Presentation Of Cutaneous Melanoma Research Articles

Differences in presentation of cutaneous melanoma among Asian American and Pacific Islander patients

Differences in presentation of cutaneous melanoma among Asian American and Pacific Islander patients

A glimpse at locally advanced melanomas in the settings of poverty: pathologist's viewpoint.

Cutaneous melanoma is the most aggressive cancer of the skin arising from pigment-producing cells, known as melanocytes. It is notorious for spreading early to distant locations. Survival of patients with melanoma largely depends on the thickness of the lesion at the primary site thus spotting it early is crucial. Early diagnosis of melanoma, with an improved quality of life and treatment outcomes, is being achieved in some developed nations through screening and health education. On the contrary, as practicing pathologists in a resource-scarce country, we frequently encounter patients with locally advanced melanoma manifesting as ulceration, bleeding, fungation, and bone erosion. Several factors, including low socioeconomic status, medical mistrust, inaccessibility of health facilities, and absent screening and surveillance services can be attributed to the delayed diagnosis. Therefore to alleviate the burden and complications caused by the late presentation of cutaneous melanoma, an urgent massive community mobilization, information campaigning, and the provision of accessible basic primary health care are urgently needed.

Complete regression of cutaneous melanoma presenting as tumoral melanosis: A case series

Introduction: Tumoral melanosis (TM) is characterised by nodular accumulation of melanophages and extracellular melanin, without melanocytes, in the dermis or subcutis. While melanophages in moderate numbers are typical of partially regressed melanoma, complete regression of primary melanoma with TM is rare, and presents a diagnostic challenge.

Completely regressed primary cutaneous melanoma presenting with nodal metastasis: A case with sequential photographic evidence

Completely regressed primary cutaneous melanoma presenting with nodal metastasis: A case with sequential photographic evidence

Diagnostic challenge for ovarian malignant melanoma in premenopausal women: Primary or metastatic?

BackgroundIn the ovary, metastatic malignant melanoma may be confused with primary malignant melanoma and presents a diagnosis challenge. Most cases are associated with disseminated diseases and poor prognosis. We present this case report of a metastatic ovarian malignant melanoma simulating primary ovarian cancer.Case reportA 45-year-old premenopausal woman was incidentally found to have an abdominal mass, 3 years after removal of a cutaneous melanoma lesion. Ultrasound and CT scan revealed left two solid masses, which were found to be an ovarian tumor at laparotomy. Left oophorectomy was performed. Histopathology and immunohistochemistry showed melanoma metastasis to the ovary. Nine months later, the patient developed epilepsy and confusion. Magnetic Resonance Imaging showed unique Wright frontal lobe lesion. She underwent stereotactic radio surgery and dacarbazine monotherapy. For months later, the patient is died from disseminate disease progression.ConclusionOvarian metastasis is an unusual presentation of cutaneous melanoma and the prognosis was dismal. As illustrated by this case report, a differential diagnosis of a metastatic malignant melanoma must be considered.

Cutaneous melanoma metastatic to the vitreous cavity.

To report a case of cutaneous melanoma metastatic to the vitreous cavity. Retrospective case report. A 72-year-old white man with a history of cutaneous melanoma but no known distant metastases presented with floaters and decreased vision. The patient was initially treated for a presumptive diagnosis of ocular toxoplasmosis. After failure to respond to treatment, he underwent diagnostic pars plana vitrectomy. Pathology of the vitreous specimen was suggestive of metastatic melanoma, and systemic workup revealed metastases to the brain. In patients with a known history of cutaneous melanoma presenting with ocular inflammation, a high index of suspicion for metastatic disease should be maintained.

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

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

Identical Twins With Primary Cutaneous Melanoma Presenting at the Same Time and Location

Thus far there have been very few cases that document such a rarity as the same cancer occurring in monozygotic twins, at the same time, in the same location. We report this extraordinary phenomenon in our patients, 71-year-old identical female twins, presenting with melanoma at the same time (within 10 days of each other) and location (the right calf).

Melanoma in Children and Teenagers: An Analysis of Patients From the National Cancer Data Base

This study examines the demographics, presentation, and outcomes of children and teenagers with melanoma using a US hospital-based oncology database. Data from the National Cancer Data Base from 1985 through 2003 were examined for demographics, presentation, and survival of patients aged 1 to 19 years, as well as a comparison group of patients aged 20 to 24 years. Two-sided linear and Pearson chi2 tests were calculated to examine associations. Proportions were compared using two-sided z tests. Five-year overall observed survival was evaluated using the Kaplan-Meier method and the log-rank test. Cox proportional hazards regression was used to estimate risk of mortality. Of 3,158 patients aged 1 to 19 years, 96.3% had cutaneous melanoma, 3.0% had ocular melanoma, and 0.7% had an unknown primary tumor. Cutaneous melanoma in patients aged 1 to 19 years was more common in girls (55.5%) and patients older than 10 years (90.5%). The demographics and presentation of cutaneous melanoma were age related; younger children were significantly more likely to be nonwhite and male and more likely to present with a head and neck primary tumors and with regional or distant metastases (linear chi2, P < .001 for sex, race, and extent of disease). Poorer survival was associated with higher stage and younger age. In contrast to patients aged 20 to 24 years, survival was not related to thickness in patients aged 1 to 19 years with localized invasive melanoma. Melanoma in children and teenagers differs from melanoma in young adults in demographics, presentation, and survival. Further investigation is warranted to elucidate possible biologic correlates of the unique aspects of melanoma in children and teenagers.

Regressed Subungual Melanoma Simulating Cellular Blue Nevus: Managed with Sentinel Lymph Node Biopsy

Subungual melanoma, a not uncommon presentation of cutaneous melanoma in Asian populations, is easily overlooked as benign and thus is improperly treated. To present two cases with clinical suspicion of subungual melanoma. Skin biopsies failed to demonstrate the diagnostic features of malignancy. Lymphoscintigraphy and sentinel lymph node (SLN) biopsies were performed to determine regional lymph node status. Both hematoxylin-eosin and HMB45 staining revealed melanoma cells in the SLN of the patient. The second patient's SLN was negative for malignant cells, but her excised primary lesion showed extensive regressed melanoma. Regression phenomena are not uncommon for subungual melanoma. An extention biopsy techniques are useful for determining nodal basin status in regressed subungual melanoma.

Regressed Subungual Melanoma Simulating Cellular Blue Nevus

BACKGROUND Subungual melanoma, a not uncommon presentation of cutaneous melanoma in Asian populations, is easily overlooked as benign and thus is improperly treated. OBJECTIVE To present two cases with clinical suspicion of subungual melanoma. Skin biopsies failed to demonstrate the diagnostic features of malignacy. METHODS Lymphoscintigraphy and sentinel lymph node (SLN) biopsies were performed to determine regional lymph node status. RESULTS Both hematoxylin-eosin and HMB45 staining revealed melanoma cells in the SLN of the patient. The second patient's SLN was negative for malignant cells, but her excised primary lesion showed extensive regressed melanoma. CONCLUSION Regression phenomena are not uncommon for subungual melanoma. An extention biopsy techniques are useful for determining nodal basin status in regressed subungal melanoma.

Melanoma Arising in a Skin Graft

Cutaneous melanoma remains an ongoing public health threat, and the cornerstone of management continues to be early diagnosis and treatment. Unfortunately, primary melanomas may have atypical presentations, making early diagnosis difficult and causing significant treatment delays. In this report, an unusual case is presented in which a patient experienced the synchronous development of a melanoma in situ within a skin graft donor site and an invasive melanoma within the recipient skin graft site. This exceptional presentation of cutaneous melanoma is discussed to highlight key principles of skin grafting in relation to the management of malignant melanoma.

Severe course of cutaneous melanoma associated paraneoplastic retinopathy.

Melanoma associated retinopathy (MAR) is a paraneoplastic syndrome in metastatic cutaneous melanoma presenting with nightblindness, light sensations, mild visual loss, and reduced b-waves in the electroretinogram (ERG). A patient with MAR was followed for a period of 25 months with repeated examinations including visual field testing and recording of standard electro-oculography, standard ERG, and photopic On and Off responses. A male patient with a very severe course of MAR is described. In addition to the clinical signs seen in previous patients, severe visual deterioration and vitreous inflammation were the predominant signs. The vitreous inflammation resolved after systemic corticosteroid therapy. Nightblindness and the reduced b-waves in the ERG remained unchanged during the follow up period. However, further visual deterioration and paracentral scotomas developed. Dark adaptation was markedly abnormal. Photopic On responses were reduced, but Off responses were preserved. Antibodies against retinal bipolar cells were isolated from blood samples of this patient. Vitreous inflammation may mask the diagnosis of MAR. ERG findings indicate that the more severe and progressive course is the result of local retinal changes and not progressive generalised retinal degeneration.

Seasonality of presentation of cutaneous melanoma, squamous cell cancer and basal cell cancer in the Oxford Region.

The seasonality of presentation of 1019 skin melanomas in Oxford Region 1952-1975, and of 1,523 squamous cell and 4,865 basal cell skin cancers in the region 1967-1975, were analysed using data from the Oxford Cancer Registry. For males and for females, for each of the histologies there was a peak of presentations during July to September. In further subdivisions of the data by age and by skin site, a summer or autumn peak was generally present except where numbers of cases were small. Amplitude of seasonality did not show consistent differences by histology, sex, or skin site, but for both melanoma and squamous cell cancer amplitude was greater for persons aged under 55 years than for older persons. There was no substantial seasonality for presentations of cancers of all non-skin sites in the region. The seasonality of presentation of skin cancers appeared not to be mainly an artefact of the cancer registration process or of organisational aspects of medical care attendance, and only a small proportion of it could be explained as an artefact of the longer term increase in registrations of these cancers. The visibility of skin cancers might have lead to seasonal variation in rapidity of presentation to medical care, for instance for social reasons, or the results might reflect a short induction period effect of exposure to a seasonal insult, perhaps sun radiation, on the aetiology, growth or symptoms of skin cancers; for melanoma there is previous evidence suggesting a short induction period aetiological effect of sun radiation.