ulcerated lesions and lymph nodes for in vitro cultures, which were processed under field conditions at the local health centre. Skin lesion biopsies were tested at a reference laboratory using kinetoplastid DNA (kDNA)-PCR to detect DNA. The median time required to obtain a positive culture from the skin samples was seven days and the contamination rate of the samples was 1.8%. The positivities of the cultures from skin lesions, kDNA-PCR and the combination of the two methods were 78.2% (95% CI: 73-82.6%), 89.3% (95% CI: 85.1-92.4%) and 97.1% (95% CI: 94.5-98.5%). We conclude that parasite culture is a feasible method for the detection of Leishmania in field conditions and that the combination of culture and PCR has a potential role for the diagnosis of CL in candidates for clinical trials.

  18. Update on cutaneous calciphylaxis

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    Uwe Wollina

    2013-01-01

    Full Text Available Calciphylaxis is a devastating disorder with a mortality rate of 80% due to sepsis and organ failure. Hallmarks of this rare disease are arteriolar media calcification, thrombotic cutaneous ischemia, and necrotic ulcerations. Different mechanisms of vascular calcification can lead to calciphylaxis. Early diagnosis by deep cutaneous ulcer biopsy is most important for prognosis. Here, dermatologists play a significant role although treatment usually needs an interdisciplinary approach. Surgical procedures had been the cornerstone of treatment in the past including parathyroidectomy, but recently new medical treatments emerged aiming to normalize disturbances of minerals to reduce the serum concentration of sodium phosphate and to prevent precipitation and calcification. Multimodal therapy is warranted but only aggressive surgical debridement of cutaneous ulcers has shown significant outcome improvement.

  19. [Choroidal melanoma - evolution and prognosis].

    Science.gov (United States)

    Chiruţa, Daria; Stan, Cristina

    2014-01-01

    Choroidal melanoma is the most common primary intraocular malignant tumor. We present the case of a 62 year old patient who was diagnosed with intraocular tumor in his right eye, for about three years. Regarding the fact that the patient refused any kind of treatment during this period, we just had the opportunity to monitor this case. Finally, the diagnosis was choroidal melanoma, confirmed by the histopathological exam.

  20. A Rare Thyroid Metastasis from Uveal Melanoma and Response to Immunotherapy Agents

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    Dearbhaile Catherine Collins

    2016-01-01

    Full Text Available Thyroid metastasis is a rare occurrence with cutaneous melanoma and even more uncommon with uveal melanoma. The management of such metastasis is uncertain due to its infrequency and, in the era of immunotherapy, the effect of these novel drugs on uncommon metastasis, such as to the thyroid, is unknown. We report the rare case of a thyroid metastasis in a patient diagnosed with ocular melanoma initially managed with enucleation. Metastatic disease developed in the lung and thyroid gland. The case patient received the immunotherapy ipilimumab with stable disease in the thyroid and progressive disease elsewhere. The patient was then further treated with a second immunotherapy agent, pembrolizumab, and remains with stable disease one year later. We discuss the current literature on thyroid metastases from all causes and the optimal known management strategies. Furthermore, we provide an original report on the response of this disease to the novel immunomodulators, ipilimumab, and pembrolizumab with stable disease four years after initial diagnosis of ocular melanoma.

  1. Rôles et modes d'action de l'annexine A1 dans la dissémination du mélanome cutané

    OpenAIRE

    Boudhraa, Zied

    2013-01-01

    Cutaneous melanoma is the most aggressive skin cancer. Treatment options are limited and inefficient when melanoma has metastasized. In order to identify new markers of melanoma dissemination, protein profiles of two genetically similar murine melanoma cell lines have been compared. Both B16F10 and B16Bl6 cells induced primary tumours after subcutaneous graft, however, only B16Bl6 melanomas develop metastases. Among proteins differentially expressed, annexin A1 (ANXA1) is overexpressed in the...

  2. Critérios anatomopatológicos para melanoma maligno cutâneo: análise qualitativa de sua eficácia e revisão da literatura Anatomicopathological criteria for cutaneous malignant melanoma: qualitative analysis of efficacy and review of the literature

    Directory of Open Access Journals (Sweden)

    Luiz Alberto Veronese

    2004-04-01

    ; 9 cellular atypias; 10 mitosis; 11 melanization; 12 isolated cells proliferation. The characteristics of each one and their application in the diagnosis of melanomas were shown, always remembering possible exceptions in which these criteria might present in benign melanocytic lesions. Farther more, tables of differential diagnostic features are offered, for benign and malignant melanocytic lesions, using these histopathological criteria. As any criterion must not be considered by itself, the rigorous application of this data set here provided can substantially help the generalist surgical pathologist (non-specialist in melanocytic lesions to solve some of the problems at his daily routine.

  3. Update on the targeted therapy of melanoma.

    Science.gov (United States)

    Johnson, Douglas B; Sosman, Jeffrey A

    2013-06-01

    Melanoma is the most aggressive of the cutaneous malignancies, causing more than 9,000 deaths in the past year in the United States. Historically, systemic therapies have been largely ineffective, because melanoma is usually resistant to cytotoxic chemotherapy. However, during the past few years, several targeted therapies have proved effective in this challenging disease. These recent advances have been facilitated by an improved understanding of the driving genetic aberrations of melanoma, particularly mutations in the mitogen-activated protein kinase (MAPK) pathway. Vemurafenib, a BRAF inhibitor, demonstrated an overall survival advantage in phase III trials and is an appropriate option for first-line therapy in metastatic BRAF mutant melanoma. Dabrafenib, another BRAF inhibitor, and trametinib, a MEK inhibitor, also have been shown to be effective in phase III trials for BRAF mutant melanoma and may be additional treatment options as monotherapy or in combination pending regulatory approval. Additionally, imatinib is a promising targeted therapy for patients whose tumors harbor a KIT mutation in exons 11 and 13. Although these targeted agents cause objective responses and clinical benefit in patients with metastatic melanoma, resistance invariably develops. New targets and strategies to overcome acquired resistance are urgently needed. Furthermore, no effective targeted therapy has been developed for NRAS mutant tumors or in melanomas with as yet unknown driver mutations. In this review, we discuss current molecular targeted treatment options and promising ongoing research to develop new strategies to treat melanoma.

  4. Mucosal melanoma of the head and neck.

    Science.gov (United States)

    Ascierto, Paolo Antonio; Accorona, Remo; Botti, Gerardo; Farina, Davide; Fossati, Piero; Gatta, Gemma; Gogas, Helen; Lombardi, Davide; Maroldi, Roberto; Nicolai, Piero; Ravanelli, Marco; Vanella, Vito

    2017-04-01

    Mucosal melanoma of the head and neck is a very rare and aggressive malignancy with a very poor prognosis. The nasal cavity, paranasal sinuses, and oral cavity are the most common locations. One-, 3- and 5-year survival rates between 2000 and 2007 were 63%, 30% and 20%, respectively. Cigarette smoking seems to be a risk factor even though the evidence for this is very low. Clinical signs and symptoms are usually nonspecific. While surgery is considered the mainstay of treatment for most mucosal melanomas of the head and neck region, radiotherapy has a role in local control of the disease after surgery. Many new treatment options in the last years, in particular targeted therapies (i.e. inhibitors of c-KIT, NRAS/MEK or BRAF) and immunotherapies (anti CTLA-4 and anti PD-1/PD-L1 antibodies), have changed the history of cutaneous melanoma. Despite the different biology, mucosal melanoma is currently treated in the same way as cutaneous melanoma; however, patients with mucosal melanoma were excluded from the majority of recent clinical trials. Recent molecular findings offer new hope for the development of more effective systemic therapy. Copyright © 2017 Elsevier B.V. All rights reserved.

  5. Pediatric melanoma, moles, and sun safety.

    Science.gov (United States)

    Hawryluk, Elena B; Liang, Marilyn G

    2014-04-01

    Although pediatric melanoma is a rare disease, diagnosis and management of pigmented lesions in the pediatric population, particularly dysplastic nevi and Spitz nevi, can be challenging. In this article, we provide an overview of pigmented lesions in children, including melanoma and management of melanoma risk factors and melanocytic nevi in the pediatric population. Congenital melanocytic nevi, Spitz nevi, dysplastic and acquired nevi, and changes over time are reviewed. We discuss considerations for excision and management of pigmented lesions in children.

  6. Clinical features of the head and neck mucosal melanoma. А review

    Directory of Open Access Journals (Sweden)

    A. V. Ignatova

    2015-01-01

    Full Text Available Melanoma is an aggressive and rare neoplasm of melanocytic origin. Mucosal melanomas of the head and neck account for 1 % of neoplasms, 0,2–8,0 4 % of all melanomas and over 50 % of all mucosal melanomas. To date, in Russian and foreign literature only few retrospective series and case reports have been reported on mucosal melanoma. Despite melanoma’s common histological origin, head and neck mucosal melanoma presentation has some specific features due to its anatomical localization and poor clinical outcomes compared with those of cutaneous melanomas. Mucosal melanoma has a high metastatic potential. Five-year overall survival does not exceed 30 %. Advances in understanding of the clinical presentation can be used for prediction of behaviour and prognosis of this disease. We considered and analised articles devoted to clinical features of head and neck mucosal melanoma according to its localization.

  7. Spitzoid Melanoma: A Ten Year-Old Boy

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    Işıl Kılınç Karaarslan

    2008-01-01

    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

  8. Cutaneous loxoscelism

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    Purohit S

    1995-01-01

    Full Text Available A case of spider bitea presenting as cutaneous loxoscelism is reported. The clinical features and management of spider bite are highlighted and the relevant literature has been reviewed

  9. Direct bony invasion of malignant melanoma

    Directory of Open Access Journals (Sweden)

    Mula Viswanath

    2009-01-01

    Full Text Available Malignant melanoma is known to spread by local extention, by the lymphatics by the blood stream. Direct invasion of the bone from a cutaneous melanoma is unknown. Hence, this case is presented in view of its rarity. A 75-year-old Caucasian lady presented with a small papillary lesion in the region of a recurrent chronic cellulitis on the lower third of the lateral aspect of the right leg. Histopathology diagnosed the lesion as locally advanced malignant melanoma. Radiological investigations by X-ray and magnetic resonance imaging revealed malignant infiltration of the tibia in its mid and lower third with two soft tissue metastatic masses adjacent. Histology following amputation confirmed malignant melanoma with cranial resection margin involvement. She underwent a further above-knee amputation followed by chemotherapy. The patient recovered from the amputation but subsequently died 6 months later due to bronchopneumonia from lung metastasis.

  10. [Molecular alterations in melanoma and targeted therapies].

    Science.gov (United States)

    Mourah, Samia; Lebbé, Céleste

    2014-12-01

    Melanoma is a skin cancer whose incidence is increasing steadily. The recent discovery of frequent and recurrent genetic alterations in cutaneous melanoma allowed a molecular classification of tumors into distinct subgroups, and paved the way for targeted therapy. Several signaling pathways are involved in the progression of this disease with oncogenic mutations affecting signaling pathways: MAPK, PI3K, cAMP and cyclin D1/CDK4. In each of these pathways, several potential therapeutic targets have been identified and specific inhibitors have already been developed and have shown clinical efficacy. The use of these inhibitors is often conditioned by tumors genotyping. In France, melanomas genotyping is supported by the platforms of the National Cancer Institute (INCA), which implemented a national program ensuring access to innovation for personalized medicine. The identification of new targets in melanoma supplies a very active dynamic development of innovative molecules contributing to changing the therapeutic landscape of this pathology.

  11. Role of SPECT-CT in sentinel lymph node biopsy in patients diagnosed with head and neck melanoma.

    Science.gov (United States)

    López-Rodríguez, E; García-Gómez, F J; Álvarez-Pérez, R M; Martínez-Castillo, R; Borrego-Dorado, I; Fernández-Ortega, P; Zulueta-Dorado, T

    2016-01-01

    Assess the role of SPECT-CT in sentinel lymph node (SLN) biopsy in the accurate anatomical location of the SNL in patients with cutaneous head and neck melanoma. A retrospective study was conducted from February 2010 to June 2013 on 22 consecutive patients with a diagnosis of cutaneous head and neck melanoma (9 female, 13 male), with a mean age of 55 years old and who met the inclusion criteria for SLN biopsy. Patients underwent preoperative scanning after peri-scar injection of (99m)Tc-labeled-nanocolloid. Planar images of the injection-site, whole-body, and SPECT-CT scanning were acquired. Detection rate of SLN reached up to 91% (20/22 patients) by planar lymphoscintigraphy and 95.4% (21/22 patients) by SPECT-CT. SPECT-CT provided an accurate location of SLN in 14/22 patients, enabling to improve the surgical approach (clinical impact: 63.6%). SLN was positive for metastatic cells in 9.1% patients. SPECT-CT provides detailed anatomical SLN location and allows detecting a higher number of SLN than planar lymphoscintigraphy. Routine use of SPECT-CT is recommended in order to optimise the SLN detection and location in patients with head and neck melanoma. Copyright © 2015 Elsevier España, S.L.U. and SEMNIM. All rights reserved.

  12. Pediatric melanoma.

    Science.gov (United States)

    Tracy, Elisabeth T; Aldrink, Jennifer H

    2016-10-01

    Childhood melanoma is a rare pediatric malignancy, with fewer than 500 new diagnoses annually. The incidence is increasing, particularly in the adolescent population. This review highlights the epidemiology, clinical presentation, and histopathologic challenges of pediatric melanoma. Surgical resection remains the cornerstone for localized and regionally advanced disease. Adjuvant therapies, including current options and potential novel therapeutics for this unique population will be discussed. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Sarcoidosis in Melanoma Patients: Case Report and Literature Review

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    Beutler, Bryce D., E-mail: brycebeutler@hotmail.com [School of Allied Health Sciences, University of Nevada, Las Vegas, 1060 Wiegand Road, Encinitas, CA 92024 (United States); Cohen, Philip R., E-mail: brycebeutler@hotmail.com [Department of Dermatology, University of California San Diego, 10991 Twinleaf Court, San Diego, CA 92131 (United States)

    2015-06-15

    Sarcoidosis is a systemic inflammatory disease characterized by the development of noncaseating granulomas in multiple organ systems. Many hematologic malignancies and solid tumors, including melanoma, have been associated with sarcoidosis. We describe the clinical and pathologic findings of a 54-year-old man with melanoma-associated sarcoidosis. In addition, we not only review the literature describing characteristics of other melanoma patients with sarcoidosis, but also the features of melanoma patients with antineoplastic therapy-associated sarcoidosis. Sarcoidosis has been described in 80 melanoma patients; sufficient information for analysis was provided in 39 of these individuals. In 43.6% of individuals (17 out of 39), sarcoidosis was directly associated with melanoma; in 56.4% of oncologic patients (22 out of 39), sarcoidosis was induced by antineoplastic therapy that had been administered for the treatment of their metastatic melanoma. The discovery of melanoma preceded the development of sarcoidosis in 12 of the 17 (70.5%) individuals who did not receive systemic treatment. Pulmonary and/or cutaneous manifestations of sarcoidosis were common among both groups of patients. Most patients did not require treatment for sarcoidosis. Melanoma patients—either following antineoplastic therapy or without systemic treatment—may be at an increased risk to develop sarcoidosis. In antineoplastic therapy naive melanoma patients, a common etiologic factor—such as exposure to ultraviolet light—may play a role in their developing melanoma and sarcoidosis.

  14. Sarcoidosis in Melanoma Patients: Case Report and Literature Review

    Science.gov (United States)

    Beutler, Bryce D.; Cohen, Philip R.

    2015-01-01

    Sarcoidosis is a systemic inflammatory disease characterized by the development of noncaseating granulomas in multiple organ systems. Many hematologic malignancies and solid tumors, including melanoma, have been associated with sarcoidosis. We describe the clinical and pathologic findings of a 54-year-old man with melanoma-associated sarcoidosis. In addition, we not only review the literature describing characteristics of other melanoma patients with sarcoidosis, but also the features of melanoma patients with antineoplastic therapy-associated sarcoidosis. Sarcoidosis has been described in 80 melanoma patients; sufficient information for analysis was provided in 39 of these individuals. In 43.6% of individuals (17 out of 39), sarcoidosis was directly associated with melanoma; in 56.4% of oncologic patients (22 out of 39), sarcoidosis was induced by antineoplastic therapy that had been administered for the treatment of their metastatic melanoma. The discovery of melanoma preceded the development of sarcoidosis in 12 of the 17 (70.5%) individuals who did not receive systemic treatment. Pulmonary and/or cutaneous manifestations of sarcoidosis were common among both groups of patients. Most patients did not require treatment for sarcoidosis. Melanoma patients—either following antineoplastic therapy or without systemic treatment—may be at an increased risk to develop sarcoidosis. In antineoplastic therapy naive melanoma patients, a common etiologic factor—such as exposure to ultraviolet light—may play a role in their developing melanoma and sarcoidosis. PMID:26083934

  15. A rapid molecular diagnosis of cutaneous leishmaniasis by colorimetric malachite green-loop-mediated isothermal amplification (LAMP) combined with an FTA card as a direct sampling tool.

    Science.gov (United States)

    Nzelu, Chukwunonso O; Cáceres, Abraham G; Guerrero-Quincho, Silvia; Tineo-Villafuerte, Edwin; Rodriquez-Delfin, Luis; Mimori, Tatsuyuki; Uezato, Hiroshi; Katakura, Ken; Gomez, Eduardo A; Guevara, Angel G; Hashiguchi, Yoshihisa; Kato, Hirotomo

    2016-01-01

    Leishmaniasis remains one of the world's most neglected diseases, and early detection of the infectious agent, especially in developing countries, will require a simple and rapid test. In this study, we established a quick, one-step, single-tube, highly sensitive loop-mediated isothermal amplification (LAMP) assay for rapid detection of Leishmania DNA from tissue materials spotted on an FTA card. An FTA-LAMP with pre-added malachite green was performed at 64°C for 60min using a heating block and/or water bath and DNA amplification was detected immediately after incubation. The LAMP assay had high detection sensitivity down to a level of 0.01 parasites per μl. The field- and clinic-applicability of the colorimetric FTA-LAMP assay was demonstrated with 122 clinical samples collected from patients suspected of having cutaneous leishmaniasis in Peru, from which 71 positives were detected. The LAMP assay in combination with an FTA card described here is rapid and sensitive, as well as simple to perform, and has great potential usefulness for diagnosis and surveillance of leishmaniasis in endemic areas.

  16. Cutaneous mercury granuloma

    OpenAIRE

    Kalpana A Bothale; Mahore, Sadhana D.; Sushil Pande; Trupti Dongre

    2013-01-01

    Cutaneous mercury granuloma is rarely encountered. Clinically it may pose difficulty in diagnosis. Here, we report a 23-year-old male presented with erythematous, nodular lesions over the forearm and anterior aspect of chest wall. Metallic mercury in tissue sections appear as dark black, opaque, spherical globules of varying size and number. They are surrounded by granulomatous foreign-body reaction. It is composed of foreign body giant cells and mixed inflammatory infiltrate composed of hist...

  17. Study Suggests Smaller Melanoma Excision Margins May Be Option for Some Patients

    Science.gov (United States)

    A randomized controlled trial of patients with stage IIA–C cutaneous melanoma thicker than 2-mm found that a 2-cm surgical resection margin is sufficient and is as safe for patients as a 4-cm margin.

  18. [Furuncular myiasis caused by Dermatobia hominis. Fortuitous diagnosis on extemporaneous macroscopic analysis of an excised cutaneous nodule].

    Science.gov (United States)

    Hirsch, G; Jeandel, R; Biechler, M; Boivin, J-F; Hillion, B

    2015-12-01

    Furuncular myiasis is a parasitic disease caused by the development of human botfly larva in the skin. It affects people living in tropical countries and travelers returning from these countries and concerns a number of medical specialties. One form of treatment involves surgical extraction of the parasites. We report the case of a 47-year-old man returning from Guyana presenting two furuncle-like nodules of the skin on the right buttock and on the right shoulder blade. Extemporaneous intraoperative macroscopic examination of the buttock nodule resulted in diagnosis of myiasis caused by the human botfly, Dermatobia hominis. The diagnosis of furuncular myiasis is made primarily on clinical grounds and should be suspected on observation of an abscess in subjects returning from a tropical region. It is consequently rare to find D. hominis in biopsy specimens. In the present case, macroscopic examination showed an extremely rare image of the edge of the intact larva in a longitudinal cut, which to our knowledge has never been published to date. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  19. Malignant Melanoma with Concurrent BRAF E586K and NRAS Q81K Mutations

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    Rodney Shackelford

    2014-05-01

    Full Text Available Cutaneous melanoma is an aggressive malignant tumor of melanocytes which accounts for 80% of skin cancer-related deaths. A number of driver mutations have been identified in melanoma, with the mutually exclusive BRAF V600E and NRAS Q61A mutations together accounting for roughly 70% of mutations. Simultaneous BRAF V600E and NRAS Q61A mutations in melanoma are rare, with evidence suggesting that up to 2.9% (2/69 of primary cutaneous melanomas carry both mutations. Here we describe a 42-year-old man with concurrent BRAF E586K and NRAS Q81K driver mutations. To our knowledge, this is the first description of these driver mutations occurring simultaneously in primary cutaneous melanoma.

  20. Malignant Melanoma with Concurrent BRAF E586K and NRAS Q81K Mutations.

    Science.gov (United States)

    Shackelford, Rodney; Pollen, Maressa; Vora, Moise; Jusion, Tamara T; Cotelingam, James; Nair, Binu

    2014-05-01

    Cutaneous melanoma is an aggressive malignant tumor of melanocytes which accounts for 80% of skin cancer-related deaths. A number of driver mutations have been identified in melanoma, with the mutually exclusive BRAF V600E and NRAS Q61A mutations together accounting for roughly 70% of mutations. Simultaneous BRAF V600E and NRAS Q61A mutations in melanoma are rare, with evidence suggesting that up to 2.9% (2/69) of primary cutaneous melanomas carry both mutations. Here we describe a 42-year-old man with concurrent BRAF E586K and NRAS Q81K driver mutations. To our knowledge, this is the first description of these driver mutations occurring simultaneously in primary cutaneous melanoma.

  1. Intercellular crosstalk in human malignant melanoma.

    Science.gov (United States)

    Dvořánková, Barbora; Szabo, Pavol; Kodet, Ondřej; Strnad, Hynek; Kolář, Michal; Lacina, Lukáš; Krejčí, Eliška; Naňka, Ondřej; Šedo, Aleksi; Smetana, Karel

    2017-05-01

    Incidence of malignant melanoma is increasing globally. While the initial stages of tumors can be easily treated by a simple surgery, the therapy of advanced stages is rather limited. Melanoma cells spread rapidly through the body of a patient to form multiple metastases. Consequently, the survival rate is poor. Therefore, emphasis in melanoma research is given on early diagnosis and development of novel and more potent therapeutic options. The malignant melanoma is arising from melanocytes, cells protecting mitotically active keratinocytes against damage caused by UV light irradiation. The melanocytes originate in the neural crest and consequently migrate to the epidermis. The relationship between the melanoma cells, the melanocytes, and neural crest stem cells manifests when the melanoma cells are implanted to an early embryo: they use similar migratory routes as the normal neural crest cells. Moreover, malignant potential of these melanoma cells is overdriven in this experimental model, probably due to microenvironmental reprogramming. This observation demonstrates the crucial role of the microenvironment in melanoma biology. Indeed, malignant tumors in general represent complex ecosystems, where multiple cell types influence the growth of genetically mutated cancer cells. This concept is directly applicable to the malignant melanoma. Our review article focuses on possible strategies to modify the intercellular crosstalk in melanoma that can be employed for therapeutic purposes.

  2. [Molecular diagnosis of melanocytic tumors].

    Science.gov (United States)

    Bauer, J

    2016-01-01

    Melanoma therapy has undergone a paradigm shift. Classic chemotherapies with poor treatment responses have been replaced by modern immune checkpoint blockades and targeted therapies with excellent responses. The latter require precise diagnosis of mutations in the melanoma genome as molecular targets for the small molecules. The diagnosis of melanomas has also been supplemented by molecular techniques. Differential diagnosis of melanoma and melanoma simulators such as atypical Spitz nevi can be supported by fluorescence in situ hybridization (FISH) and comparative genomic hybridization (CGH). Here we review the indications and methods for molecular diagnosis of melanocytic tumors.

  3. Linfonodo sentinela em melanoma de criança: relato de caso Sentinel lymph node in children with melanoma: case report

    Directory of Open Access Journals (Sweden)

    Renato Santos de Oliveira Filho

    2002-10-01

    Full Text Available Objetivo: apresentar um caso de melanoma cutâneo na infância, submetido à biópsia de linfonodo sentinela. Descrição: criança de 12 anos de idade, portadora da síndrome do nevo displásico, desenvolveu melanoma em dorso. A biópsia excisional revelou melanoma (Breslow = 1,5 mm, sendo submetida a tratamento cirúrgico da lesão, com ampliação de margem de 2cm e biópsia de linfonodo sentinela. O exame anatomopatológico não mostrou doença residual. O exame do linfonodo sentinela não mostrou metástases ao exame histopatológico por hematoxilina eosina, nem à imunohistoquímica (S100 e HMB45. No entanto, a pesquisa de RNA mensageiro da tirosinase por RT-PCR se mostrou positiva. A paciente não mostrou sinais de metástase ou recidiva local nestes doze meses iniciais de seguimento. Comentários: o melanoma é raro em crianças, corresponde a menos de 1% dos tumores da infância. Inúmeros trabalhos mostram o aumento da incidência mundial do melanoma. Em cerca de 70%, se originam de nevos melanocíticos pré-existentes, e nos 30% restantes, eles surgem de novo. Dada a agressividade do melanoma, a sobrevida depende do diagnóstico precoce. A biópsia do linfonodo sentinela tem contribuído na decisão de se realizar ou não a linfadenectomia completa, e alguns autores já estão utilizando a mesma em crianças.Objective: to present a case of a child who was subjected to sentinel lymph node biopsy for cutaneous melanoma. Description: a 12 year-old child with Dysplastic Nevus Syndrome developed melanoma on the lumbar region. The excision biopsy revealed a melanoma with depth of 1.5 mm. The patient was submitted to amplification of the margins 2 cm in all directions and the sentinel node was also excised. The histopathological exam did not show residual disease. Sentinel on exam did not show metastases either under hematoxylin-eosin stain or immunohistochemistry (S-100 and HMB45. Therefore, RT-PCR for tyrosinase mRNA was positive. The

  4. Small bowel perforation caused by advanced melanoma.

    Science.gov (United States)

    den Uil, Sjoerd H; Thomassen, Irene; Vermeulen, Erik Gj; Vuylsteke, Ronald Jclm; Stockmann, Hein Bac; de Vries, Mattijs

    2014-01-01

    The incidence of melanoma has been increasing over the years and it remains, despite the heterogeneous survival for different stages, a disease with high mortality. Dissemination occurs primarily by the lymphatic route, followed by the hematogenous route. Gastrointestinal metastases do occur, but they are mainly intraluminal mucosal melanomas. Peritoneal or primary mucosal melanomas are rare. Only a few cases have been described of patients presenting with acute abdominal pain due to a melanoma. In this report we present a young patient with no prior health problems. Due to silent progression of disease at first, and secondarily avoidance of medical consultation, she finally presented to our emergency department with signs of intestinal perforation. In the operating theater a massive metastasis in the intestines with perforation was seen, as well as many smaller intra-abdominal and cutaneous lesions. Approximately 35 cm of jejunum had to be resected. Furthermore, the primary melanoma on the left forearm was excised and turned out to be in almost complete regression. Although initial recovery after surgery was good, the patient died only one month after presentation due to the advanced nature of her disease, which points to the devastating effect of undiagnosed melanoma and gastrointestinal metastasis. Since the melanoma incidence is rising, similar cases may present in the near future. This emphasizes the importance of proper full physical examination in patients with atypical abdominal symptoms.

  5. Sporadic naturally occurring melanoma in dogs as a preclinical model for human melanoma.

    Science.gov (United States)

    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

    2014-01-01

    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.

  6. Cutaneous polyarteritis nodosa: A rare isolated cutaneous vasculitis

    Directory of Open Access Journals (Sweden)

    Praveen Kumar A Subbanna

    2012-01-01

    Full Text Available Cutaneous polyarteritis nodosa (CPAN is a rare form of cutaneous vasculitis that involves small and medium sized arteries of the dermis and subcutaneous tissue without systemic involvement. It presents with tender subcutaneous nodules, digital gangrene, livedo reticularis and subcutaneous ulcerations. The diagnosis is by skin biopsy and characteristic pathologic feature is a leukocytoclastic vasculitis in the small to medium-sized arterioles of the dermis. We report a rare case of benign cutaneous PAN in a 14-year-old girl who presented with history of fever, subcutaneous nodules with cutaneous ulcer and digital gangrene. The skin biopsy showed leukocytoclastic vasculitis with fibrinoid necrosis in the dermal vessels. She received treatment with steroids and lesions resolved completely over a period of month.

  7. Diagnostic and Prognostic Biomarkers in Melanoma

    Science.gov (United States)

    Leininger, Jennifer; Hamby, Carl; Safai, Bijan

    2014-01-01

    Melanoma is a lethal melanocytic neoplasm. Unfortunately, the histological diagnosis can be difficult at times. Distinguishing ambiguous melanocytic neoplasms that are benign nevi from those that represent true melanoma is important both for treatment and prognosis. Diagnostic biomarkers currently used to assist in the diagnosis of melanoma are usually specific only for melanocytic neoplasms and not necessarily for their ability to metastasize. Traditional prognostic biomarkers include depth of invasion and mitotic count. Newer diagnostic and prognostic biomarkers utilize immunohistochemical staining as well as ribonucleic acid, micro-ribonucleic acid, and deoxyribonucleic acid assays and fluorescence in situ hybridization. Improved diagnostic and prognostic biomarkers are of increasing importance in the treatment of melanoma with the development of newer and more targeted therapies. Herein, the authors review many of the common as well as newer diagnostic and prognostic biomarkers used in melanoma. PMID:25013535

  8. Novel approaches in melanoma prevention and therapy.

    Science.gov (United States)

    Grimaldi, Antonio M; Cassidy, Pamela B; Leachmann, Sancy; Ascierto, Paolo A

    2014-01-01

    The incidence of cutaneous melanoma has risen at a rate significantly higher than that for other malignancies. This increase persists despite efforts to educate the public about the dangers of excess exposure to UV radiation from both the sun and tanning beds. Melanoma affects a relatively younger population and is notorious for its propensity to metastasize and for its poor response to current therapeutic regimens. These factors make prevention an integral component to the goal of decreasing melanoma-related mortality. Transformation of melanocytes into malignant melanoma involves the interplay between genetic factors, UV exposure, and the tumor microenvironment. The roles of UV radiation in the etiology of melanoma are mediated by both direct damage of DNA through formation of photoproducts and production of reactive oxygen species (ROS). Many of the promising antioxidant agents under development for the prevention of melanoma are derived from foodstuffs. B-Raf is a member of the Raf kinase family of serine/threonine-specific protein kinases that plays a role in regulating the MAP kinase/ERKs signaling pathway. About 50 % of melanomas harbor activating BRAF mutations. BRAF mutations are found in 59 % of the melanomas arising in skin with intermittent sun exposure, such as trunk and arms, as compared with only 23 % of the acral melanomas, 11 % of mucosal melanomas, and 0 % of uveal melanomas. Two new agents, ipilimumab and vemurafenib, have been shown to improve outcome of advanced melanoma as presented at the plenary session of the 2011 annual meeting of the American Society of Clinical Oncology. Vemurafenib is the first personalized compound which demonstrated an improvement in progression-free survival (PFS) and overall survival (OS) in metastatic melanoma harboring the BRAFV600 mutation and represents the first drug of a class that exerts its anti-proliferative activity through inhibition of a highly specific molecular target. GSK2118436 (dabrafenib), the

  9. Molecular targets in melanoma: time for `ethnic personalization'

    OpenAIRE

    Morita, Shane Y; Markovic, Svetomir N.

    2012-01-01

    Worldwide, the incidence of melanoma continues to rise. Although not the most common cutaneous malignancy, it is the most lethal. Until recently, while other oncologic patients benefited from the nuances of targeted therapy, those afflicted with melanoma lacked that option. In 2011, the US FDA approved an oral agent that targets the BRAF oncogene. As this information is promising, it is essential that other populations (in addition to Caucasians) are examined, in order to further comprehend t...

  10. Arsenic and ultraviolet radiation exposure: melanoma in a New Mexico non-Hispanic white population.

    Science.gov (United States)

    Yager, Janice W; Erdei, Esther; Myers, Orrin; Siegel, Malcolm; Berwick, Marianne

    2016-06-01

    Cases of cutaneous melanoma and controls were enrolled in a New Mexico population-based study; subjects were administered questionnaires concerning ultraviolet (UV) and inorganic arsenic (iAs) exposure. Historical iAs exposure was estimated. UV exposure estimates were also derived using geospatial methods. Drinking water samples were collected for iAs analysis. Blood samples were collected for DNA repair (Comet) and DNA repair gene polymorphism assays. Arsenic concentrations were determined in urine and toenail samples. UV exposures during the previous 90 days did not vary significantly between cases and controls. Mean (±SD) current home iAs drinking water was not significantly different for cases and controls [3.98 μg/L (±3.67) vs. 3.47 μg/L (±2.40)]. iAs exposure showed no effect on DNA repair or association with melanoma. Results did not corroborate a previously reported association between toenail As and melanoma risk. Arsenic biomarkers in urine and toenail were highly significantly correlated with iAs in drinking water. A UV-DNA repair interaction for UV exposure over the previous 7-90 days was shown; cases had higher DNA damage than controls at low UV values. This novel finding suggests that melanoma cases may be more sensitive to low-level UV exposure than are controls. A UV-APEX1 interaction was shown. Subjects with the homozygous rare APEX1 DNA repair gene allele had a higher risk of early melanoma diagnosis at low UV exposure compared with those with the homozygous wild type or the heterozygote. Notably, a UV-arsenic interaction on inhibition of DNA repair was not observed at iAs drinking water concentrations below 10 ppb (μg/L).

  11. Fractal dimension of chromatin is an independent prognostic factor for survival in melanoma

    Directory of Open Access Journals (Sweden)

    Landman Gilles

    2010-06-01

    Full Text Available Abstract Background Prognostic factors in malignant melanoma are currently based on clinical data and morphologic examination. Other prognostic features, however, which are not yet used in daily practice, might add important information and thus improve prognosis, treatment, and survival. Therefore a search for new markers is desirable. Previous studies have demonstrated that fractal characteristics of nuclear chromatin are of prognostic importance in neoplasias. We have therefore investigated whether the fractal dimension of nuclear chromatin measured in routine histological preparations of malignant melanomas could be a prognostic factor for survival. Methods We examined 71 primary superficial spreading cutaneous melanoma specimens (thickness ≥ 1 mm from patients with a minimum follow up of 5 years. Nuclear area, form factor and fractal dimension of chromatin texture were obtained from digitalized images of hematoxylin-eosin stained tissue micro array sections. Clark's level, tumor thickness and mitotic rate were also determined. Results The median follow-up was 104 months. Tumor thickness, Clark's level, mitotic rate, nuclear area and fractal dimension were significant risk factors in univariate Cox regressions. In the multivariate Cox regression, stratified for the presence or absence of metastases at diagnosis, only the Clark level and fractal dimension of the nuclear chromatin were included as independent prognostic factors in the final regression model. Conclusion In general, a more aggressive behaviour is usually found in genetically unstable neoplasias with a higher number of genetic or epigenetic changes, which on the other hand, provoke a more complex chromatin rearrangement. The increased nuclear fractal dimension found in the more aggressive melanomas is the mathematical equivalent of a higher complexity of the chromatin architecture. So, there is strong evidence that the fractal dimension of the nuclear chromatin texture is a new

  12. 犬皮肤肥大细胞瘤的组织病理学诊断%Histopathology Diagnosis of Canine Cutaneous Mast Cell Tumor

    Institute of Scientific and Technical Information of China (English)

    汪仁莉; 张珠明

    2012-01-01

    犬皮肤肥大细胞瘤约占皮肤肿瘤的20%,因为占位小且不明显,所以是犬的癌症中非常严重的一种.有的切除后没什么后遗症,有的却能成为威胁生命的疾病.正确的鉴别和处置在控制本病方面显得尤为重要.为确诊一例犬皮肤肿物的类型,将病犬皮肤肿物制成石蜡切片,观察HE染色和TB染色结果,发现增多的肿瘤细胞具有肥大细胞典型的组织学和细胞形态学特征,确诊该肿瘤为犬皮肤的肥大细胞瘤.%Canine mast cell tumors account for up to 20% of all skin tumors in dogs. While they often appear small and somewhat insignificant, they can be a very serious form of cancer in the dog. Some mast cell tumors are easily removed without the development of any further problems and others can lead to a life threatening disease. Proper identification and treatment are very important in controlling these tumors. The final diagnosis "mast cell tumor" of a case of canine cutaneous lump was based on the demonstration of focal accumulations of mast cells with typical histological and cytomorphological properties via hematoxylin eosin staining,Toluidine Blue staining of the paraffin sections.

  13. Risk of invasive melanoma in patients with rheumatoid arthritis treated with biologics

    DEFF Research Database (Denmark)

    Mercer, Louise K; Askling, Johan; Raaschou, Pauline;

    2017-01-01

    OBJECTIVES: Some studies have reported a possible association between exposure to tumour necrosis factor (TNF) inhibitors and an increased risk of melanoma. The aim of this study was to investigate the incidence of invasive cutaneous melanomas in patients with rheumatoid arthritis (RA) treated wi...

  14. Up-regulation of hepatoma-derived growth factor facilitates tumor progression in malignant melanoma [corrected].

    Directory of Open Access Journals (Sweden)

    Han-En Tsai

    Full Text Available Cutaneous malignant melanoma is the fastest increasing malignancy in humans. Hepatoma-derived growth factor (HDGF is a novel growth factor identified from human hepatoma cell line. HDGF overexpression is correlated with poor prognosis in various types of cancer including melanoma. However, the underlying mechanism of HDGF overexpression in developing melanoma remains unclear. In this study, human melanoma cell lines (A375, A2058, MEL-RM and MM200 showed higher levels of HDGF gene expression, whereas human epidermal melanocytes (HEMn expressed less. Exogenous application of HDGF stimulated colony formation and invasion of human melanoma cells. Moreover, HDGF overexpression stimulated the degree of invasion and colony formation of B16-F10 melanoma cells whereas HDGF knockdown exerted opposite effects in vitro. To evaluate the effects of HDGF on tumour growth and metastasis in vivo, syngeneic mouse melanoma and metastatic melanoma models were performed by manipulating the gene expression of HDGF in melanoma cells. It was found that mice injected with HDGF-overexpressing melanoma cells had greater tumour growth and higher metastatic capability. In contrast, mice implanted with HDGF-depleted melanoma cells exhibited reduced tumor burden and lung metastasis. Histological analysis of excised tumors revealed higher degree of cell proliferation and neovascularization in HDGF-overexpressing melanoma. The present study provides evidence that HDGF promotes tumor progression of melanoma and targeting HDGF may constitute a novel strategy for the treatment of melanoma.

  15. Cutaneous metastasis from gastrointestinal adenocarcinoma of unknown primary origin.

    Science.gov (United States)

    Junqueira, Ana Lucia Ariano; Corbett, Ana Maria França; Oliveira Filho, Jayme de; Nasser, Kassila da Rosa; Haddad, Natalie Nejem; Tebet, Ana Carolina Franco

    2015-01-01

    Cutaneous metastasis is a rare manifestation of visceral malignancies that indicates primarily advanced disease. Due to its low incidence and similarity to other cutaneous lesions, it is not uncommon to have a delayed diagnosis and a shortened prognosis. We describe the case of a patient who presented with a cutaneous nodule in the sternal region as a first sign of malignancy.

  16. Cutaneous metastasis from gastrointestinal adenocarcinoma of unknown primary origin*

    Science.gov (United States)

    Junqueira, Ana Lucia Ariano; Corbett, Ana Maria França; de Oliveira Filho, Jayme; Nasser, Kassila da Rosa; Haddad, Natalie Nejem; Tebet, Ana Carolina Franco

    2015-01-01

    Cutaneous metastasis is a rare manifestation of visceral malignancies that indicates primarily advanced disease. Due to its low incidence and similarity to other cutaneous lesions, it is not uncommon to have a delayed diagnosis and a shortened prognosis. We describe the case of a patient who presented with a cutaneous nodule in the sternal region as a first sign of malignancy. PMID:26375228

  17. Cutaneous endometriosis--Surgical presentations of a gynaecological condition.

    Science.gov (United States)

    Chiang, David T; Teh, Wan T

    2006-11-01

    Endometriosis is a common gynaecological condition; cutaneous endometriosis is a subtype of endometriosis. Although cutaneous endometriosis involving the abdominal wall is not common, preoperative diagnosis of cutaneous endometriosis can be easily mistaken for a suture granuloma, lipoma, abscess, cyst or hernia. We report two common surgical presentations of this gynaecological condition.

  18. Multiple primary melanoma in a Thai male: a case report.

    Science.gov (United States)

    Payapvipapong, Kittisak; Kanechorn-Na-Ayuthaya, Pinyapat

    2014-02-01

    Melanoma is a malignant tumor of melanocytes and the most threatening skin cancer documenting one of the highest in mortality rates in comparison to other non-skin cancers due to its potential to metastasize. Although the global incidence of melanoma has increased, the melanoma-related deaths decreased owing to the fact that melanoma is curable under the condition that early diagnosis is made and treatment is undertaken as soon as possible. Patients with primary melanoma developing a second primary melanoma are less common compared to the generalpopulation developing the first. Not only is melanoma less commonly found in Thaipatients but multiple primary melanomas (MPM) are rarely reported. The present report of a 48-year-old Thai male who presented with asymptomatic black patch on the right big toe nail and an atypical mole on the back, both ofwhich were histologically confirmed melanomas. Treatment included amputation of the right big toe and wide excision of melanoma on the back, which cleared the malignancy without recurrence until present. Although MPM are rare in Thais, the authors should be alert in cases displaying multiple moles for the possibility of melanomas. The total body examination, early diagnosis and regular follow-up are important to decrease the mortality rate in melanoma patient.

  19. What Is Melanoma Skin Cancer?

    Science.gov (United States)

    ... Z About Melanoma Skin Cancer What Is Melanoma Skin Cancer? Key Statistics for Melanoma Skin Cancer What’s New in Melanoma ... Policy . About Melanoma Skin Cancer What Is Melanoma Skin Cancer? Key Statistics for Melanoma Skin Cancer What’s New in Melanoma ...

  20. Expression of BRAF V600E mutant protein in cutaneous malignant melanoma%BRAF V600E突变蛋白在皮肤黑素瘤中的表达

    Institute of Scientific and Technical Information of China (English)

    任丹阳; 康晓静; 于世荣; 时晓辉; 吴秀娟; 靳颖; 普雄明

    2014-01-01

    Objective To detect the expression of BRAF V600E mutant protein in cutaneous malignant melanoma (CMM),and to evaluate the sensitivity and specificity of immunohistochemistry (IHC) in detecting BRAF V600E mutation.Methods IHC with an anti-BRAF V600E monoclonal antibody was performed to detect the expression of BRAF V600E mutant protein in paraffin-embedded tissue sections from 103 patients with CMM and 40 patients with nevus.Statistical analysis was carried out with SPSS software version 17.0,and the expression rate of BRAF V600E mutant protein was compared by chi-square test.Results The expression rate of BRAF V600E mutant protein in the CMM patients was 20.4% (21/103),significantly higher than that in the nevus patients (5.0% (2/40),x2 =5.06,P < 0.05).Significant differences were observed in the expression rate of BRAF V600E mutant protein between CMM patients of different age groups (29.8% (14/47) in patients aged < 60 years vs.12.5% (7/56) in those aged ≥ 60 years,P < 0.05) and nationality (30.2% (13/43) for Uygur nationality vs.13.3% (8/60) for Han nationality,P < 0.05),as well as among CMM lesions from different anatomical sites (13.6% (6/42) in acral sites vs.11.8% (4/29) in mucous membrane vs.45.8% (11/32) in non-acral sites,P < 0.05) and of different Clark levels (8.6% (4/42) for grade Ⅰ-Ⅲ vs.12.4% (17/61) for grade Ⅳ-Ⅴ,P< 0.05),but not between male and female CMM patients or between CMM patients with lymph node metastasis and those without (both P > 0.05).IHC with the anti-BRAF V600E antibody showed a sensitivity of 100% (15/15) and a specificity of 98.5% (65/66) in detecting BRAF V600E mutation.Conclusions The expression of BRAF V600E mutant protein is up-regulated in CMM lesions,and CMM patients of Uygur nationality seems to have a higher expression rate than those of Han nationality.IHC appears to be an accurate and rapid method to detect V600E BRAF mutation.%目的 探讨皮肤黑素瘤BRAF V600E突变