Artykuły w czasopismach na temat „Melanoma”
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Panizzon i Guggisberg. "Clinical aspects and histopathology of melanoma". Therapeutische Umschau 56, nr 6 (1.06.1999): 302–8. http://dx.doi.org/10.1024/0040-5930.56.6.302.
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Die jährliche Melanominzidenz ist weiter ansteigend. Die Melanome können im Prinzip gut diagnostiziert werden, da sie auf der Haut leicht erkennbar sind. Die Prognose des Melanoms ist ausgezeichnet, wenn es früh erkannt wird. Es ist wichtig, die klinischen Merkmale eines Melanoms, d.h. die ABCDE-Regel, zu kennen. Die klinischen Formen des Melanoms umfassen in der Reihenfolge der Häufigkeit das oberflächlich-spreitende Melanom (SSM), das noduläre Melanom (NM), das Lentigo maligna-Melanom (LMM) und das akro-lentiginöse Melanom (ALM). Daneben kennen wir einige klinische Sonderformen wie Melanome auf einem kongentialen Riesenaevus und das Schleimhaut-Melanom. Ähnlich unterscheiden wir histopathologisch aufgrund der Histogenese folgende Melanomformen: Melanom vom Typ SSM, NM, LMM und ALM, wobei letztere besser als akanthosisch-lentiginöse Form bezeichnet werden sollte, da «akrallentiginös» ein klinischer Ausdruck darstellt. Weitere histopathologische Sonderformen sind z.B. das desmoplastische Melanom, das Melanom vom Typ Naevus Spitz oder aus einem Naevus bleu. Wir beschrieben auch 2 Sonderformen, das Melanom vom Typ des dysplastischen Naevus oder vom Typ des Lichen ruber planus. Wichtig ist, der histopathologische Bericht umfasst a) die Dickenangabe in mm (Breslow), da sie das wichtigste Prognosekriterium darstellt, und b) die Infiltrationstiefe nach Clark (5 Stufen).
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Barcala, Natália da Silva, Felipe Narracci, Gabriel Martins Perillo, Júlia Cauneto Banheti Corredato, Lilian Mariano Fonsatti, Francielli Elaine de Araújo Sampaio, Lorraine da Rosa Bueno i in. "MELANOMA: UMA ANÁLISE ABRANGENTE". Brazilian Journal of Implantology and Health Sciences 5, nr 5 (8.12.2023): 4856–69. http://dx.doi.org/10.36557/2674-8169.2023v5n5p4856-4869.
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O melanoma é uma neoplasia cutânea maligna originada nos melanócitos, células responsáveis pela produção de melanina. Este tipo de câncer de pele tem a capacidade de se disseminar rapidamente para outros órgãos, o que pode resultar em complicações sérias. A dermatoscopia, biópsia cutânea e tomografia por emissão de pósitrons são técnicas essenciais para o diagnóstico precoce e estadiamento do melanoma. O tratamento do melanoma envolve uma abordagem multidisciplinar, incorporando cirurgia, imunoterapia, terapia-alvo e radioterapia, conforme a extensão da doença. Avanços notáveis incluem inibidores de checkpoint imunológico, como ipilimumabe e pembrolizumabe, que demonstraram eficácia significativa em melanomas avançados. A prevenção do melanoma é fundamentada na conscientização sobre fatores de risco, como exposição excessiva ao sol, e programas de rastreamento dermatológico em populações de alto risco. A compreensão molecular do melanoma, incluindo mutações em genes como BRAF, tem contribuído para estratégias de tratamento mais personalizadas. Em suma, o melanoma representa um desafio clínico significativo, exigindo uma abordagem integrada que abrange desde técnicas diagnósticas avançadas até terapias inovadoras, com ênfase na prevenção e conscientização.
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Avello Canisto, Francisco, i Allan Avello Peragallo. "Melanoma en la región de cabeza y cuello." Anales de la Facultad de Medicina 76, nr 2 (10.07.2015): 187. http://dx.doi.org/10.15381/anales.v76i2.11146.
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El melanoma es una neoplasia maligna producto de la degeneración y atipia del melanocito (célula formadora del pigmento melanina). Al melanocito lo encontramos en la piel (capa basal de la epidermis), globo ocular (membrana coroidea) y sistema nervioso central (piamadre). La localización en cabeza y cuello, representa el 30% de todos los melanomas en general, después de las extremidades inferiores y superiores, y más de las dos terceras partes se localizan en la piel de la cara. Menos frecuente es su origen en las membranas mucosas (fosas nasales, cavidad oral, conjuntivas), donde generalmente carece de melanina. Hay casos reportados de melanoma intraocular y de glándula salival submaxilar, pero su presentación es muy rara.
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Rader, Ryan K., Katie S. Payne, Uday Guntupalli, Harold S. Rabinovitz, Maggie C. Oliviero, Rhett J. Drugge, Joseph J. Malters i William V. Stoecker. "The Pink Rim Sign: Location of Pink as an Indicator of Melanoma in Dermoscopic Images". Journal of Skin Cancer 2014 (2014): 1–7. http://dx.doi.org/10.1155/2014/719740.
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Background. In dermoscopic images, multiple shades of pink have been described in melanoma without specifying location of these areas within the lesion.Objective. The purpose of this study was to determine the statistics for the presence of centrally and peripherally located pink melanoma and benign melanocytic lesions.Methods. Three observers, untrained in dermoscopy, each retrospectively analyzed 1290 dermoscopic images (296 melanomas (170in situand 126 invasive), 994 benign melanocytic nevi) and assessed the presence of any shade of pink in the center and periphery of the lesion.Results. Pink was located in the peripheral region in 14.5% of melanomas and 6.3% of benign melanocytic lesions, yielding an odds ratio of 2.51 (95% CI: 1.7–3.8,P<0.0001). Central pink was located in 12.8% of melanomas and 21.8% of benign lesions, yielding an odds ratio of 0.462 (95% CI: 0.67,P=0.204). Pink in melanomain situtended to be present throughout the lesion (68% of pink lesions). Pink in invasive melanoma was present in 17% of cases, often presenting as a pink rim.Conclusions. The presence of pink in the periphery or rim of a dermoscopic melanocytic lesion image provides an indication of malignancy. We offer the “pink rim sign” as a clue to the dermoscopic diagnosis of invasive melanoma.
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Hansson, Johan, Mia Bergenmar, Per-Åke Hofer, Göran Lundell, Eva Månsson-Brahme, Ulrik Ringborg, Ingrid Synnerstad, Annika Ternesten Bratel, Ann-Marie Wennberg i Inger Rosdahl. "Monitoring of Kindreds With Hereditary Predisposition for Cutaneous Melanoma and Dysplastic Nevus Syndrome: Results of a Swedish Preventive Program". Journal of Clinical Oncology 25, nr 19 (1.07.2007): 2819–24. http://dx.doi.org/10.1200/jco.2007.11.4108.
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Purpose To evaluate a program initiated in 1987 by the Swedish Melanoma Study Group aiming to provide preventive surveillance to kindreds with hereditary cutaneous melanoma and dysplastic nevus syndrome. Patients and Methods Overall, 2,080 individuals belonging to 280 melanoma families were followed for 14 years between 1987 and 2001 at 12 participating centers. Data were registered in a central database. Results Among 1,912 skin lesions excised during follow-up, 41 melanomas were removed in 32 individuals. Of these, 15 (37%) were in situ melanomas and 26 (63%) invasive melanomas. The median tumor thickness of invasive melanomas was 0.5 mm. Ulceration was absent in 24 of 26 invasive melanomas (92%) and 12 (46%) lacked vertical growth phase. Compared with melanomas in the general Swedish population, the melanomas identified in these kindreds during follow-up had better prognostic characteristics. All melanomas except one were diagnosed in families with two or more first-degree relatives with melanoma. Diagnosis of melanoma occurred in three of eight kindreds with germline CDKN2A mutations, supporting that families with such mutations are at increased risk for melanoma development. Of the 32 individuals who developed melanoma during follow-up, 21 (66%) had had at least one previously diagnosed melanoma. Conclusion This study shows that a coordinated program aimed at detecting and offering skin surveillance in kindreds with hereditary cutaneous melanoma results in a low incidence of melanomas during the follow-up period and that the tumors that do arise have favorable prognostic characteristics.
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Palacios-Diaz, Rodolfo David, Blanca de Unamuno-Bustos, Carlos Abril-Pérez, Mónica Pozuelo-Ruiz, Javier Sánchez-Arraez, Ignacio Torres-Navarro i Rafael Botella-Estrada. "Multiple Primary Melanomas: Retrospective Review in a Tertiary Care Hospital". Journal of Clinical Medicine 11, nr 9 (22.04.2022): 2355. http://dx.doi.org/10.3390/jcm11092355.
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Multiple primary melanomas (MPM) refer to the occurrence of more than one synchronous or metachronous melanoma in the same individual. The aim of this study was to identify the frequency of MPM and describe the clinical and histopathologic characteristics of patients with MPM. An observational single-center retrospective study was designed based on a cohort of melanoma patients followed in a tertiary care hospital. Fifty-eight (8.9%) patients developed MPM. Most patients were men (65.5%) and the median age at the time of diagnosis of the first melanoma was 71 years old. The median time of diagnosis of the second melanoma from the first melanoma was 10.9 months, and 77.6% of second melanomas were diagnosed within the first 5 years. In total, 29 (50%) and 28 (48.3%) first and second melanomas were located in the trunk, respectively. Concordance of anatomic site between primary and subsequent melanoma was found in 46.6% of the patients. Proportion of in situ melanomas was increasingly higher in subsequent melanomas (from 36.21% of first melanomas to 100% of fifth melanomas). An increasing rate of melanomas with histological regression was observed within subsequent melanomas (from 60.3% of first melanomas to 80% of third melanomas). Our results support the importance of careful long-term follow-up with total body examination in melanoma patients.
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Apostu, Adina Patricia, Loredana Ungureanu, Salomea Ruth Halmagyi, Ioana Irina Trufin i Simona Corina Șenilă. "Multiple primary melanomas: A literature review". Medicine 102, nr 30 (28.07.2023): e34378. http://dx.doi.org/10.1097/md.0000000000034378.
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Survival rates for melanoma have increased in recent years, a higher number of patients survive after diagnosis, and, therefore, are at an increased risk of developing second primary melanoma. The aim of this literature review is to identify and integrate the incidence rates and other characteristics of multiple primary melanomas. A total of 36 independent studies were included in this review. The incidence of multiple primary melanomas reported ranged from 1.1% to 20.4%. Synchronous melanomas account for 5% to 66% of the reported lesions. The most common site for both first and subsequent melanomas is the trunk. Superficial spreading melanoma is the most common histological type in both first and subsequent primary melanoma. Regarding the mean Breslow index, subsequent melanomas appeared to be thinner than first melanomas. Our review suggests that melanoma patients are at a higher risk of developing a second primary melanoma and long-term surveillance is needed.
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Bol, Kalijn Fredrike, Marco Donia, Steffen Heegaard, Jens Folke Kiilgaard i Inge Marie Svane. "Genetic Biomarkers in Melanoma of the Ocular Region: What the Medical Oncologist Should Know". International Journal of Molecular Sciences 21, nr 15 (23.07.2020): 5231. http://dx.doi.org/10.3390/ijms21155231.
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Melanoma of the ocular region (ocular melanoma) comprises about 5% of all patients with melanoma and covers posterior uveal melanoma, iris melanoma, and conjunctival melanoma. The risk of metastasis is much higher in patients with ocular melanoma compared to a primary melanoma of the skin. The subtypes of ocular melanoma have distinct genetic features, which should be taken into consideration when making clinical decisions. Most relevant for current practice is the absence of BRAF mutations in posterior uveal melanoma, although present in some iris melanomas and conjunctival melanomas. In this review, we discuss the genetic biomarkers of the subtypes of ocular melanoma and their impacts on the clinical care of these patients.
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Papageorgiou, Chrysoula, Demetrios Ioannides, Zoe Apalla, Efstratios Vakirlis, Elisabeth Lazaridou, Eleni Sotiriou i Aimilios Lallas. "Dermoscopy of difficult-to-diagnose Melanomas". Serbian Journal of Dermatology and Venereology 8, nr 3 (1.09.2016): 121–27. http://dx.doi.org/10.1515/sjdv-2016-0011.
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Abstract Dermoscopy is a non-invasive procedure that allows the evaluation of cutaneous lesions, and is considered to be a useful tool that improves the diagnostic accuracy of melanoma. Many dermoscopic criteria of melanoma have been established and several algorithms have been created for melanoma detection. However, the recognition of some melanomas remains challenging. Melanomas on specific body sites, melanomas in patients with multiple atypical moles, and nodular melanomas represent the most difficult-to-recognize melanoma subtypes, since they typically lack the “classic” melanoma-specific criteria. This paper provides an update on dermoscopy of difficult-to-diagnose melanomas by summarizing the newest data. Lastly, we highlight the importance of digital dermoscopy in the follow-up of melanocytic lesions for the detection of incipient melanomas while maintaining a low excision rate.
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Dumaz, Nicolas, Fanélie Jouenne, Julie Delyon, Samia Mourah, Armand Bensussan i Céleste Lebbé. "Atypical BRAF and NRAS Mutations in Mucosal Melanoma". Cancers 11, nr 8 (8.08.2019): 1133. http://dx.doi.org/10.3390/cancers11081133.
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Primary mucosal melanomas represent a minority of melanomas, but have a significantly worse prognosis than cutaneous melanomas. A better characterization of the molecular pathogenesis of this melanoma subtype could help us understand the risk factors associated with the development of mucosal melanomas and highlight therapeutic targets. Because the Mitogen-Activated Protein Kinase (MAPK) pathway plays such a significant role in melanoma development, we explore v-raf murine sarcoma viral oncogene homolog B (BRAF) and neuroblastoma RAS viral oncogene homolog (NRAS) mutations in mucosal melanoma and compare them to the mutation profiles in cutaneous melanoma and other tumors with BRAF and NRAS mutations. We show that in addition to being less frequent, BRAF and NRAS mutations are different in mucosal melanoma compared to cutaneous melanomas. Strikingly, the BRAF and NRAS mutation profiles in mucosal melanoma are closer to those found in cancers such as lung cancer, suggesting that mutations in mucosal melanoma could be linked to some genotoxic agents that remain to be identified. We also show that the atypical BRAF and NRAS mutations found in mucosal melanomas have particular effects on protein activities, which could be essential for the transformation of mucosal melanocytes.
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Shannon, Adrienne B., Jonathan S. Zager i Matthew C. Perez. "Clinical Characteristics and Special Considerations in the Management of Rare Melanoma Subtypes". Cancers 16, nr 13 (28.06.2024): 2395. http://dx.doi.org/10.3390/cancers16132395.
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Rare histologic subtypes of melanoma, including acral, mucosal, uveal, and desmoplastic melanomas, only make up 5% of all diagnosed melanomas and are often underrepresented in large, randomized trials. Recent advancements in systemic therapy have shown marked improvement in pathologic response rates, improving progression-free and overall survival among cutaneous melanoma patients, but there are limited data to demonstrate improved survival among rarer subtypes of melanoma. Acral melanoma has a poor response to immunotherapy and is associated with worse survival. Mucosal melanoma has a large variability in its presentation, a poor prognosis, and a low mutational burden. Uveal melanoma is associated with a high rate of liver metastasis; recent adoption of infusion and perfusion therapies has demonstrated improved survival among these patients. Desmoplastic melanoma, a high-risk cutaneous melanoma, is associated with high locoregional recurrence rates and mutational burden, suggesting this melanoma may have enhanced response to immunotherapy. While these variants of melanoma represent distinct disease entities, this review highlights the clinicopathologic characteristics and treatment recommendations for each of these rare melanomas and highlights the utility of modern therapies for each of them.
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Polesie, Sam, Lisa Sundback, Martin Gillstedt, Hannah Ceder, Johan Dahlén Gyllencreutz, Julia Fougelberg, Eva Johansson Backman, Jenna Pakka, Oscar Zaar i John Paoli. "Interobserver Agreement on Dermoscopic Features and their Associations with In Situ and Invasive Cutaneous Melanomas". Acta Dermato-Venereologica 101, nr 10 (14.10.2021): adv00570. http://dx.doi.org/10.2340/actadv.v101.281.
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Several melanoma-specific dermoscopic features have been described, some of which have been reported as indicative of in situ or invasive melanomas. To assess the usefulness of these features to differentiate between these 2 categories, a retrospective, single-centre investigation was conducted. Dermoscopic images of melanomas were reviewed by 7 independent dermatologists. Fleiss’ kappa (κ) was used to analyse interobserver agreement of predefined features. Logistic regression and odds ratios were used to assess whether specific features correlated with melanoma in situ or invasive melanoma. Overall, 182 melanomas (101 melanoma in situ and 81 invasive melanomas) were included. The interobserver agreement for melanoma-specific features ranged from slight to substantial. Atypical blue-white structures (κ=0.62, 95% confidence interval 0.59–0.65) and shiny white lines (κ=0.61, 95% confidence interval 0.58–0.64) had a substantial interobserver agreement. These 2 features were also indicative of invasive melanomas >1.0 mm in Breslow thickness. Furthermore, regression/peppering correlated with thin invasive melanomas. The overall agreement for classification of the lesions as invasive or melanoma in situ was moderate (κ=0.52, 95% confidence interval 0.49–0.56).
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Ramasamy, Villalan, Anand Lakshmanan, Senthilkumaran Govindaraj Raman i Kannan Devigounder. "Primary malignant melanoma of the duodenum: a rare case report". International Surgery Journal 5, nr 11 (26.10.2018): 3771. http://dx.doi.org/10.18203/2349-2902.isj20184663.
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Malignant melanoma especially primary melanoma is uncommon in the gastrointestinal (GI) tract. GI melanomas are usually metastatic from skin melanoma. Anorectal region and small bowel are the most common sites of primary and metastatic GI melanoma respectively. Various theories have been put forward to explain the origin of Primary Melanoma of Small intestine. Melanomas of the GI tract can produce range of symptoms based on their location and size. Surgery is the main stay of treatment for localized disease. We reported a case of primary duodenal melanoma which was managed by surgically.
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Dyduch, Grzegorz, Katarzyna Ewa Tyrak, Anna Glajcar, Joanna Szpor, Magdalena Ulatowska-Białas i Krzysztof Okoń. "Melanomas and Dysplastic Nevi Differ in Epidermal CD1c+ Dendritic Cell Count". BioMed Research International 2017 (2017): 1–7. http://dx.doi.org/10.1155/2017/6803756.
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Background. Dendritic cells could be involved in immune surveillance of highly immunogenic tumors such as melanoma. Their role in the progression melanocytic nevi to melanoma is however a matter of controversy. Methods. The number of dendritic cells within epidermis, in peritumoral zone, and within the lesion was counted on slides immunohistochemically stained for CD1a, CD1c, DC-LAMP, and DC-SIGN in 21 of dysplastic nevi, 27 in situ melanomas, and 21 invasive melanomas. Results. We found a significant difference in the density of intraepidermal CD1c+ cells between the examined lesions; the mean CD1c cell count was 7.00/mm2 for invasive melanomas, 2.94 for in situ melanomas, and 13.35 for dysplastic nevi. The differences between dysplastic nevi and melanoma in situ as well as between dysplastic nevi and invasive melanoma were significant. There was no correlation in number of positively stained cells between epidermis and dermis. We did not observe any intraepidermal DC-LAMP+ cells neither in melanoma in situ nor in invasive melanoma as well as any intraepidermal DC-SIGN+ cells in dysplastic nevi. Conclusion. It was shown that the number of dendritic cells differs between dysplastic nevi, in situ melanomas, and invasive melanomas. This could eventually suggest their participation in the development of melanoma.
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Chen, Xianjin, Lili Chang, Yan Qu, Jinning Liang, Waishu Jin i Xiujuan Xia. "Tea polyphenols inhibit the proliferation, migration, and invasion of melanoma cells through the down-regulation of TLR4". International Journal of Immunopathology and Pharmacology 31 (1.01.2018): 039463201773953. http://dx.doi.org/10.1177/0394632017739531.
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Melanoma is the most common skin cancer and malignant melanoma which can cause skin cancer-related deaths. Toll-like receptor 4 (TLR4) had been reported to play an important role in melanoma, and tea polyphenol (TP) is regarded as an anticancer substance. However, the relationship between TP and TLR4 in melanoma is not well explored. Therefore, our aim is to figure out how TP has an influence on melanoma. Melanoma cell lines (B16F10 and A375) were treated with TP and lipopolysaccharides (LPS). Western blot assay was used to examine TLR4 expression, and MTT assay was conducted to assess proliferation. Wound healing assay was conducted to evaluate the migration of melanoma cells, and transwell assay was used to examine the melanoma cells’ invasiveness. Besides, in vivo experiments were practiced for TP function in mice with melanoma cells. TP inhibited the proliferation, migration and invasion ability of melanoma cells, which displayed a dosage and time dependence. TLR4 was highly expressed in melanoma cells compared with normal skin cells. TP could suppress TLR4 expression both in normal melanomas and in stimulated melanomas by TLR4 agonist LPS. Suppressing TLR4 in melanomas could inhibit cell function (proliferation, migration, and invasion), and blocking the expression of 67LR could abolish TP function on TLR4. TP can inhibit melanoma (B16F10) growth in vivo.
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Čelakovská, Jarmila, Josef Bukač, Lenka Čáková, Marie Šimková i Eva Jandová. "Epidemiology of Melanoma in the Czech Republic in East Bohemia in the Period 2002–2017 and the Effect of the Annual Sunshine Exposure". Acta Medica (Hradec Kralove, Czech Republic) 63, nr 1 (2020): 10–17. http://dx.doi.org/10.14712/18059694.2020.10.
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Aim: The evaluation of the trend in the occurrence of melanoma nodulare, melanoma superficiale, lentigo maligna and melanoma in situ in the period of 2002–2017 in East Bohemia region in the Czech Republic. We examine if the annual numbers of hours of sunshine could affect the number of patients with melanoma. Method: In the peridod of 2002–2017, altogether 2230 patients with new diagnosis of melanoma were examined. We studied 1) If there is some trend in the occurrence of lentigo maligna and melanoma in situ, melanoma superficiale, and melanoma nodulare and if there is a difference in the age of patients with this diagnosis (adjusted calculation of specific kind of melanomas and adjusted calculation of age). 2) If the annual numbers of hours of sunshine affect the trend in the occurrence of melanoma and if the annual numbers of hours of sunshine affect the body site of melanoma. Results and conclusion: Our study confirmed that the number of patients with lentigo maligna and melanoma in situ had increased in East Bohemia region in the period of 2002–2017. The number of melanomas of nodular and superficial type does not increase. The total number of melanomas in this period does not increase either. No difference of the age of patients with melanoma nodulare, superficiale, lentigo maligna and melanoma in situ was confirmed. We confirmed no relation of the annual numbers of hours of sunshine to the number of melanoma and to the body site of melanoma.
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Paul, Sharad P. "Micromelanomas: A Review of Melanomas≤2 mm and a Case Report". Case Reports in Oncological Medicine 2014 (2014): 1–4. http://dx.doi.org/10.1155/2014/206260.
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The ABCD acronym used to screen pigmented lesions for melanoma obviously was not designed to contend with melanomas that are under 2 mm in diameter. Previously, views ranged that such small lesions could not be melanomas until a few reports of such “micromelanomas” emerged. The author presents a 2 mm melanoma in situ presenting as an insignificant pigmented lesion in a 60-year-old patient with no previous history of melanoma or multiple nevi—which is usually the norm in cases of small melanoma. This paper reiterates the fact that when it comes to a melanoma, size does not matter. In this paper, the term “micromelanoma” is used by the author to represent melanomas under 2 mm. Dermatoscopy and histopathology findings are discussed in this case, along with a review of small melanomas.
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Elder, David E. "Thin Melanoma". Archives of Pathology & Laboratory Medicine 135, nr 3 (1.03.2011): 342–46. http://dx.doi.org/10.5858/2009-0479-ra.1.
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Abstract Context.—The incidence of malignant melanoma is increasing and a preponderance of the melanomas diagnosed today are “thin” in terms of Breslow criteria. Although thin melanomas, as a group, are associated with a very good prognosis, a subset of these tumors may metastasize and cause death. These cases can be identified by using prognostic models, including the “standard” American Joint Committee on Cancer criteria, and other attributes identified in follow-up studies. Objective.—To review the history of concepts of prognostic modeling in melanoma, focusing on thin melanomas. Data Sources.—Selected literature. Conclusions.—About 40 years ago, it was realized that malignant melanoma, once almost uniformly fatal, could be divided into categories with better or worse prognosis through the use of prognostic models. The first simple models, Clark levels of invasion and Breslow thickness, are still in use. Thickness remains the single most useful variable. Breslow recognized that melanomas less than 0.76 mm in thickness were associated with a very good prognosis, with no metastases in his limited initial study. The American Joint Committee on Cancer selected a cutoff of 1.0 mm, which achieves a similar result, with stage modifiers, although some metastases and deaths do occur with stage I lesions. Clark demonstrated an almost equally good prognosis for his level II invasive melanomas and recognized that most of these lesions, although invasive, lacked the ability to form tumors or to undergo mitosis in the dermis and were therefore “nontumorigenic” and “nonmitogenic” and lacked competence for metastasis. Studies of these low-risk melanomas have led to the development of criteria for earlier diagnosis and a steady, but still inadequate, improvement in prognosis for melanoma overall. Multivariable models currently can identify groups of patients within the “thin melanoma” category whose prognosis varies, from a disease-free survival of close to 100% to about 70%. Prognosis declines more or less linearly with increasing thickness, modified by ulceration, mitotic rate, and other attributes.
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Hastings, Karen, Jennifer Nguyen, Richard Bernert, Christine Ko, Noemi Sebastiao i Chengcheng Hu. "Gamma-interferon-inducible lysosomal thiol reductase is upregulated in human melanoma (TUM2P.1038)". Journal of Immunology 194, nr 1_Supplement (1.05.2015): 69.35. http://dx.doi.org/10.4049/jimmunol.194.supp.69.35.
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Abstract T cell-mediated immunity has the ability to produce durable anti-melanoma responses resulting in improved survival of patients with advanced melanoma. Antigen presentation in the tumor microenvironment directs anti-melanoma T cell responses. Gamma-interferon-inducible lysosomal thiol reductase (GILT) is critical for MHC class II-restricted presentation of multiple melanoma antigens to CD4+ T cells. However, GILT expression in melanoma has not been defined. We evaluated GILT and MHC class II expression in human primary and metastatic melanomas and nevi using immunohistochemistry. Both GILT and MHC class II expression were increased in melanocytes of primary and metastatic melanomas compared with nevi. GILT expression was increased in antigen presenting cells of primary and metastatic melanomas compared to nevi, whereas MHC class II had equivalent high expression in antigen presenting cells of all melanocytic lesions. Keratinocytes in primary melanoma lesions had increased GILT and MHC class II expression compared with nevi. Increased GILT expression in melanocytes, antigen presenting cells and keratinocytes of melanoma demonstrates that changes in the antigen presentation pathway occur in the tumor microenvironment. GILT expression in melanoma is anticipated to result in improved presentation of melanoma antigens and more effective anti-melanoma T cell responses and may be a biomarker of immune recognition of melanoma.
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Feloniuk, Roman. "Case Report: Primary Mucosal Melanoma. An Extremely Rare Case in the Private Dental Practice". Journal of Diagnostics and Treatment of Oral and Maxillofacial Pathology 2, nr 4 (25.12.2018): 186–89. http://dx.doi.org/10.23999/j.dtomp.2018.4.7.
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Mucosal melanoma (synonyms: oral melanoma, oral mucosal melanoma, and oral malignant melanoma) of the head and neck is a very rare and aggressive malignancy with a very poor prognosis. A 56-year-old white gentleman was referred to the private dental clinic with a darkly pigmented lesion on upper alveolar ridge, upper lip mucosa, and hard palate. That paper describes: differential diagnostics, classification of oral melanomas that differs from cutaneous melanomas, tumor-node-metastasis (TNM) staging of the oral mucosal melanoma, and treatment options.
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Tchernev, Georgi, i Anastasiya Atanasova Chokoeva. "New Safety Margins for Melanoma Surgery: Nice Possibility for Drinking of "Just That Cup of Coffee"?" Open Access Macedonian Journal of Medical Sciences 5, nr 3 (11.06.2017): 352–58. http://dx.doi.org/10.3889/oamjms.2017.068.
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BACKGROUND: The American Joint Committee on Cancer (AJCC’s) skin melanoma surgical treatment recommendations from 2011 are characterised by a prima facie "freedom of choice" regarding how extensive should be the excisions for melanomas with tumour thickness up to 2 mm and melanoma in situ. It is unclear why the recommended surgical security margins vary between 0.5 and 1 cm for melanoma in situ, whereas for melanomas with a tumour thickness of up to 1.99 mm, the range of variation is also between 1 and 2 cm, without specifying when the surgical field should be broader and, narrower, accordingly. This "uncertainty or lack of intent" of the guilders often leads to the same surgical approach to melanomas at different stages, or to a different approach in cases of melanomas at the same stage, in contrast. Therefore, this should be defined as wrong, logically.CASE PRESENTATION: We present 3 patients with cutaneous melanomas, treated with similar fields of surgical security. Current issues, generated within the framework of melanoma’s surgery guided by the recommendations of the AJCC are also discussed. A new surgical approach in patients with melanoma is recommended, discussed for the first time in world literature. We hypothesize that the introduction of a certain recommendations for a 2 cm surgical field in all directions during the initial excision, combined with the parallel performance of a sentinel lymph node biopsy, will lead in fact to several important advantages: 1) avoiding of the secondary excision in at least 70% - 90% of the patients (depending on the tumor thickness), 2) minimizing the risk of lymphatic effusion change and misinterpretation of the sentinel lymph node biopsy’s results in patients with secondary excision; 3) optimization of the surgical team’s work; 4) minimizing the possibility of unprepared/uninformed personnel to take part in decisions for treating a specific disease such as skin melanoma, 4) facilitating the appropriate patients’ group selection at the appropriate stage when involving them in different studies, leading to equal leveling of the initial positions;CONCLUSION: Whether the proposed approach will be subjected to a detailed discussion of AJCC’s expert’s remains currently unclear.
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Egorenkov, V. V., F. V. Moiseenko, N. M. Volkov, M. S. Molchanov, M. S. Ravkina, N. Kh Abduloeva, A. V. Linets, V. R. Khairutdinov, M. S. Aksenov i V. M. Moiseyenko. "Incidence of Synchronous Multiple Primary Melanoma in Patients with Solitary Melanoma: a Prospective Comparative Study". Creative surgery and oncology 11, nr 2 (22.05.2021): 118–24. http://dx.doi.org/10.24060/2076-3093-2021-11-2-118-124.
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Background. Malignant melanoma is steadily exaggerating over the recent decades. Nonetheless, improved systemic therapies have substantially increased life expectancy in patients with a locally advanced or disseminated disease. Higherincidence recurrent melanocytic skin lesions become essentially problematic and require more attention and control.Aim. Cross-survey on the incidence of synchronous multiple primary melanomas in patients with solitary melanoma and those with other operable solid tumours.Materials and methods. A total of 289 patients with suspected malignant pigmented skin melanoma were included in the survey. Patients were divided in two cohorts by the presence of primary skin melanoma and its tractability for radical excision. Patients with operable melanoma comprised the study cohort, and those with other solid tumours were the control.Results and discussion. The survey covered 289 patients, with 148 in the study and 141 in the control cohort. The study148 patients revealed 112 malignant pigmented melanomas, but none in the control cohort. A chi-square statistical analysis of clinical values in single and multiple melanoma cases showed a slightly higher prevalence of first-visit melanomas in patients with synchronous tumours (30% pT4 — p = 0.007).Conclusion. The observed 10% rate of second melanoma in the study cohort and a zero melanoma incidence in the control support the alternative hypothesis of a higher rate of newly detected melanomas in primarily diagnosed melanoma patients vs. those with solid tumours.
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Borsari, Stefania, Riccardo Pampena, Margherita Raucci, Marica Mirra, Simonetta Piana, Giovanni Pellacani i Caterina Longo. "Neck Melanoma: Clinical, Dermoscopic and Confocal Features". Dermatology 236, nr 3 (8.11.2019): 241–47. http://dx.doi.org/10.1159/000503284.
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Background: The head and neck are considered one single anatomical unit. No data on clinical, dermoscopic and confocal aspects of neck melanoma are currently available. Objectives: To identify clinical, dermoscopic and confocal diagnostic features of neck melanomas. Methods: Consecutive malignant (cases) and benign (controls) melanocytic skin lesions located on the neck, excised as suspected of being melanoma from March 2011 to February 2018, were retrospectively retrieved. Dermoscopic criteria of the 7-point checklist, integrated by other melanoma features (such as grey colour and irregular hyperpigmented areas) were assessed. Reflectance confocal microscopy (RCM) images were examined when available. Results: 282 lesions located to the head and neck area were biopsied to rule out melanoma. Thirty-one out of 282 (11%) lesions were located on the neck: 21 melanomas and 10 naevi. Melanoma patients were older than patients with naevi (mean age: 60.4 vs. 37.9 years, p < 0.001). Neck melanomas were more frequently located on sun-damaged skin compared to naevi (76.2 vs. 30%, p = 0.02). Dermoscopically, neck melanomas were characterized by irregular dots/globules, grey colour and regression (76.2, 81 and 46.7% of cases) and showed criteria of lentigo maligna melanoma (LMM) in 52.4% of cases. Regression, grey colour, irregular hyperpigmented areas and criteria of LMM typified melanomas on sun-damaged skin, whereas tumours located on non-sun-damaged areas were often characterized by irregular pigmentation (blotches). RCM, implemented to dermoscopy, correctly diagnosed 10/12 melanomas and 3/5 naevi. Conclusion: Neck melanoma has peculiar clinical and dermoscopic aspects that could help clinicians to distinguish it from naevi and to diagnose melanoma earlier.
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Juul Nielsen, Lea, i Lisbet Rosenkrantz Hölmich. "Eleven Primary Melanomas, Colon Cancer, and Atypical Nevi in the Same Patient: A Case Report and Literature Review". Case Reports in Dermatological Medicine 2016 (2016): 1–8. http://dx.doi.org/10.1155/2016/3145986.
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Background. As the incidence of cutaneous malignant melanoma increases in the Caucasian population, an increasing population of melanoma survivors is at risk of developing multiple primary melanomas (MPM) as well as secondary primary cancers.Objective. To present a case of a patient with atypical nevi, 11 primary melanomas over 33 years, and colon cancer and to review the literature on multiple primary melanomas, atypical nevi, and correlation of nonmelanoma cancers.Conclusion. The literature indicates that patients with MPM are not uncommon, although 11 primary melanomas are rarely described, that patients with MPM may have a better survival than patients with single primary melanoma, that atypical nevi are a risk marker of not only melanoma in general but also MPM, and that melanoma patients have a significantly increased risk of developing nonmelanoma skin and other cancers, which may be even higher for patients with MPM.
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Minarikova, E., M. Smolarova i M. Minarik. "Activity of Skin Cancer Clinic at Martin University Hospital in 2017". Acta Medica Martiniana 18, nr 1 (1.06.2018): 21–29. http://dx.doi.org/10.2478/acm-2018-0003.
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Abstract The authors present new cases of malignant melanoma seen at the Skin Cancer Clinic of the University Hospital in Martin in the year 2017. There have been 112 new cases of malignant melanoma, 66 in men and 46 in women, diagnosed in 2017. We have recorded a occurence of two melanomas in one person in 3 patients, two men and one women. One patient had metastatic melanoma found in lymph nodes without corresponding skin lesions. The most common tumor body localisation in both men and women was on the back (51 melanomas, 45 %). In women, the most common localisation was upper extremities (13 melanomas, 29 %), followed by lower extremities and the back at the same rate (11 melanomas, 24 %). In men, the most common localisation was on the back (40 melanomas, 60 %). Histologically, the most common type was superficial spreading malignant melanoma (50 melanomas), the second most common was non specific type of malignant melanoma (19 melanomas). The majority of cases were low risk lesions with histological Breslow thickness in the range from 0,1 mm to 1 mm (47 melanomas). High risk lesions with histological Breslow thickness more than 4 mm were the second most common type (24 melanomas).
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Patnaik, A. K., i S. Mooney. "Feline Melanoma: A Comparative Study of Ocular, Oral, and Dermal Neoplasms". Veterinary Pathology 25, nr 2 (marzec 1988): 105–12. http://dx.doi.org/10.1177/030098588802500201.
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Melanomas diagnosed in 29 cats over an 11 year period included 19 ocular (16 intraocular, three palpebral), five oral, and five dermal melanomas. Intraocular melanomas involved the ciliary body and iris in 12; the whole eye was involved in four. The average age of cats with intraocular melanomas was 11 years; the female:male ratio was 9:7. Histologically, eight intraocular tumors were mixed, six were epithelioid, and two were spindle cell. Ten of 16 cats (62.5%) with intraocular melanomas were killed because of the tumor at a mean of 156 days; four arc living with no evidence of disease (average, 255 days). The mean time of death in cats with palpebral melanoma was 409 days. Metastasis occurred in 63% of cats with intraocular melanoma and all cats with palpebral melanoma. Four cats with oral melanoma were killed at a mean of 61 days; all had metastasis. Of five cats with cutaneous melanoma, one was killed with metastasis at 90 days; three cats were alive without evidence of recurrence or metastasis >365 days after surgery. Results of this study indicate that in the cat, ocular melanomas are more common than oral and dermal melanomas, and ocular and oral melanomas arc more malignant than dermal melanomas, with higher rates of mortality and metastasis.
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Zou, Zhengyun, Qiuxiang Ou, Yu Ren, Qing Lv, Lanqun Qin, Lianjun Zhao, Shu Su i in. "Comprehensive genomic profiling reveals distinct patterns of driver mutations and chromosomal alterations in acral and mucosal melanomas." Journal of Clinical Oncology 37, nr 15_suppl (20.05.2019): 9576. http://dx.doi.org/10.1200/jco.2019.37.15_suppl.9576.
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9576 Background: The incidence of melanoma subtypes differs significantly among ethnicities. Ultraviolet (UV) radiation-driven melanomas are common in Caucasians, while non-cutaneous melanomas including acral and mucosal melanomas are more frequent in Asians. It will be of great interest and clinical relevance to decipher the molecular pathogenesis of different melanoma subtypes. Methods: We retrospectively studied a cohort of 89 Chinese melanoma patients who underwent surgical resection of their primary tumors followed by chemotherapy. Genomic profiling of primary melanomas was performed using next generation sequencing by targeting 422 cancer-relevant genes. The Kaplan-Meier method and logrank test were used for survival analysis, and a cox model was used for multivariate survival analysis. Results: Acral melanomas (54/89, 60%) were the most common subtype of this cohort, while cutaneous and mucosal subtypes accounted for 25% and 15%, respectively. Mutation profiling revealed that BRAF was most frequently mutated in cutaneous melanomas, but aberrant BRAF, RAS, KIT, and NF1 were almost evenly represented in acral and mucosal melanomas; of note, mucosal melanomas had a propensity for concurrent driver mutations. Chromosomal alterations were detected across all subtypes, and chr7p amplification significantly correlated with poor prognosis while independently of melanoma subtypes. Furthermore, acral and mucosal melanomas demonstrated higher rates of focal copy number variations (CNVs) than cutaneous melanomas. The amplification of CDK4/CCND1 and NOTCH2 was observed predominantly in acral melanomas , and RAD51 loss was significantly enriched in mucosal melanomas correlating with poor survival. In addition, the tumor mutation burden (TMB) was significantly lower in acral or mucosal melanomas than in cutaneous melanomas. Conclusions: Our findings revealed distinct patterns of driver mutations and chromosomal alterations in acral and mucosal melanomas in contrast to cutaneous melanoma, and highlighted the association of chromosome 7p amplification and RAD51 deletion with unfavourable survival in melanoma patients treated with standard chemotherapy.
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Akoz, I., S. Ayas, S. Eren i R. Bilgic. "Synchronous cervical and vulvar malign melanomas: metastasis or multifocality of the disease? A case report and review of the literature". International Journal of Gynecologic Cancer 16, nr 2 (marzec 2006): 917–20. http://dx.doi.org/10.1136/ijgc-00009577-200603000-00075.
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Vulvar melanoma is rare and has a worse prognosis and higher recurrence rate than cutaneous melanoma. Multifocality is also more common in vulvar melanomas. A case having synchronous cervix and vulvar malign melanoma is presented and discussed in the light of the literature whether it is a metastasis of vulvar malign melanoma to cervix or multifocal originated disease. In conclusion, it is important to evaluate the whole genital system in vulvar melanomas as it is in squamous cancers.
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Naderi-Azad, Sheida, Faisal Sickandar i Rossanna C. Pezo. "Examining the impact of body mass index on overall survival in vulvar, vaginal and other mucosal melanomas: a retrospective cohort study". Current Gynecologic Oncology 18, nr 2 (31.12.2020): e43-e45. http://dx.doi.org/10.15557/cgo.2020.0009.
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Aim of the study: In this retrospective cohort study we have examined differences in survival profiles with respect to the body mass index in patients with mucosal melanoma on immune checkpoint inhibitor therapy. Materials and methods: The primary outcome included the association between the body mass index and overall survival in patients with metastatic mucosal melanoma. The secondary outcomes included the clinical presentation and management of vulvar and vaginal melanomas with oral and anorectal mucosal melanomas, as well as the surgical and radiological management of vulvar and vaginal melanomas. Kaplan–Meier analysis and log-rank test were used for the assessment of overall survival. Results: The results showed that patients with mucosal melanoma whose body mass index was ≥25 had better overall survival (p = 0.02). Overall survival was different between vulvar/vaginal vs. oral mucosal melanoma (p = 0.02). Overall survival was not different between vulvar/vaginal vs. anorectal melanoma (p = 0.77). Some immune toxicities were specific to patients with vulvar/vaginal melanoma. Conclusions: Obesity is associated with improved survival in patients with metastatic mucosal melanoma, although findings can be heterogeneous depending on the subtype of mucosal melanoma.
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Barillaro, Francesco, Marco Camilli, Paolo Dessanti, Nader Gorji, Fabio Chiesa, Alessandro Villa, Alessandro Pastorino, Carlo Aschele i Enrico Conti. "Primary melanoma of the bladder: Case report and review of the literature". Archivio Italiano di Urologia e Andrologia 90, nr 3 (30.09.2018): 224–26. http://dx.doi.org/10.4081/aiua.2018.3.224.
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Skin melanoma represents one of the most common and lethal solid tumor. It usually develops on the skin but it can occur in any tissues with melanine- containing-cells (extracutaneous malignant melanoma). Only 4-5% of malignant melanomas originate in extracutaneous tissues, and they have an extremely lethal behavior (1). These non-skin malignant melanomas are rare but extremely aggressive. Primary melanoma of the genitourinary tract accounts for less than 0.2% of all melanomas. To date only 28 cases of primary bladder melanoma (PMM) are described. We report a rare case of PMM of the bladder in a 72 years old man treated with radical cystectomy and immunotherapy with Nivolumab.
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Shreberk-Hassidim, Rony, Stephen M. Ostrowski i David E. Fisher. "The Complex Interplay between Nevi and Melanoma: Risk Factors and Precursors". International Journal of Molecular Sciences 24, nr 4 (10.02.2023): 3541. http://dx.doi.org/10.3390/ijms24043541.
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One effort to combat the rising incidence of malignant melanoma is focused on early detection by the clinical and dermoscopic screening of melanocytic nevi. However, the interaction between nevi, which are congenital or acquired benign melanocytic proliferations, and melanoma is still enigmatic. On the one hand, the majority of melanomas are thought to form de novo, as only a third of primary melanomas are associated with a histologically identifiable nevus precursor. On the other hand, an increased number of melanocytic nevi is a strong risk factor for developing melanoma, including melanomas that do not derive from nevi. The formation of nevi is modulated by diverse factors, including pigmentation, genetic risk factors, and environmental sun exposure. While the molecular alterations that occur during the progression of a nevus to melanoma have been well characterized, many unanswered questions remain surrounding the process of nevus to melanoma evolution. In this review, we discuss clinical, histological, molecular, and genetic factors that influence nevus formation and progression to melanoma.
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Beasley, K., i R. C. Cartotto. "Narrow Resection of Cutaneous Melanoma". Journal of Cutaneous Medicine and Surgery 2, nr 3 (styczeń 1998): 133–37. http://dx.doi.org/10.1177/120347549800200304.
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Background: There has been a progressive reduction in the extent of resection of primary cutaneous melanoma. Although overall survival appears to have been unaffected by this trend, the effect of narrow resection on local recurrence is not entirely clear. Objective: To examine the relationship between narrow resection margins and local recurrence of primary cutaneous melanoma. Methods: Primary melanoma, 104 cases, treated by surgical resection were reviewed retrospectively. Results: “Thin” (< 1 mm) melanomas (31 cases) were resected with a mean margin of 0.87 cm; “intermediate” (1–4 mm) melanomas (37 cases) were resected with a mean margin of 1.26 cm; and 14 “thick” (> 4 mm) melanomas were resected with a mean margin of 1.25 cm. Local recurrence rates were 6.5%, 16.2%, and 42.9%, respectively. In the “intermediate” group, two local recurrences occurred in melanomas < 2 mm thick despite use of margins of 1.7 cm and 2.4 cm. Conclusions: The results do not support the use of excessively narrow resection margins around primary cutaneous melanoma. Additionally, we question the true safety of currently accepted 1 to 2 cm margins for 1 to 2 mm thick melanomas.
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Yong, Ji Fung, Michael O’Connell, Alana Durack i Lyndsey Paul. "P053 Synchronous melanoma: a single-centre 5-year retrospective study". British Journal of Dermatology 191, Supplement_1 (28.06.2024): i39. http://dx.doi.org/10.1093/bjd/ljae090.080.
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Abstract Synchronous melanoma (SM) is defined as at least two melanomas diagnosed at the same time, or a second within 3 months of diagnosing the first melanoma. Previous studies have shown that 0.5% of all patients with cutaneous melanoma have synchronous second primaries. A retrospective study of melanoma data in one of the eight designated cancer centres in the Republic of Ireland was undertaken. We reviewed the demographics, risk factors and melanoma types in all the cases of SM discussed at the melanoma multidisciplinary team (MDT) meeting for the last 5 years. Melanoma MDT lists, and histopathology and clinical records were reviewed from July 2018 to July 2023 inclusive, for SMs. This study included invasive malignant melanoma (MM), lentigo maligna (LM) and melanoma in situ (MIS). In total, 1082 patients were diagnosed with cutaneous melanomas over the 5-year period. Of these patients, 42 (3.9%) with SMs were identified (26 male, 16 female). Ages ranged from 44 to 93 years. Thirty patients (71%) had SMs diagnosed at the same time, with the rest diagnosed within a 3-month period. Nine cases (21%) had a previous history of melanoma, with four having previous SMs. Other risk factors noted included history of immunosuppression (10%, n = 4), first-degree relatives with a history of melanoma (7%, n = 3) and history of previous nonmelanoma skin cancer (5%, n = 2). Of the 42 patients, four (10%) had more than two individual melanomas identified on the same occasion (three patients had three melanomas and one had five). Of these four patients, two had a first-degree family history of cutaneous melanomas and were referred for genetic testing, with results pending. Of the total number of SMs (n = 91), 29% (26) were invasive MM, 24% (22) were LM and 47% (43) were MIS. Most lesions (33%, n = 30) were located on the trunk, with 19 (58%) on the back. Twenty patients (48%) had synchronous in situ lesions (LM/MIS), 20 (48%) had LM/MIS with an invasive melanoma (pathological stage 1A to 4B) and two (5%) had synchronous stage 1a and 1b melanomas. In total, 93% of cases (n = 39) attended dermatology services for follow-up. To the best of our knowledge, this is the largest reported case series to date of SM. A higher incidence of SMs in our cancer centre is noted compared with the literature (3.8% vs. 0.5%). It highlights the importance of a full skin check, especially once a melanoma has been identified, to ensure further melanomas are not missed. For patients diagnosed with SMs, who also have first-degree family history of cutaneous melanoma, genetic testing should be considered to look for germline mutations and genetic variants.
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Bugaeva, Olga, Pilvi Maliniemi, Wenche S. Prestvik, Eeva Leivo, Nicolas Kluger, Alexander Salava, Sanna Virtanen i in. "Tumour Suppressor Neuron Navigator 3 and Matrix Metalloproteinase 14 are Co-expressed in Most Melanomas but Downregulated in Thick Tumours". Acta Dermato-Venereologica 103 (8.03.2023): adv00883. http://dx.doi.org/10.2340/actadv.v103.298.
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Melanoma is a highly metastatic tumour originating from neural crest-derived melanocytes. The aim of this study was to analyse the expression of neuron navigator 3 (NAV3) in relation to membrane type-1 matrix metalloproteinase MMP14, a major regulator of invasion, in 40 primary melanomas, 15 benign naevi and 2 melanoma cell lines. NAV3 copy number changes were found in 18/27 (67%) primary melanomas, so that deletions dominated (16/27 of samples, 59%). NAV3 protein was found to be localized at the leading edge of migrating melanoma cells in vitro. Silencing of NAV3 reduced both melanoma cell migration in 2-dimensional conditions, as well as sprouting in 3-dimensional collagen I. NAV3 protein expression correlated with MMP14 in 26/37 (70%) primary melanomas. NAV3 and MMP14 were co-expressed in all tumours with Breslow thickness < 1 mm, in 11/23 of mid-thickness tumours (1–5 mm), but in only 1/6 samples of thick (> 5 mm) melanomas. Altogether, NAV3 number changes are frequent in melanomas, and NAV3 and MMP14, while expressed in all thin melanomas, are often downregulated in thicker tumours, suggesting that the lack of both NAV3 and MMP14 favours melanoma progression.
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Elder, David E., Boris C. Bastian, Ian A. Cree, Daniela Massi i Richard A. Scolyer. "The 2018 World Health Organization Classification of Cutaneous, Mucosal, and Uveal Melanoma: Detailed Analysis of 9 Distinct Subtypes Defined by Their Evolutionary Pathway". Archives of Pathology & Laboratory Medicine 144, nr 4 (14.02.2020): 500–522. http://dx.doi.org/10.5858/arpa.2019-0561-ra.
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Context.— There have been major advances in the understanding of melanoma since the last revision of the World Health Organization (WHO) classification in 2006. Objective.— To discuss development of the 9 distinct types of melanoma and distinguishing them by their epidemiology, clinical and histologic morphology, and genomic characteristics. Each melanoma subtype is placed at the end of an evolutionary pathway that is rooted in its respective precursor, wherever appropriate and feasible, based on currently known data. Each precursor has a variable risk of progression culminating in its fully evolved, invasive melanoma. Data Sources.— This review is based on the “Melanocytic Tumours” section of the 4th edition of the WHO Classification of Skin Tumours, published in 2018. Conclusions.— Melanomas were divided into those etiologically related to sun exposure and those that are not, as determined by their mutational signatures, anatomic site, and epidemiology. Melanomas on the sun-exposed skin were further divided by the histopathologic degree of cumulative solar damage (CSD) of the surrounding skin, into low and high CSD, on the basis of degree of associated solar elastosis. Low-CSD melanomas include superficial spreading melanomas and high-CSD melanomas incorporate lentigo maligna and desmoplastic melanomas. The “nonsolar” category includes acral melanomas, some melanomas in congenital nevi, melanomas in blue nevi, Spitz melanomas, mucosal melanomas, and uveal melanomas. The general term melanocytoma is proposed to encompass “intermediate” tumors that have an increased (though still low) probability of disease progression to melanoma.
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Karapetyan, Lilit, Xi Yang, Hong Wang, Arivarasan Karunamurthy, Cindy Sander, Ashley Moyer, Melissa Wilson i John M. Kirkwood. "Tanning bed exposure in association with multiple primary melanoma." Journal of Clinical Oncology 38, nr 15_suppl (20.05.2020): e22107-e22107. http://dx.doi.org/10.1200/jco.2020.38.15_suppl.e22107.
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e22107 Background: Patients with primary cutaneous melanoma are at increased risk of subsequent new primary melanoma. Indoor tanning is a risk factor for melanoma. The primary objective of this study was to determine the association between indoor tanning and multiple primary melanoma (MPM). The secondary objective was to compare clinical and pathological characteristics of primary and secondary malignant melanoma. Methods: This retrospective case-control study of MPM and gender-matched controls with single primary melanoma retrieved at 2:1 ratio from the University of Pittsburgh Cancer Institute Melanoma Center Biological Sample and Nevus Bank from January 1996 through October 2019. Logistic regression models were used to examine the association between MPM and risk factors. Results: In total, 330 patients (39.1% men; median [SD] age, 51 [15] years) were enrolled, including 110 with single and 220 with MPM. Median time between diagnosis of first and second primary melanoma was 13 months. 22.7% of patients with MPM had 3 or more primary melanomas. Compared with patients who had a single primary melanoma, patients with multiple melanomas were younger at diagnosis of first melanoma (median age 46 vs 52, p = 0.006), more likely to be discovered at Stage 0 and 1 (68% vs 49%, p < 0.0001), and to have had indoor tanning exposure (34% vs 10%, p < 0.0001), family history of melanoma (18% vs 8%, p = 0.0045), atypical moles (37% vs 13%, p < 0.0001), dysplastic nevi (21% vs 5%, p < 0.0001), and Breslow thickness of less than 1 mm (61% vs 33%, p < 0.0001). Compared with the patient’s first melanoma, subsequent melanomas were more likely to be thinner (0.6mm vs 1.2mm, p = 0.0007) or in situ (24% vs 13%, p = 0.0004). The estimated probability of locus that was the same for first and second primary melanomas was 34% with (95% CI 25%, 44%). The most common location for second primary melanoma was upper extremity (34%). In univariate analysis, lifetime tanning bed exposure of > 10 sessions was associated with an increased risk of second primary melanoma OR 4.60 [95% CI, 2.52-8.42, p < 0.0001]. In multivariate analysis after adjusting for age, family history of melanoma, presence of atypical and dysplastic nevi, recreational sun exposure, indoor tanning remained significantly associated with MPM (OR 4.32 [95% CI, 1.54-12.15, p = 0.0026]). Conclusions: Indoor tanning for > 10 sessions is associated with increased risk of second primary melanoma. Subsequent melanomas are more likely to be thin or in situ, and to occur in different anatomic locations.
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Kheir, Wajiha J., Jane S. Kim i Miguel Angel Materin. "Multiple Uveal Melanoma". Ocular Oncology and Pathology 6, nr 5 (2020): 368–75. http://dx.doi.org/10.1159/000508393.
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Introduction: Multiple uveal melanoma is a rare occurrence and includes bilateral melanoma, unilateral multiple/multifocal melanoma, or melanoma with metastasis to the ipsilateral or contralateral eye. Methods: A chart review of patients diagnosed with uveal melanoma between January 2013 and January 2019 at the Duke University Eye Center Ophthalmic Oncology Service was performed. Results: Three patients with multiple, sequential melanoma were identified; patient 1 had bilateral choroidal melanoma and patients 2 and 3 had 2 choroidal melanomas occurring in the same eye. In all 3 patients, both the first and sequential choroidal melanomas were treated with I-125 radioactive plaque brachytherapy (PBT). Two patients were found to have developed secondary metastatic uveal melanoma as a presenting sign of systemic metastases. Patient 4, initially treated with PBT, was diagnosed with ipsilateral metastatic choroidal melanoma, also treated with PBT. Patient 5 had right eye enucleation for choroidal melanoma and developed vision-threatening metastasis in the left eye, which was treated with PBRT. None of the patients had history of cancer prior to their first diagnosis. Patients 1 and 5 were tested with a systemic melanoma panel; both were negative for BAP1, but patient 1 had a variant of unknown significance in BRCA2. Patient 3 had oculodermal melanocytosis, an established risk factor of uveal melanoma. Conclusion: Although rare, the possibility of multiple uveal melanoma does exist. Examination of the treated and contralateral eye on a regular basis is crucial, not only to identify local failure but also new metastases from the primary tumor and additional primary tumors.
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Rebegea, Laura, Dorel Firescu, Gabriela Stoleriu, Manuela Arbune, Rodica Anghel, Mihaela Dumitru, Raul Mihailov, Anca Iulia Neagu i Xenia Bacinschi. "Radiotherapy and Immunotherapy, Combined Treatment for Unresectable Mucosal Melanoma with Vaginal Origin". Applied Sciences 12, nr 15 (1.08.2022): 7734. http://dx.doi.org/10.3390/app12157734.
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Gynecologic melanomas are uncommon and malignant mucosal melanomas with vaginal origin are extremely rare, treatment strategies are limited and extrapolated from those of cutaneous melanoma. A better understanding of the vulvovaginal melanoma’s biology and its risk factors is needed. Therapeutic strategies include surgery, systemic therapy and radiotherapy. For vulvovaginal melanoma, surgery is selected as the primary treatment. Immunotherapy and target treatment have recently enhanced the systemic therapy for cutaneous melanoma (CM). Immunotherapy and new target agents demonstrated a better survival of melanoma and might be considered as treatment of vulvovaginal melanoma. Radiotherapy is included in the therapeutic arsenal for mucosal melanoma and may be performed on selected patients who may receive concurrent checkpoints and inhibition neoadjuvant radiotherapy with the purpose of reducing morbidity and mortality.
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Stahl, Alexandre, Nicolo Riggi, Katya Nardou, Michael Nicolas, Gurkan Kaya i Alexandre Moulin. "5-Hydroxymethylcytosine Loss in Conjunctival Melanoma". Dermatopathology 8, nr 2 (5.06.2021): 176–84. http://dx.doi.org/10.3390/dermatopathology8020023.
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Aims: Conjunctival and cutaneous melanoma partially share similar clinical and molecular backgrounds. As 5-hydroxymethylcytosine (5-hmC) loss has been demonstrated in cutaneous melanoma, we decided to assess if similar changes were occurring in conjunctival melanoma. Methods: 5-methylcytosine (5-mC), 5-hmC and TET2 were respectively identified by immunohistochemistry and RNA ISH in 40 conjunctival nevi and 37 conjunctival melanomas. Clinicopathological correlations were established. Results: 5-mC, TET2 and 5-hmC were respectively identified in 67.5%, 95% and 100% of conjunctival nevi and in 81.1%, 35.1% and 54% of conjunctival melanomas. A significant 5-hmC and TET2 loss was identified in conjunctival melanoma comparing to nevus, as well as a significant correlation between TET2 and 5-hmC expression. In the melanomas, 5-hmC expression was only significantly associated with local lymphatic invasion, but not with other clinicopathological parameters. There was a correlation between TET2 expression and the localization of the tumors. 5-mC expression was not associated with any clinicopathological parameters. Conclusions: We identified a significant 5-hmC loss in conjunctival melanoma similar to cutaneous melanoma. This loss may possibly be attributed to TET2 loss or IDH1 mutations. 5-hmC loss in conjunctival melanoma may help in the differential diagnosis between atypical conjunctival nevus and conjunctival melanoma.
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Weber, Ariana Lebsa, Daniel Holthausen Nunes, Jorge José de Souza Filho i Carlos José de Carvalho Pinto. "Avaliação de 496 laudos anatomopatológicos de melanoma diagnosticados no município de Florianópolis, Santa Catarina, Brasil". Anais Brasileiros de Dermatologia 82, nr 3 (czerwiec 2007): 227–32. http://dx.doi.org/10.1590/s0365-05962007000300003.
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FUNDAMENTOS- O melanoma é a mais letal das neoplasias cutâneas, e sua incidência vem aumentando em todo o mundo. O conhecimento estatístico do comportamento biológico do melanoma cutâneo em Florianópolis é fundamental tanto para orientar o raciocínio clínico da prática ambulatorial diária como para auxiliar políticas de saúde pública. OBJETIVOS - Estabelecer dados epidemiológicos sobre melanoma em Florianópolis, Brasil. MÉTODOS - Foram analisados 496 laudos de 432 pacientes com diagnóstico histopatológico de melanoma, de dois centros de serviços de anatomia patológica entre primeiro de janeiro de 1999 e 31 de dezembro de 2004 em Florianópolis. O protocolo, baseado no questionário do Grupo Brasileiro de Melanoma, incluiu sexo, tipo histológico, presença de nevo no tumor, índice de Breslow, ulceração, mitose, presença de infiltrado inflamatório, margens e presença de metástase. RESULTADOS - Observaram-se 186 melanomas in situ, 210 invasivos, e 100 metastáticos. O tipo histológico mais comum foi o melanoma extensivo superficial (60%). A média de Breslow dos melanomas lentigo maligno e extensivo superficial foi 1,829mm e dos melanomas nodular e acral de 5,035mm (p< 0,0001). Os principais locais de metástases foram a pele e o subcutâneo, linfonodos e o cérebro. CONCLUSÕES - O perfil histopatológico do melanoma cutâneo observado neste estudo foi de melanoma tipo extensivo superficial, invasivo, com Breslow de 1,25mm, com infiltrado inflamatório e margens livres.
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Kit, Oleg, Yevgeniy Kolesnikov, Roman Myagkov, Leonid Kharin i Yevgeniya Nepomnyashchaya. "PRIMARY MELANOMA OF THE GALLBLADDER MANIFESTED BY ACUTE CHOLECYSTITIS. DESCRIPTION OF A SINGLE CASE". Problems in oncology 64, nr 2 (1.02.2018): 253–55. http://dx.doi.org/10.37469/0507-3758-2018-64-2-253-255.
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Most of melanomas of the gallbladder are metastatic lesions of cutaneous melanoma. Primary melanomas of the gallbladder are described as single, polypoid, intraluminal masses emanating from the mucous membrane. The most important characteristic is the absence of melanoma damage to the skin. If it is not possible to localize primary melanoma a multidisciplinary approach to diagnostic search comes to the fore. Predicting for primary melanoma of the gallbladder is a difficult task due to the small number of cases and the absence of long-term follow-up for this category of patients.
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Sadrolashrafi, Kaviyon, i David Graham Cotter. "Not Your Mother’s Melanoma: Causes and Effects of Early Melanoma Diagnosis". Dermatopathology 9, nr 4 (27.11.2022): 368–78. http://dx.doi.org/10.3390/dermatopathology9040043.
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The year 2022 will herald approximately 100,000 new cases of cutaneous melanoma (CM), and over 7000 deaths from CM. Over the past 40 years, CM incidence has increased nearly six-fold; however, annual mortality has remained relatively constant. These trends encapsulate the phenomenon of overdiagnosis. Increased recognition of indolent lesions that appear histologically malignant may be leading to a melanoma epidemic. Enhanced melanoma awareness, screening efforts, physician uncertainty, medical-legal pressures, and diagnostic scrutiny using tools like immunohistochemical staining, mole mapping, dermoscopy, confocal microscopy, and molecular diagnostics contribute to increased CM diagnosis. As a result, current melanoma staging and treatment guidelines are being challenged. Existing standards fail to accurately identify histologically benign lesions that are lethal or, conversely, histologically malignant lesions that are innocuous. Healthcare systems and, more importantly, patients suffer from this diagnostic ambiguity that leads to the over-treatment of innocuous melanomas and under-treatment of aggressive melanomas. As dermatology continues to experience a shift towards earlier diagnosis of melanoma, management strategies must adapt. Herein, we review factors that may contribute to the increased incidence of melanoma, emphasize deficiencies in current staging systems, and provide insights into the future of melanoma management via precision medicine.
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Teixido, Cristina, Paola Castillo, Clara Martinez-Vila, Ana Arance i Llucia Alos. "Molecular Markers and Targets in Melanoma". Cells 10, nr 9 (5.09.2021): 2320. http://dx.doi.org/10.3390/cells10092320.
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Melanoma develops as a result of several genetic alterations, with UV radiation often acting as a mutagenic risk factor. Deep knowledge of the molecular signaling pathways of different types of melanoma allows better characterization and provides tools for the development of therapies based on the intervention of signals promoted by these cascades. The latest World Health Organization classification acknowledged the specific genetic drivers leading to melanoma and classifies melanocytic lesions into nine distinct categories according to the associate cumulative sun damage (CSD), which correlates with the molecular alterations of tumors. The largest groups are melanomas associated with low-CSD or superficial spreading melanomas, characterized by frequent presentation of the BRAFV600 mutation. High-CSD melanomas include lentigo maligna type and desmoplastic melanomas, which often have a high mutation burden and can harbor NRAS, BRAFnon-V600E, or NF1 mutations. Non-CSD-associated melanomas encompass acral and mucosal melanomas that usually do not show BRAF, NRAS, or NF1 mutations (triple wild-type), but in a subset may have KIT or SF3B1 mutations. To improve survival, these driver alterations can be treated with targeted therapy achieving significant antitumor activity. In recent years, relevant improvement in the prognosis and survival of patients with melanoma has been achieved, since the introduction of BRAF/MEK tyrosine kinase inhibitors and immune checkpoint inhibitors. In this review, we describe the current knowledge of molecular pathways and discuss current and potential therapeutic targets in melanoma, focusing on their clinical relevance of development.
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Song, Jung Min, Joel Daniel Marcus, Carolyn Stanek, Michael J. McNamara, Brian Gastman, Ahmad A. Tarhini i Pauline Funchain. "Single center experience of dermatologic and oncologic surveillance patterns for late stage melanomas that progressed from early stage melanoma." Journal of Clinical Oncology 36, nr 7_suppl (1.03.2018): 182. http://dx.doi.org/10.1200/jco.2018.36.7_suppl.182.
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182 Background: Recent data suggests a greater proportion and greater absolute number of thin (T1) melanomas contribute to melanoma death than thicker melanomas (Whiteman et al., J Invest Dermatol 2015). NCCN guidelines for early stage melanoma, defined as stages IA-IIA, suggest at least yearly skin check and H&P, but do not specify if dermatologic and/or oncologic surveillance should be pursued. Methods: We reviewed internal and external records of 16 consecutive patients with new, non-de novo diagnoses of unresectable stage III or IV melanoma undergoing active cancer treatment, i.e. late stage melanoma, from 2016-2017 that had progressed from a preceding primary early stage (IA-IIA) melanoma. Results: Primary early stage melanomas were diagnosed a median of 10.5 years (range, 4 to 29) prior to advanced disease progression. Two of 16 patients (13%) had oncologic follow up. Seven (44%) had continuous dermatology follow-up, of which 6 (38%) were followed only by dermatology. Only one patient had both dermatology and oncology follow-up at the time of progression. Follow up could not be determined for 8 patients due to lack of sufficient records, it is notable however that these 8 (50%) were not following dermatology or oncology at the time of progression. Conclusions: Only a small minority of patients who progressed from early stage melanoma to advanced stage melanoma requiring treatment were followed regularly by medical oncology, despite half having at least regular dermatology follow-up. We conclude that survivorship plans are important for early stage melanomas, and there is a need to effectively educate a larger early stage melanoma population about the infrequent but real oncologic issue of progressing to late stage melanoma.
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Henderson, Evita, i Curtis E. Margo. "Iris Melanoma". Archives of Pathology & Laboratory Medicine 132, nr 2 (1.02.2008): 268–72. http://dx.doi.org/10.5858/2008-132-268-im.
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AbstractThe iris is the least common site of primary uveal melanoma. The prognosis of iris melanoma is better than that of melanoma of the ciliary body and choroid, but the reason for this difference is unclear. One possible explanation is that iris melanoma is smaller than its posterior segment counterparts at the time of diagnosis. Most iris melanomas are spindle cell types, according to a modified Callender classification system. There is evidence that the proliferation of melanocytes of the anterior iris surface (iris plaque) and diffuse stromal invasion may be risk factors for local recurrence and metastasis, respectively.
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Nazzaro, Gianluca, Emanuela Passoni, Fabio Pozzessere, Carlo Alberto Maronese i Angelo Valerio Marzano. "Dermoscopy Use Leads to Earlier Cutaneous Melanoma Diagnosis in Terms of Invasiveness and Size? A Single-Center, Retrospective Experience". Journal of Clinical Medicine 11, nr 16 (21.08.2022): 4912. http://dx.doi.org/10.3390/jcm11164912.
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Background: The incidence of cutaneous melanoma has risen in recent years. The aim of this study was to compare cutaneous melanomas diagnosed at the Dermatology Unit of Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy, from 2006 to 2020 and between two specific biennia, i.e., 2006–2007 and 2019–2020. Methods: Retrospective chart review, with dermoscopic image collection, of cutaneous melanomas diagnosed at the Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy, from 1 January 2006 to 31 December 2020 Results: A statistically significant increase was shown in the proportions of in situ melanoma and melanoma measuring less than 6 mm, i.e., small-diameter melanoma (SDM), across the studied period (p < 0.001). Moreover, in the biennium 2006–2007, among 220 melanoma diagnoses, 6 were in situ (2.7%), as compared with 68 melanomas in situ out of a total of 236 (28.8%) melanomas diagnosed in the biennium 2019–2020. A statistically significant difference in the proportion of in situ melanoma between the two biennia was demonstrated (p < 0.001). Furthermore, during the first biennium, 27/220 (12.3%) SDM were identified, as compared with 61/236 (25.9%) in the last. A statistically significant difference was shown in the proportion of SDM between the two (p < 0.001). Conclusions: The percentage of in situ melanomas and those that can be detected at a diameter <6 mm has increased. The latter has been shown to be around one-third of excised lesions, thus undermining the practicality of the ABCD mnemonic. Dermoscopic criteria for SDM are needed to help further refine melanoma diagnosis.
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Rademaker, Marius, i Amanda Oakley. "Digital monitoring by whole body photography and sequential digital dermoscopy detects thinner melanomas". Journal of Primary Health Care 2, nr 4 (2010): 268. http://dx.doi.org/10.1071/hc10268.
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INTRODUCTION: Population screening for melanoma remains controversial. There are no studies demonstrating that population screening increases survival. As prognosis of melanoma is directly related to Breslow thickness, a surrogate marker of survival is thickness of melanoma. The development of several self-referred, whole-body photography and sequential digital dermoscopy imaging services reflects the publics concern regarding melanoma. AIM: To assess the ability of one of these services to detect melanoma at an early, thin stage. METHODS: Demographic and histological details from 100 melanomas diagnosed through self-referred whole-body photography and sequential digital dermoscopy imaging service compared to those diagnosed through traditional methods from data held by the New Zealand Cancer Registry. RESULTS: There were 52 invasive and 48 in-situ melanomas: 90% superficial spreading type, 6% lentigo-maligna type and 4% nodular on histology. Forty-eight were diagnosed on first visit; the remainder by serial digital dermoscopy. Thirty-five percent of patients reported having had previous primary melanoma. In 60%, patients had been concerned by the lesion, the rest (40%) detected solely by screening. Patients diagnosed by whole-body photography and sequential digital dermoscopy screening had thinner melanomas compared to the Registry data: 69% <0.75 mm Breslow thickness compared to 52% (p=0.0216); only 1.9% thicker than 3 mm compared to 10.8% (p=0.067). DISCUSSION: Melanomas detected by self-referred, whole-body photography with sequential digital dermoscopy service are thinner than melanomas detected by traditional diagnostic methods. It remains to be determined whether earlier diagnosis results in improved survival. KEYWORDS: Dermoscopy; mass screening; diagnosis, melanoma; telemedicine; teledermatology
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Bower, Matthew R., Charles R. Scoggins, Robert C. G. Martin, Michael P. Mays, Michael J. Edwards, Douglas S. Reintgen, Merrick I. Ross i in. "Second Primary Melanomas: Incidence and Outcome". American Surgeon 76, nr 7 (lipiec 2010): 675–81. http://dx.doi.org/10.1177/000313481007600718.
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The objective of this study was to determine the incidence of multiple primary melanomas (MPM) and other cancers types among patients with melanoma. Factors associated with development of MPM were assessed in a post hoc analysis of the database from a multi-institutional prospective randomized trial of patients with melanoma aged 18 to 70 years with Breslow thickness 1 mm or greater. Disease-free survival (DFS) and overall survival (OS) were evaluated by Kaplan-Meier analysis. Forty-eight (1.9%) of 2506 patients with melanoma developed additional primary melanomas. Median follow-up was 66 months. Except in one patient, the subsequent melanomas were thinner (median, 0.32 mm vs 1.50 mm; P < 0.0001). Compared with patients without MPM, patients with MPM were more likely to be older (median age, 54.5 vs 51.0 years; P = 0.048), to have superficially spreading melanomas (SSM) ( P = 0.025), to have negative sentinel lymph nodes ( P = 0.021), or to lack lymphovascular invasion (LVI) ( P = 0.008) with the initial tumor. On multivariate analysis, age ( P = 0.028), LVI ( P = 0.010), and SSM subtype of the original melanoma ( P = 0.024) were associated with MPM. Patients with MPM and patients with single primary melanoma had similar DFS (5-year DFS 88.7 vs 81.3%, P = 0.380), but patients with MPM had better OS (5-year OS 95.3 vs 80.0%, P = 0.005). Nonmelanoma malignancies occurred in 152 patients (6.1%). Ongoing surveillance of patients with melanoma is important given that a significant number will develop additional melanoma and nonmelanoma tumors. With close follow-up, second primary melanomas are usually detected at an early stage.
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Kılıçkaya, M. Mustafa, Giray Aynali, Ali Murat Ceyhan i Metin Çiriş. "Metastatic Malignant Melanoma of Parotid Gland with a Regressed Primary Tumor". Case Reports in Otolaryngology 2016 (2016): 1–4. http://dx.doi.org/10.1155/2016/5393404.
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Malignant melanoma of the parotid gland is often metastatic and mainly originates from malignant melanomas in the head and neck. Nevertheless, some malignant melanomas may metastasize and subsequently regress. Therefore, it may not be possible to observe a metastatic malignant melanoma and its primary melanoma simultaneously. The investigation of a patient’s old photographs may help in the detection of preexisting and regressed pigmented lesions in the facial and neck regions.
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Slingluff, C. L., A. L. Cox, R. A. Henderson, D. F. Hunt i V. H. Engelhard. "Recognition of human melanoma cells by HLA-A2.1-restricted cytotoxic T lymphocytes is mediated by at least six shared peptide epitopes." Journal of Immunology 150, nr 7 (1.04.1993): 2955–63. http://dx.doi.org/10.4049/jimmunol.150.7.2955.
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Abstract HLA-A2.1-associated peptides were extracted from human melanoma cell lines and used to study epitopes for melanoma-specific HLA-A2.1-restricted CTL. CTL were generated from tumor-involved nodes by in vitro stimulation, initially with autologous melanoma cells and subsequently with allogeneic A2.1+ melanoma cells. These CTL lysed autologous melanoma plus four allogeneic HLA-A2.1+ melanomas, including an HLA-A2.1-transfected melanoma. K562, HLA-A2- melanomas and HLA-A2+ nonmelanomas were not lysed. HLA-A2.1 molecules were purified from human melanoma cell lines by immunoaffinity column chromatography of detergent-solubilized cell pellets. Peptides bound to the MHC molecules were acid eluted and fractionated by reversed phase HPLC. Individual fractions were assessed for their ability to reconstitute melanoma-specific epitopes by addition to the HLA-A2.1+ Ag-processing mutant, 721.174XCEM.T2 (T2). Five peaks of reconstitution were observed. Second dimension HPLC separations of reconstituting fractions revealed evidence for two distinct reconstituting peptides within one of these peaks. Based on these data, a minimum of six distinct peptides associated with HLA-A2.1 and recognized by melanoma-specific CTL are present on these different melanoma lines. These data document the presence of multiple peptide-defined CTL epitopes that are shared by at least three unrelated human melanoma cell lines.