Gastrointestinal Melanoma Research Articles

Abstract 414: Role of stem cell marker, nestin in human uterine cervical intraepithelial neoplasia and cervical cancer

Abstract BACKGROUND: Nestin, a class VI intermediate filament protein, was originally described as a neuronal stem cell marker expressed during central nervous system development. Increased nestin expression has been reported in various tumor cells, including central nervous system tumors, gastrointestinal stromal tumors, pancreatic cancers, prostate cancers, breast cancers and malignant melanomas. Recent studies have shown that nestin is a cancer stem cell (CSC) marker in glioblastoma and malignant melanoma, and its expression correlates with aggressive growth, metastasis, and poor prognosis in the tumors. However, expression of nestin and its role in cervical cancer cells have not been well identified. In the present study, we used gene transfection to clarify nestin expression levels in cervical intraepithelial neoplasia (CIN) and cervical cancer and determine the role of nestin in cervical cancer. METHODS: To determine nestin expression patterns, we performed immunohistochemical analysis of nestin in CIN (26 cases) and cervical cancer tissues (55 cases). Furthermore, nestin expression was examined in human cervical cancer cell lines (ME-180 and CaSki). To examine the role played by nestin in cervical cancer cells, we transfected a stable expression vector containing nestin cDNA into ME-180 cells. Empty vector transfected ME-180 cells were prepared as the negative control (mock cells). We then studied the effects of increased nestin expression on cell proliferation, cell motility, migration, invasion, and sphere and soft agar formations. RESULTS: Nestin was not localized in the squamous epithelium in normal cervical tissue, but it was weakly expressed in the basal squamous epithelium of CIN 1 tissue. In CIN 2 tissue, nestin was found to be localized in the basal to lower two-third section of the squamous epithelium, whereas in CIN 3, it was localized in the majority of the squamous epithelium. Nestin was detected in all cases of invasive cervical cancer examined. Using in situ hybridization analysis, we confirmed that the expression patterns of nestin mRNA were similar to those of nestin protein. Nestin mRNA was expressed in both ME-180 and CaSki cells, with the expression level lower in ME-180 than in CaSki cells. The growth rates and migration ability of stable nestin-transfected ME-180 cells were lower than those of the mock cells, but cell motility and invasion ability were no different from the mock cells. However, the nestin-transfected ME-180 cells formed more spheres and colonies than the mock cells. CONCLUSION: There is a positive correlation between increased nestin expression and advanced grades of CIN. In cervical cancer, nestin expression correlates with the property of CSC. These findings suggest that nestin plays an important role in the carcinogenesis and maintainance of cervical CSC functions. Nestin may be a novel therapeutic target for CIN and cervical cancer. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 414. doi:1538-7445.AM2012-414

Comparison of prognostic factors and survival outcome between gastrointestinal tract and cutaneous invasive malignant melanoma.

618 Background: Gastrointestinal melanoma (GIM) is a rare disease. The objective of this study is to compare the overall survival (OS), cancer specific survival (CSS) and prognostic factors of GIM to those of skin melanoma (SKM) using the Surveillance, Epidemiology, and End Results (SEER) registry. Methods: Patients diagnosed with invasive GIM (406) and SKM (173,622) between 1973 and 2008 were identified from the SEER database. Factors analyzed included age (18-40/41-60/61-100), gender, race (White/nonwhite), marital status, stage (localized/regional/distant), year of diagnosis (1973-87/1988-97/1998-2008), and type of treatment (radiotherapy (RT)/surgery). OS and CSS were evaluated using the Kaplan-Meier method. Cox proportional hazards regression analysis examined what factors were prognostic of survival. Results: The median age was 69 and 57 for patients with GIM and SKM, respectively. The GIM group was older with more advanced-stage cancer than the SKM group. Surgery was performed on 85% and 95%, while RT was received by 18% and 2% of GIM and SKM patients, respectively. The GIM group had a median OS and CSS of 15 and 16 months, respectively, while the SKM group had a median OS of 283 months and did not reach a median CSS. Cox analysis showed that SKM had significantly lower risk of total and cancer-specific mortality compared to GIM (Hazard Ratio (HR) 0.40, p<0.0001) and (HR 0.34, p<0.0001). Factors associated with improved OS and CSS in SKM included: age ≤60, female gender, non-white race, early stage, being married, more recent diagnosis, undergoing surgery and not receiving RT. Factors associated with improved OS and CSS in GIM included: age ≤60, early stage, non-white race and undergoing surgery. Subgroup analysis on patients who underwent surgery showed that lymph node status was the only prognostic factor for GIM, while all of the previously identified prognostic factors except for race were associated with OS and CSS for SKM. Conclusions: Outcomes of patients with GIM are inferior to those with SKM. The melanomas in these two sites also have different prognostic factors. Future studies should explore the reasons behind these differences to improve treatment outcomes.

Melanoma of Stomach

Melanoma of gastrointestinal tract can be either primary or secondary to metastases from other sites like skin, mucous membranes, and uvea. Primary gastrointestinal melanoma is rare and still rarer is stomach involvement. We report a case of primary malignant melanoma of stomach in a 50-year-old female who presented with an axillary lymphadenopathy. Melanoma of stomach is rare. It has characteristic endoscopic appearance. Differentiation of primary from secondary melanoma is possible on clinical behavior and histological characteristics.

Abstract 3786: LC3B-positive autophagosomes are a common feature of solid tumors and associated with proliferation, metastasis and poor outcome

Abstract Interest in autophagy and cancer has surged in recent years. Autophagy provides a source of nutrients in times of metabolic stress. A paradox for autophagy in cancer is that while autophagy is a conserved pro-survival mechanism, it can also act in tumor suppression as is the case with the autophagy-associated beclin-1 protein. However, there is growing evidence supporting a pro-survival role for autophagy in tumor progression, for example in gastrointestinal tumors and invasive melanomas wherein autophagosomes are abundant. Here we expanded previous studies on autophagosomes in malignancies to include nearly 2000 pathology specimens from 20 different cancers, analyzing for associations of autophagosomes with tumor progression. Methods. Individual pathology specimens and tumor tissue microarrays (TMAs) were stained for the autophagosome marker LC3B and the proliferation marker Ki-67 through standard IHC procedures. Automated quantitative analyses (AQUA) used fluorescence-tagged antibodies. Results: In multitumor TMAs, about 85% of all tumors showed positive staining of LC3B in a granular pattern. In melanoma TMAs, LC3B was elevated in lymph node metastases. In breast carcinoma TMAs LC3B was elevated in node-positive compared to node-negative primaries and associated with increased nuclear grade, and worse patient outcome. LC3B and Ki-67 expression correlated in both melanoma and breast carcinoma (p < 0.0001), indicating a strong association between autophagy and proliferation. Supporting this, mitotic figures were largely detected in LC3B-positive tumor cells. Conclusions. While it is clear that autophagy can play a tumor suppressor role in some settings, we posit that these results are most consistent with a pro-survival role for autophagy, at least in advanced malignancies. In cancer, autophagy is thought to be part of the pro-survival integrated stress response known as aerobic glycolysis or the Warburg effect whereby cells utilize glycolysis rather than aerobic respiration for ATP production. Since some 90% of malignancies constituitively express the Warburg effect and, as shown herein, a similar number express LC3B-positive autophagosomes, the results are most consistent with autophagy being an integral, active part of this response. That autophagosomes are expressed in proliferating tumor cells further supports this proposal. In any case, the widespread occurrence of autophagosomes in cancer shown herein, and by others, underscores the importance of autophagy as a target in the design of new anti-cancer therapies. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 3786. doi:10.1158/1538-7445.AM2011-3786

Abstract 1421: The stem cell marker nestin is a novel therapeutic target to suppress tumor growth and invasion of malignant melanoma

Abstract BACKGROUND: Nestin, a class VI intermediate filament protein, was first described as a neural stem cell/progenitor cell marker expressed during central nervous system development. Recently, nestin was detected in various neoplasms such as glioblastomas, gastrointestinal stromal tumors, prostate cancers, breast cancers, pancreatic cancers and malignant melanomas. An abundance of nestin has been identified in metastatic sites and the dermal parts of nodular melanomas, and the expression level of nestin has relevance to poor prognosis in malignant melanomas. These findings suggest that nestin plays important roles in the invasion of melanoma cells. Furthermore, recent studies have shown that nestin is one of the cancer stem cell markers in melanomas. Therefore, we hypothesized that nestin may be a novel therapeutic target for malignant melanomas. In this study, we used a silencing strategy to clarify the effectiveness of nestin-targeting therapy in malignant melanomas. METHODS: To determine the expression patterns of nestin, we performed immunohistochemical analysis of nestin in human melanoma tissues. Next, we stably knocked down nestin expression in A375 human malignant melanoma cells by short hairpin RNA (shRNA) transfection in vitro. We also transfected sham vectors to A375 cells as negative controls. Cell proliferation, invasion, morphology, and sphere-forming ability were compared with nestin-shRNA-transfected cells (Sh) and sham cells (Sc). RESULTS: Immunohistochemical staining demonstrated that nestin was strongly expressed in melanoma cells in the invasive front of human melanoma tissues. Reduced expression level of nestin mRNA and protein in Sh cells was confirmed by quantitative RT-PCR, western blot and immunocytochemical analyses. Sh and Sc cells did not show characteristic morphological differences; however, stress fiber formation of F-actin was markedly increased in Sh cells. Cell growth of Sh cells was slower than that of Sc cells at 48 hrs as determined by cell counts and MTT assay. On the cell invasion assay using a modified Boyden chamber coated with matrigel on the inner surface of the inserts, the invasion of Sh cells was significantly attenuated in comparison with that of Sc cells. Sphere-forming ability using ultra-low attachment plates supplemented with EGF and FGF-2 showed that Sh cells formed fewer spheres than Sc cells. CONCLUSION: Nestin is expressed in melanoma cells at the invasive front of melanoma tissues, and decreased expression level of nestin inhibits the growth and invasion of melanoma cells. Furthermore, nestin regulates the functions of cancer stem cells of malignant melanoma as determined by sphere-forming ability. Our findings imply that nestin is a promising novel therapeutic target in malignant melanomas. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 1421. doi:10.1158/1538-7445.AM2011-1421

Trisomy 6p and ring chromosome 11 in a melanotic schwannoma suggest relation to malignant melanoma rather than conventional schwannoma

Melanotic schwannoma is a rare entity that generally occurs in young adults and commonly arises from the sympathetic nervous system even if soft tissue and visceral organs can also be affected [1]. Although most cases are benign, the outcome of this tumor is difficult to predict. Indeed, 15% of the reported patients have died of metastatic disease [1]. We report here the first cytogenetic description of a case of malignant melanotic schwannoma. A 47-year-old male presented with abdominal pain of 2 months duration. A computed tomography scan of the abdomen revealed a 19 9 17 9 10 cm retroperitoneal mass involving the small intestine, the bladder and the left diaphragm. A biopsy was performed. Histological examination showed a proliferation mainly made up of spindle cells and a component of epithelioid cells (Fig. 1a). In some areas, spindles cells were arranged in fascicles mimicking the architecture of a schwannoma. The cytoplasm of some cells contained brown pigment positively labeled by the Masson Fontana silver stain for melanin. The nuclei were uniform showing only mild atypia and some of them containing small nucleoli. The number of mitosis was very low (1 at Gx400/10 fields). The tumor cells were strongly and diffusely positive for S-100 protein, HMB-45, and negative for EMA, CD34, chromogranin A and actin (Fig. 1b). There was no clinical evidence of primary cutaneous or gastrointestinal melanoma. Therefore, a diagnosis of melanotic schwannoma was established. Clinical workup for the manifestations of the Carney complex was performed and included screening for cardiac myxomas, pigmentation abnormalities, and endocrine diseases. No abnormality was observed and the melanotic schwannoma was considered as sporadic. The patient underwent surgery, which was not radical because of vascular involvement. The disease progressed during 2 months following surgery. Palliative chemotherapy was started with stable disease as best tumor response. Three years later, the patient developed liver metastasis. He died from progressive metastatic disease 4 years after initial diagnosis. A fresh fragment was prepared for cytogenetic analysis. The RHG-banded karyotype showed a ring chromosome 11 and additional material on the short arm of chromosome 14 suspected to originate from the short arm of chromosome 6 (Fig. 1c). Fluorescence in situ hybridization (FISH) with whole chromosomes painting (WCP) probes for chromosomes 6 and 11 was performed according to the manufacturer’s instructions (Q-BIOgene, Illkirch, France). These experiments confirmed the chromosome 11 origin of the ring chromosome as well as the composition of the derivative chromosome consisting of the short arm of chromosome 6 and long arm of chromosome 14 (Fig. 1d). This unbalanced whole-arm translocation resulted in trisomy 6p. The karytoype was: A. Italiano A.-C. Peyron F. Pedeutour Laboratory of Solid Tumors Genetics, Faculty of Medicine, Nice University Hospital, Nice, France

Intestinal malignant melanoma presenting with small bowel invagination: A case report

Gastrointestinal tract metastasis of any malignancy is rare. Cutaneous or ocular malignant melanomas are the most common tumors that metastasize to the gastrointestinal tract. Major symptoms of these metastatic lesions are bleeding and obstruction of the gastrointestinal tract. However, malignant melanoma arising in intestinal mucosa causing intestinal obstruction is a rare clinical entity. Herein, we present a case of primary gastrointestinal tract malignant melanoma who presented initially with iron deficiency anemia, which consequently triggered an invagination of jejunal and ileal segments causing obstruction symptoms, three months later.

Outcome following decompressive surgery for different histological types of metastatic tumors causing epidural spinal cord compression

Metastatic epidural spinal cord compression (MESCC) is a relatively common and debilitating complication of metastatic disease that often results in neurological deficits. Recent studies have supported decompressive surgery over radiation therapy for patients who present with MESCC. These studies, however, have grouped all patients with different histological types of metastatic disease into the same study population. The differential outcomes for patients with different histological types of metastatic disease therefore remain unknown. An institutional database of patients undergoing decompressive surgery for MESCC at an academic tertiary-care institution between 1996 and 2006 was retrospectively reviewed. Patients with primary lung, breast, prostate, kidney, or gastrointestinal (GI) cancer or melanoma were identified. Fisher exact and log-rank analyses were used to compare pre-, peri-, and postoperative variables and survival for patients with these different types of primary cancers. Twenty-seven patients with primary lung cancer, 26 with breast cancer, 20 with prostate cancer, 21 with kidney cancer, 13 with GI cancer, and 7 with melanoma were identified and categorized. All of these patients were followed up for a mean +/- SD of 10.8 +/- 3.8 months following surgery. Patients with primary lung and prostate cancers were typically older than patients with other types of primary cancers. Patients with prostate cancer had the shortest duration of symptoms and more commonly presented with motor deficits, while patients with breast cancer more commonly had cervical spine involvement and compression fractures. For all histological types, > 90% of patients retained the ability to ambulate following surgery. However, the group with the highest percentage of patients who regained ambulatory function after decompressive surgery was the lung cancer group. Patients with breast or kidney cancer and those with melanoma had the highest median duration of survival following decompressive surgery. The present study identifies differences in presenting symptoms, operative course, perioperative complications, long-term ambulatory outcomes, and duration of survival for patients with lung, breast, prostate, kidney, and GI cancers and melanoma. This understanding may allow better risk stratification for patients with MESCC.

Malignant gastrointestinal melanoma with an unknown primary

Malignant melanoma is rare in India; melanoma presenting as a metastatic disease with an unknown primary, involving the gastrointestinal tract without involving lymph nodes is extremely uncommon. We report a case of a 28-year-old male with a malignant melanoma metastasizing to stomach and liver with an unknown primary. Relevant literature is being reviewed.

Primary melanomas of the esophagus and anorectum: epidemiologic comparison with melanoma of the skin

The objective of this study was to use recently available data to describe the epidemiology of melanomas of the esophagus and the anorectum in contrast to melanoma of the skin. The methods used include descriptive epidemiology using cases reported to the Surveillance Epidemiology and End Results registry, 1973-2003. All rates were age adjusted. We found 46 759 cutaneous melanomas, 170 anorectal melanomas and 20 esophageal melanomas, corresponding to age-adjusted rates of 70.1, 0.27, and 0.03 per million population, respectively. Median age of patients with melanoma of the skin was less than those with melanoma of the anorectum or esophagus (55 years vs. 71 years and 69 years, respectively). Rates of melanoma of the skin were 1.5-fold higher for men than for women (87.1 vs. 58.1 per 10); in contrast, rates of anorectal melanoma were 1.6-fold higher for women than for men (0.324 vs. 0.199 per 10). Rates of cutaneous melanoma for whites were 13-fold higher than for blacks (80.6 vs. 6.1 per 10, P<0.001), whereas the rates of anorectal melanoma were 1.7-fold higher among whites than blacks (0.273 vs. 0.173 per 10). Comparing the period 1973-1987 with 1988-2003, the rate of cutaneous melanoma increased 1.4-fold (56.0-80.1 per 10), whereas the rate of anorectal melanoma similarly increased 1.8-fold (0.182 to 0.329 per 10).In conclusion, anorectal melanomas, and especially, esophageal melanomas remain rare malignancies. This is the first report where temporal trends in anorectal melanoma are following the increased incidence of cutaneous melanomas, but it is unclear whether immunohistochemical diagnostic practices have influenced this trend. As gastrointestinal melanomas represent melanocytic transformation in the absence of sunlight, their epidemiology may provide etiologic clues to alternative or systemic transformative factors also operant in cutaneous melanoma.

Surgery for melanoma metastases of the gastrointestinal tract: Indications and results

Aim To assess survival, morbidity and mortality following therapeutic or palliative resection of gastrointestinal (GI) tract melanoma metastases. Methods A retrospective case series of 117 patients who underwent surgical resection of GI melanoma metastases between 1981 and 2005 was reviewed. Results The 117 patients underwent 142 operations for acute and/or sub-acute symptoms or for imminently symptomatic GI metastases detected radiologically. The intent of the surgery was palliative in 53 (37.3%) and therapeutic in 89 (62.7%) operations. The most common symptoms were due to anaemia (40.8%) or bowel obstruction (32.4%). The most frequently performed operation was small bowel resection (76.8%). Preoperative imaging and/or endoscopy were used in 83 cases, with computerised tomography (CT) being most frequent (85.5%). CT had a sensitivity of 68.8% when used alone to detect the presence of GI metastases in the study population. The mortality rate following GI resection was 1.4%, and 2.5% of patients had post-operative complications. Overall 5-year survival was 27%. On multivariate analysis, the presence of residual intraabdominal disease and the presence of non-GI metastases at the time of surgery or after surgery were the most significant prognostic indicators of survival. Conclusions Resection of GI melanoma metastases is safe, relieves symptoms and can achieve prolonged remission. In patients with limited disease, an aggressive surgical approach to symptomatic or imminently symptomatic GI melanoma metastases is warranted.

Gastrointestinal Melanoma or Clear Cell Sarcoma? Molecular Evaluation of 7 Cases Previously Diagnosed as Malignant Melanoma

Clear cell sarcoma (CCS) is a rare tumor classically associated with the tendons and aponeuroses of distal extremities of young adults. CCS and malignant melanoma (MM) share immunohistochemical profiles and ultrastructural features, but classic CCS has characteristic morphology with low mitotic activity and minimal pleomorphism. Occasional cases show pleomorphism, high mitotic index, and/or melanin pigmentation, making CCS indistinguishable from MM based on morphology. However, CCS is genetically distinct owing to its consistent association with a t(12;22)(q13;q12) chromosomal translocation, leading to the formation of the EWS/ATF1 fusion transcript. This translocation has never been documented in cutaneous melanoma, and thus is regarded as specific for CCS. Recent evidence suggests that primary "malignant melanomas" in unusual anatomic sites, most notably the gastrointestinal (GI) tract, may be CCS. This is supported by 11 cases of primary GI CCS with the t(12;22) translocation. We used reverse-transcription polymerase chain reaction and fluorescence in situ hybridization to examine whether a proportion of cases diagnosed as MM of the GI tract in patients without a history of cutaneous MM actually represent primary GI CCS. In total, we examined 7 cases: Four with no prior history of MM, 2 with histories of cutaneous MM, and 1 with an anal MM. All 4 cases for which there was no history of cutaneous/mucosal MM harbored the EWS/ATF1 fusion transcript. We report the largest series of GI CCS and have shown that molecular studies may be warranted in cases that otherwise seem to represent MM of unusual primary locations.

Defining the Role of Surgery for Primary Gastrointestinal Tract Melanoma

ObjectiveThe objective of the study was to determine the outcomes for primary gastrointestinal melanomas (PGIM). Material and methodsThe Surveillance, Epidemiology, and End Results database (1973–2004) was queried. ResultsOverall, 659 cases of PGIM were identified. The annual incidence of PGIM was approximately 0.47 cases per million in 2000. Overall median survival time was 17 months. Tumors were identified in the oral–nasopharynx (32.8%), anal canal (31.4%), rectum (22.2%), esophagus (5.9%), stomach (2.7%), small bowel (2.3%), gallbladder (1.4%), and large bowel (0.9%). Univariate analysis demonstrated age, tumor location, stage, surgery, and lymph node status were significant predictors of improved survival. MST has not been reached for tumors located in the large bowel, while tumors located in the stomach demonstrated the shortest median survival (5 months). Improvement in MST was observed for those patients undergoing surgical resection. The presence of lymph node involvement conferred a poorer prognosis. Multivariate analysis of the cohort identified that location, advanced tumor stage, failure to undertake surgical resection, positive lymph node status, and age were all independent predictors of poorer outcome. ConclusionPGIM occurs most often in the oral–nasopharynx and anal canal. Surgical extirpation is the only identifiable treatment modality that significantly improves survival.

Primary Small‐Bowel Melanoma

Journal of Ultrasound in MedicineVolume 26, Issue 1 p. 121-127 Case Report Primary Small-Bowel Melanoma Color Doppler Ultrasonographic, Computed Tomographic, and Radiologic Findings With Pathologic Correlations Luciano Tarantino MD, Corresponding Author Luciano Tarantino MD luciano_tarantino@fastwebnet.it Interventional Ultrasound Unit, Department of Internal Medicine, and Departments of Radiology and Surgery, San Giovanni di Dio Hospital, Frattamaggiore, ItalyAddress correspondence to Luciano Tarantino, MD, via Montedoro 43, Parco Montedoro, IT-80059 Torre del Greco (NA), Italy.Search for more papers by this authorVincenzo Nocera MD, Vincenzo Nocera MD Interventional Ultrasound Unit, Department of Internal Medicine, and Departments of Radiology and Surgery, San Giovanni di Dio Hospital, Frattamaggiore, ItalySearch for more papers by this authorMichele Perrotta MD, Michele Perrotta MD Interventional Ultrasound Unit, Department of Internal Medicine, and Departments of Radiology and Surgery, San Giovanni di Dio Hospital, Frattamaggiore, ItalySearch for more papers by this authorGiuseppe Balsamo MD, Giuseppe Balsamo MD Interventional Ultrasound Unit, Department of Internal Medicine, and Departments of Radiology and Surgery, San Giovanni di Dio Hospital, Frattamaggiore, ItalySearch for more papers by this authorAntonio Schiano MD, Antonio Schiano MD Interventional Ultrasound Unit, Department of Internal Medicine, and Departments of Radiology and Surgery, San Giovanni di Dio Hospital, Frattamaggiore, ItalySearch for more papers by this authorPasquale Orabona MD, Pasquale Orabona MD Histopathology Unit, San Sebastiano Hospital, Caserta, ItalySearch for more papers by this authorIgnazio Francesco Maria Sordelli MD, Ignazio Francesco Maria Sordelli MD V Division of Surgery, Second University of Naples, Naples, Italy.Search for more papers by this authorCarmine Ripa MD, Carmine Ripa MD V Division of Surgery, Second University of Naples, Naples, Italy.Search for more papers by this authorDomenico Parmeggiani MD, Domenico Parmeggiani MD Interventional Ultrasound Unit, Department of Internal Medicine, and Departments of Radiology and Surgery, San Giovanni di Dio Hospital, Frattamaggiore, ItalySearch for more papers by this authorPasquale Sperlongano MD, Pasquale Sperlongano MD V Division of Surgery, Second University of Naples, Naples, Italy.Search for more papers by this author Luciano Tarantino MD, Corresponding Author Luciano Tarantino MD luciano_tarantino@fastwebnet.it Interventional Ultrasound Unit, Department of Internal Medicine, and Departments of Radiology and Surgery, San Giovanni di Dio Hospital, Frattamaggiore, ItalyAddress correspondence to Luciano Tarantino, MD, via Montedoro 43, Parco Montedoro, IT-80059 Torre del Greco (NA), Italy.Search for more papers by this authorVincenzo Nocera MD, Vincenzo Nocera MD Interventional Ultrasound Unit, Department of Internal Medicine, and Departments of Radiology and Surgery, San Giovanni di Dio Hospital, Frattamaggiore, ItalySearch for more papers by this authorMichele Perrotta MD, Michele Perrotta MD Interventional Ultrasound Unit, Department of Internal Medicine, and Departments of Radiology and Surgery, San Giovanni di Dio Hospital, Frattamaggiore, ItalySearch for more papers by this authorGiuseppe Balsamo MD, Giuseppe Balsamo MD Interventional Ultrasound Unit, Department of Internal Medicine, and Departments of Radiology and Surgery, San Giovanni di Dio Hospital, Frattamaggiore, ItalySearch for more papers by this authorAntonio Schiano MD, Antonio Schiano MD Interventional Ultrasound Unit, Department of Internal Medicine, and Departments of Radiology and Surgery, San Giovanni di Dio Hospital, Frattamaggiore, ItalySearch for more papers by this authorPasquale Orabona MD, Pasquale Orabona MD Histopathology Unit, San Sebastiano Hospital, Caserta, ItalySearch for more papers by this authorIgnazio Francesco Maria Sordelli MD, Ignazio Francesco Maria Sordelli MD V Division of Surgery, Second University of Naples, Naples, Italy.Search for more papers by this authorCarmine Ripa MD, Carmine Ripa MD V Division of Surgery, Second University of Naples, Naples, Italy.Search for more papers by this authorDomenico Parmeggiani MD, Domenico Parmeggiani MD Interventional Ultrasound Unit, Department of Internal Medicine, and Departments of Radiology and Surgery, San Giovanni di Dio Hospital, Frattamaggiore, ItalySearch for more papers by this authorPasquale Sperlongano MD, Pasquale Sperlongano MD V Division of Surgery, Second University of Naples, Naples, Italy.Search for more papers by this author First published: 01 January 2007 https://doi.org/10.7863/jum.2007.26.1.121Citations: 4Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the 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Malignant gastrointestinal melanomas of unknown origin: Should it be considered primary?

A Manou ras , M Gene t zak i s , E Lagoud i anak i s , H Markogiannakis, A Papadima, G Kafiri, K Filis, PB Kekis, V Katergiannakis, First Department of Propaedeutic Surgery, Hippocrateion Hospital, University of Athens, Athens Medical School, Athens, Greece Correspondence to: Andreas Manouras, MD, PhD, Associate Professor in General Surgery,1st Department of Propaedeutic Surgery, Hippocrateion Hospital, Athens Medical School, University of Athens, Q. Sophias 114, 11527, Athens, Greece. amanouras@hippocratio.gr Telephone: +30-697-7304422 Fax: +30-210-7707574 Received: 2007-04-05 Accepted: 2007-04-30

Primary Melanoma of the Stomach at Cardia

Melanoma is a malignant neoplasm of melanocytes most frequently arising from the skin, but primary melanoma can also arise from the mucosa of the gastrointestinal tract. Gastrointestinal melanomas are most commonly metastases from a cutaneous melanoma. Primary melanoma of the stomach is rare and carries a poor prognosis. Reported here is the case of a 75-year-old man with a primary gastric melanoma who presented with a melena, abdominal pain, and weight loss. Most cases of melanoma are treated by excision of the primary tumor. Patients with melanoma have been treated with adjuvant chemotherapy, radiation therapy, and immunotherapy. None of these modalities has been demonstrated to prolong the survival rate. To improve long-term disease-free survival, early diagnosis and surgical intervention are very important.

Primary appendiceal melanoma: fiction or reality?

Melanomas of the gastrointestinal (GI) tract are very rare, and their primary or secondary nature is often difficult to establish. We report the case of a 55-year-old Caucasian female who presented with an appendiceal melanoma. To our knowledge, appendiceal localization of melanoma has never been reported. We review the literature and discuss the issues relating to the origin of gastrointestinal melanomas. In conclusion, even if a primary site of melanoma was not evident in this case, the metastatic nature of this appendiceal melanoma cannot be completely ruled out.

Primary and metastatic diseases in malignant melanoma of the gastrointestinal tract.

In this review, the gastrointestinal (GI) manifestations of malignant melanoma including primary mucosal melanoma of the GI tract and metastatic melanoma to the GI tract are discussed. Although malignant melanoma most commonly arises in the skin, primary melanomas can also arise from the mucosal epithelial lining of the gastrointestinal tract. The vast majority of gastrointestinal melanoma is metastatic from a cutaneous primary; however, there is evidence that melanoma can arise de novo from within certain areas of the gastrointestinal system. The sporadic nature and small numbers of patients reported in the literature with mucosal melanomas have prevented a good understanding of the pathogenesis, natural history, and optimal treatment of this uncommon presentation of melanoma.

POSTER: TOPICS Breast Cancer Lung Cancer, Head and Neck Cancer Gastro Intestinal Malignancies Genito-Urinary Tract Cancer Hemolinphoproliferative Melanoma and Sarcoma Supportive Care and Quality of Life Miscellanea

POSTER: TOPICS Breast Cancer Lung Cancer, Head and Neck Cancer Gastro Intestinal Malignancies Genito-Urinary Tract Cancer Hemolinphoproliferative Melanoma and Sarcoma Supportive Care and Quality of Life Miscellanea

Spontaneous tumors including gastrointestinal neoplasms and malignant melanomas, in the Syrian hamster.

Spontaneous tumors including gastrointestinal neoplasms and malignant melanomas, in the Syrian hamster.