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Malignant Melanoma (malignant + melanoma)
Kinds of Malignant Melanoma Terms modified by Malignant Melanoma Selected AbstractsSentinel Lymph Node Excision and PET-CT in the Initial Stage of Malignant Melanoma: A Retrospective Analysis of 61 Patients with Malignant Melanoma in American Joint Committee on Cancer Stages I and IIDERMATOLOGIC SURGERY, Issue 4 2010JOACHIM KLODE MD BACKGROUND AND OBJECTIVES Sentinel lymph node excision (SLNE) for the detection of regional nodal metastases and staging of malignant melanoma has resulted in some controversies in international discussions. Positron emission tomography with computerized tomography (PET-CT), a noninvasive imaging procedure for the detection of regional nodal metastases, has increasingly become of interest. Our study is a direct comparison of SLNE and PET-CT in patients with early-stage malignant melanoma. MATERIALS AND METHODS We retrospectively analyzed data from 61 patients with primary malignant melanoma with a Breslow index greater than 1.0 mm. RESULTS Metastatic SLNs were found in 14 patients (23%); 17 metastatic lymph nodes were detected overall, only one of which was identified preoperatively using PET-CT. Thus, PET-CT showed a sensitivity of 5.9% and a negative predictive value of 78%. CONCLUSION SLNE is much more sensitive than PET-CT in discovering small lymph node metastases. We consider PET-CT unsuitable for the evaluation of early regional lymphatic tumor dissemination in this patient population and recommend that it be limited to malignant melanomas of American Joint Committee on Cancer stages III and IV. We therefore recommend the routine use of SLNE for tumor staging and stratification for adjuvant therapy of patients with stage I and II malignant melanoma. The authors have indicated no significant interest with commercial supporters. [source] Selective Spread of a Malignant Melanoma into a Graft after Ten Years: A Case of Delayed Koebner PhenomenonDERMATOLOGIC SURGERY, Issue 6 2006PEDRO REDONDO MD First page of article [source] Lessons on Dermoscopy: Malignant Melanoma on Surgical Scar,Dermoscopic FeaturesDERMATOLOGIC SURGERY, Issue 12p1 2004Nicola Arpaia MD No abstract is available for this article. [source] Locoregional Cutaneous Metastases of Malignant Melanoma and their ManagementDERMATOLOGIC SURGERY, Issue 2004Ingrid H. Wolf MD The correct classification of locoregional metastases of malignant melanoma to skin is central to the planning of treatment. Local recurrence means persistence of neoplastic cells at the local site by virtue of incomplete excision of the primary melanoma. Standard treatment is excisional surgery. In contrast, locoregional metastases of malignant melanoma (satellites, in-transit metastases) are metastases around a primary melanoma or between a primary melanoma and regional lymph nodes. They represent intralymphatic or hematogenous spread of neoplastic cells. We present a variety of available treatment options and discuss especially topical imiquimod as a novel approach for the palliative treatment of locoregional cutaneous melanoma metastases in selected patients. [source] Primary Malignant Melanoma of the Maxillary GingivaDERMATOLOGIC SURGERY, Issue 3 2003Betül Gözel Ulusal MD BACKGROUND Mucosal malignant melanoma arising from the mucosa of the head and neck region is a rare entity, accounting for approximately 0.2% of all melanomas. Most of these lesions (80%) have occurred on the maxillary anterior gingival area, especially on the palatal and alveolar mucosa. OBJECTIVE Mucosal malignant melanomas are more aggressive than cutaneous melanomas. On the other hand, complex anatomy of this area makes complete surgical excision difficult. Thus, early diagnosis and treatment are important. METHODS We presented primary malignant melanoma of the maxillary gingiva in two cases. CONCLUSION In mucosal malignant melanoma, survival rates may be increased by early diagnosis and treatment. The clinician must carefully examine oral cavity, and pigmented lesions should be biopsied. Because some melanomas may be amelanotic, a high index of suspicion is necessary. [source] Pigmented Bowen's Disease (Squamous Cell Carcinoma in situ): A Mimic of Malignant MelanomaDERMATOLOGIC SURGERY, Issue 7 2001Ravi Krishnan MD Background. Darkly pigmented individuals may manifest unusual or uncharacteristic presentations of various skin conditions, including heavy pigmentation of cutaneous tumors. Objective. To increase the awareness of an unusual presentation of Bowen's disease in a darkly pigmented individual. Methods. We report the case of a 52 year old black woman that presented with a lesion clinically consistent with malignant melanoma. However, histopathologic examination revealed pigmented Bowen's disease. Results. A biopsy is almost always indicated to confirm the diagnosis of lesions in darkly pigmented individuals. Conclusion. This case is presented to reinforce the idea that pigmented Bowen's disease should be considered in the differential diagnosis of malignant melanoma. [source] Focal Regression-Like Changes in Dysplastic Back Nevi :A Diagnostic Pitfall for Malignant MelanomaJOURNAL OF CUTANEOUS PATHOLOGY, Issue 1 2005A. Hassanein Regression in melanoma can be complete or partial. Melanocytic nevi may show focal regression-like changes (RLC). We studied the incidence of RLC in a total of 777 melanocytic back nevi. These included 17 cases of blue nevi, 28 cases of compound nevi, 385 cases of compound dysplastic nevi, 34 cases of congenital compound nevi, 26 cases of congenital intradermal nevi, 58 cases of intradermal nevi, and 229 cases of junctional dysplastic nevi. The dysplastic nevi were categorised according to the associated cytologic atypia (mild, moderate, and severe). 21 malignant melanomas of the back were also reviewed for regression. RLC were seen with a striking correlation with the degree of cytologic atypia in dysplastic nevi. RLC were seen in 4.5% of mildly, 9.6% of moderately, and 17.2% of severely dysplastic compound nevi. RLC were seen in 10.3% of mildly, 18.8% of moderately, and 39.3% of severely dysplastic junctional nevi. The incidence of regression in non-dysplastic nevi was much less, ranging from 2.9% to 3.6%. We believe this phenomenon is probably related to trauma/irritation. Caution should be taken before rendering the diagnosis of regressed malignant melanoma on the back since dysplastic nevi may show focal similar changes. [source] CD99 Immunoreactivity in Metastatic Malignant MelanomaJOURNAL OF CUTANEOUS PATHOLOGY, Issue 1 2005AE Wilkerson CD99, also known as p30/32, is a glycoprotein product of the MIC2 gene, which is located on the short arm of both chromosome X and Y. This transmembrane protein was originally utilized in immunohistochemistry as a unique marker for Ewing sarcoma, other primitive neuroectodermal tumors, and more recently in a wide variety of tumors. It's expression in malignant melanoma (MM) has not been well documented. A recent study at our institution demonstrated membranous staining in approximately 61% of primary MM. As CD99 is expressed by hematopoeitic cells, it has been proposed as a mechanism for lymphocytes to gain access to the vasculature.1 This study is designed to determine if CD99 expression in melanoma cells has a similar role using cases of metastatic MM from our archives. Our evaluation shows that 13 of 28 cases (46.4%) demonstrated membranous CD99 staining. A case of this magnitude has not been previously reported. Reference: 1. Shenkel AR, Mamdouh Z, Chen X, Liebman RM, Muller WA. CD99 plays a major role in the migration of monocytes through endothelial junctions. Nature Immunol 2002;3:143,150. [source] Malignant Melanoma Associated with Lichen Sclerosus in the Vulva of a 10-Year-OldPEDIATRIC DERMATOLOGY, Issue 4 2004Ashraf M. Hassanein M.D., Ph.D. Lichen sclerosus of the vulva in childhood is also a rare disease. The association of these two rare lesions in the vulva of young girls is extremely rare. We present a 10-year-old white girl with malignant melanoma associated with lichen sclerosus of the vulva. She had dark pigmentation of both the labia minora and posterior fourchette. The inner labia majora and fourchette showed whitish, glistening areas of skin. Histologic examination found mostly an in situ lentiginous/mucosal melanoma with focal invasion to a depth of 0.44 mm in the left upper labium majus. All specimens showed evidence of lichen sclerosus. Partial vulvectomy was performed, and no metastases were detected at the time of treatment. The patient has been disease free for the 12 months after treatment. It is critical for physicians to realize that melanoma can occur in children, and although rare, can occur in the vulva. We feel that lichen sclerosus in this instance may represent a pattern of host immune response to melanoma. [source] Malignant Melanoma on the Sole: How to Detect the Early Lesions EfficientlyPIGMENT CELL & MELANOMA RESEARCH, Issue 2000TOSHIAKI SAIDA Early detection of malignant melanoma (MM) is essential to improve the prognosis. In non-white populations, including Japanese, the sole is the most prevalent site of MM. On the sole, however, melanocytic nevus is also frequently found. Clinical differentiation of early MM from benign melanocytic nevus on the sole is sometimes difficult because both are observed as a brownish-black macule. For the effective early detection of MM on the sole, the author has proposed guidelines based on the data of hundreds of melanocytic lesions on the sole. The algorithmic guidelines are as follows: when you see a pigmented lesion on the sole, first exclude congenital melanocytic nevus and some other specified disorders, and then measure the maximum diameter of the lesion. If it is more than 7 mm, biopsy it for histopathologic evaluation. If it is 7 mm or less, just follow the course of the lesion and advise the patient to come back if it enlarges to more than 7 mm. Even when the lesion is 7 mm or less, a biopsy is recommended on it, if it shows marked irregularity in shape and/or color or it shows the parallel ridge pattern with epiluminescence microscopy (ELM). The author believes the guidelines surely work efficiently in screening early MM on the sole. [source] Annexin VII as a Novel Marker for Invasive Phenotype of Malignant MelanomaCANCER SCIENCE, Issue 1 2000Tatsuki R. Kataoka Both F10 and BL6 sublines of B16 mouse melanoma cells are metastatic after intravenous injection, but only BL6 cells are metastatic after subcutaneous injection. While examining the genetic difference between the two sublines, we found a marked reduction of annexin VII expression in BL6 cells. In addition, fusion cell clones of both sublines, were as poorly metastatic as F10 cells after subcutaneous injection, and contained the annexin VII message as abundantly as F10 cells. Hence, we examined whether the annexin VII expression was correlated with the less malignant phenotype of clinical cases by immunohistochemistry. Immunoreactivities to anti-annexin VII antibody in melanoma cells were evaluated quantitatively by using skin mast cells as an internal positive control. Eighteen patients with malignant melanoma were divided into two groups: lymph node metastasis-negative and positive groups. The ratio of numbers of patients positive versus negative to the antibody was significantly larger in the former than in the latter group. These results not only indicated that annexin VII serves as a marker for less invasive phenotype of malignant melanoma, but also suggested a possible role of annexin VII in tumor suppression. [source] Role of Sun Exposure in MelanomaDERMATOLOGIC SURGERY, Issue 4 2006GIL B. IVRY BS BACKGROUND Malignant melanoma is the third most common skin cancer in the United States. It is commonly thought that sun exposure is causative in these tumors. Recently, however, the significance of the role of sun exposure in melanoma has come into question. Some have suggested that other factors, such as genetics, play a larger role, and that sun protection may even be harmful. OBJECTIVE AND METHODS To investigate the role of sun exposure in melanoma etiology. An extensive review of basic science and clinical literature on this subject was conducted. RESULTS Although exceptions exist, sun exposure likely plays a large role in most melanomas. The pattern of this exposure, however, is not fully known, and controversy exists, especially in the use of sunscreens. Sun exposure may interact with genetic factors to cause melanomas, and sun protective measures appear to be prudent. CONCLUSIONS The cause of melanoma is probably variable and multifactorial. Sun exposure may play a primary or supporting role in most melanoma tumors. [source] Fatal malignant melanoma in a child with neurofibromatosis type 1INTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 9 2007Yousef Bin Amer MBBS Neurofibromatosis type 1 is an autosomal dominant disease and is considered one of the most commonly inherited diseases in humans. Malignant melanoma has been reported in up to 5% of patients with neurofibromatosis type 1. We report a young Saudi boy with neurofibromatosis type 1 who developed fatal metastatic malignant melanoma arising from giant melanocytic nevi within speckled lentiginous nevus (SLN). [source] Skin cancer trends in northern JordanINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 4 2006Abdel K. Omari MD Background, The Jordan Cancer Registry was established in 1996, since which time all cases of cancer have been reported and registered. We have used this registry to perform the first analysis of skin cancer in northern Jordan and to compare our findings with those of published reports from other regions. Methods, All histopathologically proven cases of skin cancer, reported during the years 1997 through 2001, were reviewed. Information regarding tumor type, age, gender, and anatomical location was collected. Results, A total of 272 cases of malignant skin tumors were diagnosed between the years 1997 and 2001. Basal cell carcinoma (BCC) was the commonest type, representing 52.9% of all skin cancers. Females were more frequently affected than males, with age-adjusted incidence rates of 23.3 and 19.7 per 100,000 of population, respectively. Squamous cell carcinoma (SCC) comprised 26.4% of the total, its age-adjusted incidence rate per 100,000 of population being 14.2 for males and 6.18 for females. the incidence rate increased in males and decreased in females during the study period. The incidence of both BCC and SCC increased with age. The head and neck region was the commonest site affected by both types of cancer. Malignant melanoma (MM) comprised 11.39% of all skin cancer cases, with a female to male ratio of 1.2 : 1. The median age at onset for female patients was 49 years while that for males was 70 years, and the commonest site affected was the lower limbs, followed by the trunk. Conclusions, In Jordan, sun-related skin cancers have relatively low incidences and a rather stable pattern, compared with other areas with similar climate and skin phenotypes. [source] Rapid growth of malignant melanoma in pregnancyJOURNAL DER DEUTSCHEN DERMATOLOGISCHEN GESELLSCHAFT, Issue 2 2008Tomotaka Sato Summary Malignant melanoma during pregnancy is a difficult problem as a variety of risks to both the mother and fetus must be weighed. We describe a rapidly progressive malignant melanoma diagnosed during pregnancy. There are no standarized guidelines for treatment; each case requires an individualized approach. We review the literature and present an algorithm to aid in approaching such patients. [source] Adrenal metastases of malignant melanoma: Characteristic computed tomography appearancesJOURNAL OF MEDICAL IMAGING AND RADIATION ONCOLOGY, Issue 4 2005A Rajaratnam Summary Malignant melanoma is an extremely aggressive form of cancer. Adrenal metastases are found in 50% of cases of malignant melanoma, and are most often clinically and biochemically silent. Clinical presentation varies, and the diagnosis of adrenal metastases is often made incidentally, and frequently years after treatment of the primary lesion. An adrenal mass lesion seen on a CT scan, greater than 5 cm in diameter, with central or irregular areas of necrosis/haemorrhage (and no lipomatous component) is characteristic of a metastasis from malignant melanoma, in the setting of normal gland function. If these features are bilateral, they are pathognomonic. Oval, low-attenuation (on CT) adrenal masses less than 3 cm in diameter should not be considered benign in a patient with any prior history of melanoma. Careful imaging review of the adrenal glands should be undertaken in all patients with malignant melanoma. Early diagnosis of these distant metastases has important prognostic and therapeutic implications. The four cases presented illustrate the spectrum of presentations and clinical course of adrenal metastases from malignant melanoma. The accompanying CT images show the characteristic appearances of adrenal metastases. [source] The prevalence of melanocytic naevi among schoolchildren in South HungaryJOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 12 2008Z Csoma Abstract Background, Malignant melanoma is an increasing public health problem worldwide; accordingly, identification of the constitutional and environmental factors which contribute to the development of the disease, and hence identification of the individuals at high risk of melanoma, is an indispensable step in all primary prevention efforts. Objectives, This paper aims to assess the prevalence of different pigmented lesions among schoolchildren and to investigate their relationship with phenotypic pigmentary characteristics, sun exposure and other factors. Patients/methods, A cross-sectional study was performed in two secondary schools in Szeged, Hungary. A total of 1320 schoolchildren, aged 14 to 18 years, underwent a whole-body skin examination. A standardized questionnaire was used to collect data on phenotypic, sun exposure and other variables. Results, One to 10 common melanocytic naevi were found in 27% of the participants, and the naevus numbers were in the range of 10,100 in 67%; 5.4% of them had more than 100 common melanocytic naevi. The prevalence of clinically atypical naevi was 24.3%. Statistically significant associations were found between the number of pigmented lesions and gender, hair colour, eye colour, skin phototype, a history of severe painful sunburns and a family history of a large number of melanocytic naevi. Conclusion, Our study population displayed a markedly high prevalence of clinically atypical melanocytic naevi. Moreover, a considerable proportion of the investigated individuals had multiple common melanocytic naevi. Since the presence of a large number of melanocytic naevi is a strong predictor for future melanoma development, health educational programmes on melanoma prevention should be aimed at young age groups. [source] Malignant melanoma in early Parkinson's disease: The DATATOP trialMOVEMENT DISORDERS, Issue 5 2007Radu Constantinescu MD Abstract The available epidemiological data on the incidence of malignant melanoma in Parkinson's disease are contradictory. The role of levodopa therapy in this context has been debated. We identified all known cases of malignant melanoma (N = 5) in the DATATOP clinical trial cohort and compared that to published expected values (N = 1.5) for a standard healthy population. The standardized event ratio was 3.3 (95% confidence interval, 1.1,7.8), indicating that incidence of malignant melanoma was higher than expected. We found no association between levodopa therapy and the incidence of melanoma. © 2007 Movement Disorder Society [source] Melanoma in private practice: Do dermatologists make a difference?AUSTRALASIAN JOURNAL OF DERMATOLOGY, Issue 4 2009Paul Cherian ABSTRACT Malignant melanoma is a major contributor to Australian morbidity and mortality. In this era of resource rationalisation, we seek to address the issue of whether routine full-skin examination by a dermatologist, rather than focussed examination of flagged lesions, will increase melanoma diagnosis. A retrospective chart review was undertaken between 1 July 2007 and 30 June 2008 in a private dermatology group practice in order to ascertain the number and characteristics of incidentally detected melanomas on routine skin examination. A total of 94 melanomas were detected during this 12-month period. Of these, 57 (60.6%) were incidentally detected by the dermatologist, 41 (71.9%) were in situ melanomas and 16 (28.1%) were invasive melanoma. Of the invasive lesions, 15 (94%) were ,thin' (less than 1.0 mm Breslow thickness). The majority of melanomas were found in men, and were distributed in areas of high cumulative sun exposure. Nine (9.6%) lesions were clinically misdiagnosed by the dermatologists and picked up on histopathology. This audit reaffirms the usefulness of routine full-skin examination by dermatologists in detecting de novo melanoma as part of the global strategy in reducing the burden of melanoma in Australia. [source] Angiotropism of human prostate cancer cells: implications for extravascular migratory metastasisBJU INTERNATIONAL, Issue 7 2005Claire Lugassy OBJECTIVES To report several samples of invasive human prostate cancer showing angiotropism, and to use human prostate cancer cells stably expressing green fluorescence protein (GFP) in in vitro and in vivo models to assess the dissemination pathway of prostate cancer cells. MATERIALS AND METHODS Malignant melanoma and prostate carcinoma cells can migrate along anatomical structures such as nerves; previous studies showed that melanoma cells can be perivascular, on the outside of the endothelium, i.e. they are angiotropic, which suggests the hypothesis that melanoma cells also may migrate along vascular channels, termed ,extravascular migratory metastasis' (EVMM). Thus we examined histologically 10 human prostatic carcinoma specimens for the presence of angiotropism. In vitro, the PC-3 prostate cancer cells were co-cultures with capillary-like structures. In vivo, PC-3 cells were implanted on the chick chorio-allantoic membrane (CAM). RESULTS Histologically, in all 10 cases, angiotropism was detected at least focally within the tumour or at the advancing front of the tumour. In vitro, the PC-3 cells spread along the external surface of the vascular tubules; in vivo, PC-3 cells formed a cuff around some vessels a few millimetres beyond the tumour, showing angiotropism. Histopathology of the CAM confirmed the perivascular location of tumour cells and the absence of tumour cells within the vessel lumina. CONCLUSION The presence of angiotropic tumour cells in human invasive prostate cancers, associated with the angiotropism of GFP prostate cancer cells cultivated in vitro and in vivo in angiogenic models, raises the possibility that some prostate tumour cells may migrate along the external surface of vessels as a mechanism of spread, i.e. EVMM. [source] Malignant melanoma in patients with hereditary nonpolyposis colorectal cancerBRITISH JOURNAL OF DERMATOLOGY, Issue 1 2008G. Ponti Summary Background, Malignant melanoma (MM) is the most aggressive skin cancer. Most MMs are sporadic, and in this setting an association with mismatch repair (MMR) gene mutations, typical of hereditary nonpolyposis colorectal cancer (HNPCC) tumours, has been proposed. Objectives, To characterize clinically and/or by molecular biology the patients with MM belonging to a cohort of 60 kindreds with HNPCC. Methods, Patients with HNPCC with a diagnosis of MM were studied by immunohistochemistry (IHC) on tumour tissue using antibodies to MLH1, MSH2, p16, ,-catenin and E-cadherin, and by direct sequencing of MMR genes on germline DNA, and BRAF and NRAS on somatic DNA extracted from MM. Results, Nine cutaneous MMs were detected in the tumour spectrum of eight families with HNPCC. The median age at diagnosis was 46 years. In one HNPCC family the diagnosis of MM was made in two first-degree relatives fitting the clinical definition of familial melanoma. IHC and sequencing analysis showed an MSH2 mutation in one patient with MM. Conclusions, Dermatological surveillance should be recommended to families in which MM is diagnosed in at least one member, especially at a young age. The combination of MMR gene mutations and abnormalities of p16 or other molecular pathways is needed to induce melanocytic carcinogenesis in a familial setting as well as in sporadic MM. [source] Malignant melanoma in a woman with LEOPARD syndrome: identification of a germline PTPN11 mutation and a somatic BRAF mutationBRITISH JOURNAL OF DERMATOLOGY, Issue 6 2007M. Seishima No abstract is available for this article. [source] Malignant melanoma of soft parts arising from Tenon's capsuleACTA OPHTHALMOLOGICA, Issue 8 2009Per Sandkull No abstract is available for this article. [source] Malignant melanoma in Chile: an unusual distribution of primary sites in men from low socioeconomic strataCLINICAL & EXPERIMENTAL DERMATOLOGY, Issue 3 2006V. Zemelman Summary Background., Mortality from malignant melanoma (MM) has increased in Chile in the past decade. The location of MM lesions on the body has been correlated with prognosis and survival. Aim. To review body site and gender relationships with histopathologically confirmed primary MM in Chile. Methods., Records of 575 cases presenting to 5 state hospitals from 1992 to 2001 were analysed. Results., There were 360 women and 215 men. Women showed a significantly higher number of MM on the legs, cheeks and arms, and in the genital area, whereas men showed a significantly higher number on the ears, backs of the hands, soles and feet. Men had a predilection for MM with a poor prognosis. Conclusion., The different body site distribution of primary MM in men and women may be explained by a different pattern of sun exposure. Ethnic and genetic factors may also be involved. The predominant location of MM in women in Chile is similar to white populations, whereas the location in men is similar to that observed in black and Asian populations. These observations may be relevant to the high mortality of MM in Chilean men. [source] Sentinel Lymph Node Excision and PET-CT in the Initial Stage of Malignant Melanoma: A Retrospective Analysis of 61 Patients with Malignant Melanoma in American Joint Committee on Cancer Stages I and IIDERMATOLOGIC SURGERY, Issue 4 2010JOACHIM KLODE MD BACKGROUND AND OBJECTIVES Sentinel lymph node excision (SLNE) for the detection of regional nodal metastases and staging of malignant melanoma has resulted in some controversies in international discussions. Positron emission tomography with computerized tomography (PET-CT), a noninvasive imaging procedure for the detection of regional nodal metastases, has increasingly become of interest. Our study is a direct comparison of SLNE and PET-CT in patients with early-stage malignant melanoma. MATERIALS AND METHODS We retrospectively analyzed data from 61 patients with primary malignant melanoma with a Breslow index greater than 1.0 mm. RESULTS Metastatic SLNs were found in 14 patients (23%); 17 metastatic lymph nodes were detected overall, only one of which was identified preoperatively using PET-CT. Thus, PET-CT showed a sensitivity of 5.9% and a negative predictive value of 78%. CONCLUSION SLNE is much more sensitive than PET-CT in discovering small lymph node metastases. We consider PET-CT unsuitable for the evaluation of early regional lymphatic tumor dissemination in this patient population and recommend that it be limited to malignant melanomas of American Joint Committee on Cancer stages III and IV. We therefore recommend the routine use of SLNE for tumor staging and stratification for adjuvant therapy of patients with stage I and II malignant melanoma. The authors have indicated no significant interest with commercial supporters. [source] Current Progress of Immunostains in Mohs Micrographic Surgery: A ReviewDERMATOLOGIC SURGERY, Issue 12 2008MAYA K. THOSANI MD Mohs micrographic surgery is often considered the treatment of choice for a variety of skin malignancies. In recent years, the application of immunostaining techniques has facilitated the successful removal of a number of common and less common cutaneous malignancies, including basal cell carcinoma, squamous cell carcinoma, malignant melanoma, dermatofibrosarcoma protuberans, microcystic adnexal carcinoma, sebaceous carcinoma, atypical fibroxanthoma, extramammary Paget's disease, and even sarcomas. Immunostains highlight the tumor cells and allow the Mohs surgeons to pinpoint and eliminate the residual tumor at the surgical margin. It is especially helpful when a tumor presents with subtle or nonspecific histologic features or when a tumor is masked in a pocket of dense inflammation. However, the cost, the labor, and the time consumption are of concern to many of our peers, as are the diversity of antigens, which may overwhelm some. This article serves as a review of the literature on current uses of immunostaining in Mohs micrographic surgery and as a summary of their realistic applications in the dermatologic surgeon's practice. We conclude that immunohistochemical technique has played an important role in Mohs surgery advancement. With greater use and more cost-effective staining methods, we believe that the use of immunostains in a Mohs practice will become routine. [source] Locoregional Cutaneous Metastases of Malignant Melanoma and their ManagementDERMATOLOGIC SURGERY, Issue 2004Ingrid H. Wolf MD The correct classification of locoregional metastases of malignant melanoma to skin is central to the planning of treatment. Local recurrence means persistence of neoplastic cells at the local site by virtue of incomplete excision of the primary melanoma. Standard treatment is excisional surgery. In contrast, locoregional metastases of malignant melanoma (satellites, in-transit metastases) are metastases around a primary melanoma or between a primary melanoma and regional lymph nodes. They represent intralymphatic or hematogenous spread of neoplastic cells. We present a variety of available treatment options and discuss especially topical imiquimod as a novel approach for the palliative treatment of locoregional cutaneous melanoma metastases in selected patients. [source] Primary Malignant Melanoma of the Maxillary GingivaDERMATOLOGIC SURGERY, Issue 3 2003Betül Gözel Ulusal MD BACKGROUND Mucosal malignant melanoma arising from the mucosa of the head and neck region is a rare entity, accounting for approximately 0.2% of all melanomas. Most of these lesions (80%) have occurred on the maxillary anterior gingival area, especially on the palatal and alveolar mucosa. OBJECTIVE Mucosal malignant melanomas are more aggressive than cutaneous melanomas. On the other hand, complex anatomy of this area makes complete surgical excision difficult. Thus, early diagnosis and treatment are important. METHODS We presented primary malignant melanoma of the maxillary gingiva in two cases. CONCLUSION In mucosal malignant melanoma, survival rates may be increased by early diagnosis and treatment. The clinician must carefully examine oral cavity, and pigmented lesions should be biopsied. Because some melanomas may be amelanotic, a high index of suspicion is necessary. [source] Pigmented Bowen's Disease (Squamous Cell Carcinoma in situ): A Mimic of Malignant MelanomaDERMATOLOGIC SURGERY, Issue 7 2001Ravi Krishnan MD Background. Darkly pigmented individuals may manifest unusual or uncharacteristic presentations of various skin conditions, including heavy pigmentation of cutaneous tumors. Objective. To increase the awareness of an unusual presentation of Bowen's disease in a darkly pigmented individual. Methods. We report the case of a 52 year old black woman that presented with a lesion clinically consistent with malignant melanoma. However, histopathologic examination revealed pigmented Bowen's disease. Results. A biopsy is almost always indicated to confirm the diagnosis of lesions in darkly pigmented individuals. Conclusion. This case is presented to reinforce the idea that pigmented Bowen's disease should be considered in the differential diagnosis of malignant melanoma. [source] Clinical pathologic correlations for diagnosis and treatment of nail disordersDERMATOLOGIC THERAPY, Issue 1 2007Olympia I. Kovich ABSTRACT:, Clinicopathologic correlation is crucial to the correct diagnosis of disorders of the nail unit. This chapter will explore four common clinical scenarios and how pathology can help differentiate between their various etiologies. These include: dark spot on the nail plate (melanin versus heme), subungual hyperkeratosis (onychomycosis versus psoriasis), longitudinal melanonychia (benign versus malignant), and verrucous papule (verruca versus squamous cell carcinoma). Consideration must be given to both when to perform a biopsy and the location of the biopsy site, which must be based on an understanding of the origin of the changes. An overarching principle is that lesions within the same differential diagnosis may be present concomitantly, such as malignant melanoma of the nail unit associated with hemorrhage. Therefore, even with a biopsy-proven diagnosis, the clinician must always monitor lesions of the nail unit for appropriate response to treatment and consider an additional biopsy for recalcitrant lesions. [source] | ||||||||||||||||||||||||||||||||||