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Desmoplastic Melanoma (desmoplastic + melanoma)

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Medical Sciences100%

Selected Abstracts

The Role of P-75 NGF-R in the Diagnosis of Desmoplastic Melanoma

JOURNAL OF CUTANEOUS PATHOLOGY, Issue 1 2005
S. Ghosn
The histologic diagnosis of desmoplastic melanoma is challenging, particularly when the overlying junctional component is absent and when the spindle cells lack melanin pigment. In these instances, the importance of immunohistochemistry cannot be overemphasized. S-100 protein, with a sensitivity approaching 90%, is the primary immunohistochemical stain used for this purpose. HMB-45, although a more specific marker for melanocytes, is often negative in these cases. A marker of schwannian differentiation, p-75 NGF-R has been shown to be a useful confirmatory marker for desmoplastic and neurotropic melanoma, with staining intensity comparable to or better than S-100 protein. We report two cases of desmoplastic melanoma which stained focally and weakly with S-100 protein in comparison with the stronger staining of p-75 NGF-R. In both cases, S-100 staining could have been missed or interpreted as non-confirmatory, thus misguiding the diagnosis. We therefore suggest that p-75 NGF-R be a complementary marker to S-100 protein in differentiating desmoplastic melanoma from other non-neural crest-derived spindle cell tumors. [source]

Desmoplastic melanoma of the lip,

HEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 6 2002
Amy C. Hessel MD
Abstract Background This retrospective study looks at the prognosis of desmoplastic melanoma of the lip, correlating it with the clinical course, treatment, and patterns of failure. Method Twenty-two patients with desmoplastic melanoma of the lip were seen at the University of Texas M. D. Anderson Cancer Center from 1965 to 1998. Results Three disease groups: (I) untreated tumor (3 patients), (II) excisional scar (10 patients), and (III) locoregional recurrence (9 patients). Group I had two cures and one failure. In group II six had no recurrences, and there were four failures. In group III, all patients failed. Ten patients (45%) had no evidence of disease, of which three (30%) had an initial misdiagnosis. Twelve patients (55%) died of disease or were living with disease, of which eight (67%) had an initial misdiagnosis. Conclusions Desmoplastic melanoma of the lip is often misdiagnosed and, therefore, inappropriately treated with multiple recurrences and poor prognosis. Accurate diagnosis and combined treatment may improve local control and survival. © 2002 Wiley Periodicals, Inc. Head Neck 24: 605,608, 2002 [source]

Immunohistochemical characteristics of melanoma

JOURNAL OF CUTANEOUS PATHOLOGY, Issue 5 2008
Steven J. Ohsie
Melanoma has a wide spectrum of histologic features which mimic epithelial, hematologic, mesenchymal, and neural tumors. Immunohistochemistry has been the primary tool to distinguish melanomas from these other tumors; it has also been studied for use as an adjunct to distinguish benign and malignant melanocytic tumors and to elucidate prognosis. Furthermore, there has been extensive effort to find a suitable marker to differentiate spindle cell and desmoplastic melanoma from other tumors. We have reviewed the literature investigating melanocytic differentiation markers, proliferation markers, immunomodulatory markers, signaling molecules, and nerve growth factors and receptors. Despite the proliferation of immunohistochemical markers, S-100 remains the most sensitive marker for melanocytic lesions, while markers such as HMB-45, MART-1/Melan-A, tyrosinase, and MITF demonstrate relatively good specificity but not as good sensitivity as S-100. No marker has proven useful in distinguishing spindle cell and desmoplastic melanomas from other tumors. Ki67 remains the most useful adjunct in distinguishing benign from malignant melanocytic tumors. None of the markers reviewed has been shown conclusively to have prognostic value for melanocytic neoplasms. [source]

Aggressive osteogenic desmoplastic melanoma: a case report

JOURNAL OF CUTANEOUS PATHOLOGY, Issue 5 2007
Patrick O. Emanuel
A case of an osteogenic desmoplastic melanoma occurring on the sole of the foot of a 60-year-old African American man is described. The tumor measured 4.8 cm in greatest dimension, invaded to a thickness of 2.2 cm and metastasized to four of ten inguinal lymph nodes. The majority of the tumor had a classic desmoplastic phenotype with malignant spindle cells set in a sclerotic and myxoid matrix and foci of lymphocyte aggregation. In other areas, there were thick trabeculae of bone rimmed by malignant epithelioid melanocytes. There was a markedly atypical lentiginous hyperplasia in the overlying epidermis. Imaging showed no continuity with the underlying calcaneus. The tumor was characterized immunohistochemically by S100 positivity. Pathologists should be aware of this diagnosis and should differentiate it from osteosarcoma. [source]

The Role of P-75 NGF-R in the Diagnosis of Desmoplastic Melanoma

JOURNAL OF CUTANEOUS PATHOLOGY, Issue 1 2005
S. Ghosn
The histologic diagnosis of desmoplastic melanoma is challenging, particularly when the overlying junctional component is absent and when the spindle cells lack melanin pigment. In these instances, the importance of immunohistochemistry cannot be overemphasized. S-100 protein, with a sensitivity approaching 90%, is the primary immunohistochemical stain used for this purpose. HMB-45, although a more specific marker for melanocytes, is often negative in these cases. A marker of schwannian differentiation, p-75 NGF-R has been shown to be a useful confirmatory marker for desmoplastic and neurotropic melanoma, with staining intensity comparable to or better than S-100 protein. We report two cases of desmoplastic melanoma which stained focally and weakly with S-100 protein in comparison with the stronger staining of p-75 NGF-R. In both cases, S-100 staining could have been missed or interpreted as non-confirmatory, thus misguiding the diagnosis. We therefore suggest that p-75 NGF-R be a complementary marker to S-100 protein in differentiating desmoplastic melanoma from other non-neural crest-derived spindle cell tumors. [source]

Immunohistochemical characteristics of melanoma

JOURNAL OF CUTANEOUS PATHOLOGY, Issue 5 2008
Steven J. Ohsie
Melanoma has a wide spectrum of histologic features which mimic epithelial, hematologic, mesenchymal, and neural tumors. Immunohistochemistry has been the primary tool to distinguish melanomas from these other tumors; it has also been studied for use as an adjunct to distinguish benign and malignant melanocytic tumors and to elucidate prognosis. Furthermore, there has been extensive effort to find a suitable marker to differentiate spindle cell and desmoplastic melanoma from other tumors. We have reviewed the literature investigating melanocytic differentiation markers, proliferation markers, immunomodulatory markers, signaling molecules, and nerve growth factors and receptors. Despite the proliferation of immunohistochemical markers, S-100 remains the most sensitive marker for melanocytic lesions, while markers such as HMB-45, MART-1/Melan-A, tyrosinase, and MITF demonstrate relatively good specificity but not as good sensitivity as S-100. No marker has proven useful in distinguishing spindle cell and desmoplastic melanomas from other tumors. Ki67 remains the most useful adjunct in distinguishing benign from malignant melanocytic tumors. None of the markers reviewed has been shown conclusively to have prognostic value for melanocytic neoplasms. [source]

Nestin expression as a new marker in malignant peripheral nerve sheath tumors

PATHOLOGY INTERNATIONAL, Issue 2 2007
Satoko Shimada
Malignant peripheral nerve sheath tumor (MPNST) can be difficult to diagnose because it lacks specific immunohistochemical markers. S-100, which is a useful marker of MPNST, has limited diagnostic utility. Recent studies suggest that nestin, which is an intermediate filament protein, is expressed in neuroectodermal stem cells. The diagnostic utility of immunostains for nestin and three other neural markers (S-100, CD56 and protein gene product 9.5 (PGP 9.5)) were evaluated in 35 cases of MPNST and in other spindle cell tumors. All MPNST cases were strongly positive for nestin and had cytoplasmic staining. Stains for S-100, CD56, and PGP 9.5 were positive in fewer cases (17/35, 11/35, and 29/35 cases, respectively), and had less extensive staining. Nestin was negative in 10/10 leiomyomas, and weak nestin expression was seen in 10/10 schwannomas, 3/10 neurofibromas, 2/8 synovial sarcomas, 2/10 liposarcomas, 4/7 carcinosarcomas and 3/7 malignant fibrous histiocytomas. In contrast, strong nestin positivity was seen in 10/10 rhabdomyosarcomas, 15/19 leiomyosarcomas, and 9/9 desmoplastic melanomas. Nestin is more sensitive for MPNST than other neural markers and immunostains for nestin in combination with other markers could be useful in the diagnosis of MPNST. [source]