Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0025202 (melanoma)
 69,561 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Although most examples of cutaneous malignant melanoma are easily recognized by their clinical appearances, in some cases this serious neoplasm may clinically simulate other less serious forms of skin cancer or benign processes. This study was undertaken to assess both the sensitivity of clinical diagnosis of cutaneous malignant melanoma and the efficacy of biopsies of clinically unsuspected melanomas in yielding specimens on which complete and accurate histologic assessments could be made. A retrospective analysis of 1784 cases of histologically proven melanomas diagnosed between 1985 and 1990 was performed in search of lesions not clinically suspected. Biopsy techniques used to sample these lesions were subjected to critique of their efficacy in yielding specimens that could be accurately diagnosed and completely assessed histologically. Of 1784 histologically proven primary cutaneous melanomas, 583 were not clinically suspected, yielding a sensitivity of 67%. Clinical diagnosis included nevi (33%), no diagnosis (17%), multiple diagnoses (13%), basal cell carcinoma (12%), keratosis (9%), and lentigo (9%) among others. The biopsy methods used to sample these lesions were shave (56%), excisional (24%), punch (11%), curettage (2%), and undetermined (6%). Eighty-six percent of shave biopsies could be accurately assessed while only 32% of punches and no curettages provided sufficient material for both definitive and complete evaluation of melanomas. Eighteen percent of specimens histologically reviewed were considered inadequate for complete evaluation. In 34%, the actual diagnosis of melanoma was uncertain because of inability to assess diagnostic features as a consequence of the biopsy technique. Melanoma may be unsuspected clinically in a significant number of cases and may be mistaken for less serious cutaneous neoplasms.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Sensitivity of diagnosis of malignant melanoma: a clinicopathologic study with a critical assessment of biopsy techniques. 136 17

Malignant melanoma occurring in burn scars is extremely rare. Nine cases are reported in the literature. We report a case of a small malignant melanoma arising in a stable thermal burn scar after a long latent period of 58 years. The case was unique in that it was of the de novo neurotropic variant. Fascicles of amelanotic, S100 protein-positive atypical spindle cells with neuroid appearance infiltrated deeply in the scarred dermis and perineural spaces. The pigmentation of the lesion was due to solar lentigo instead of atypical melanocytic proliferation in the overlying epidermis.
 ...
PMID:Neurotropic malignant melanoma occurring in a stable burn scar. 137 53

The Central Malignant Melanoma Registry (CMMR) of the German Dermatological Society was established in 1983, and 7789 cutaneous malignant melanomas (CMM) were registered by 35 dermatological departments in Germany, Austria and Switzerland until the end of 1989. Population-based incidence rates, risk factors for developing CMM and prognostic parameters for predicting the final outcome were investigated in separate multicenter studies performed by the CMMR. Among the 7789 CMM registered, there was a preponderance of females (57.7%) versus males (42.3%). The age distribution peaked in the 5th and 6th decade of life for both sexes with a mean age of 52 years. The mean detection age was 50 years for superficial spreading melanoma, 53 for nodular melanoma, and 65 for lentigo maligna melanoma. Mean tumor thickness decreased from 2 mm in 1983 to 1.5 mm in 1989, indicating better CMM-awareness of the population and the medical community in this area. 90% of the patients presented with clinical stage I CMM without detectable metastases at first diagnosis. The incidence of CMM in Berlin (West) was assessed based on 960 cases diagnosed between 1980 and 1986. The incidence increased by 49% between 1980-81 and 1985-86, and the age standardized-incidence rate (European standard population) was 9.8 for males and 7.8 for females per 100,000 inhabitants and year in 1985-86. Mortality rates decreased in this period from 3.5 to 2.6 for males and slightly increased for females from 1.2 to 1.6 per 100,000 inhabitants and year. A case control study on the relative risk (RR) for developing CMM revealed the total number of melanocytic nevi (MCN) to be the strongest risk predictor (15x -50x increased RR), followed by the presence of dysplastic MCN (7x increased RR) and the skin type I (2x increased RR). Interestingly, no differences between CMM-cases and controls were found with respect to the history of sunburns or other parameters of sun exposure in this study. Multivariate analysis of 5093 stage I CMM-patients from four departments with long-term follow-up revealed that tumor thickness is the strongest predictor of survival with an almost linear correlation to the risk of death for tumor thickness up to 6 mm with no further increase in mortality for higher tumor thickness. The best classification of tumor thickness for survival prediction was less than or equal to 1 mm, 1.01-2 mm, 2.01-4 mm and greater than 4 mm in our data set on 5093 patients.(ABSTRACT TRUNCATED AT 400 WORDS)
 ...
PMID:Epidemiology of malignant melanoma in central Europe: risk factors and prognostic predictors. Results of the Central Malignant Melanoma Registry of the German Dermatological Society. 140 31

A retrospective review of 891 patients with newly diagnosed primary cutaneous malignant melanoma (CMM) registered at the British Columbia Cancer Agency from 1972 to 1981 is presented. Age-standardized incidence rates in British Columbia have increased markedly over that time. The female-to-male ratio was 1.13:1 and the median age overall was 47 years. A change in the size of a mole was the most common presenting sign (in 43% of patients) and the median duration of signs was 5.9 months. Predominant tumour sites were the trunk for males and the lower limbs for females. Dominant growth patterns were superficial spreading melanoma (65%), nodular melanoma (25%), lentigo maligna melanoma (5%) and acral lentiginous melanoma (2%). On staging of the primary tumour, 90% of patients had local disease, 9% of patients had regional disease and 1% of patients had distant disease at presentation. Median depths of tumours were 1.45 mm for males and 1.10 mm for females; no T1 tumours (tumours 0.75 mm or less in depth [TNM classification]) were staged beyond the local area. Disease recurred in 44% of males and 32% of females. The 15-year survival rate was 55.5% for males and 70.3% for females. These findings are compared with those of recent international series. It is apparent that earlier diagnosis improves survival and that more education is needed in view of the increasing incidence and death from CMM.
 ...
PMID:Primary cutaneous malignant melanoma: experience of the British Columbia Cancer Agency from 1972 to 1981. 145 84

Lentigo maligna denotes flat, pigmented lesions predominantly in areas of actinic damage that have the propensity to become malignant. More than 10 years may pass before lentigo maligna evolves into an invasive neoplasma. As an invasive process, it is termed lentigo maligna melanoma (LMM), and it has the potential for both lymphatic and hematogenic metastases. Because of the size and location of the lesions, cosmetically unsatisfactory scars may result from conventional surgery. Therefore, alternative means of treatment, including cryosurgery, have been employed. We report on 12 patients suffering from lentigo maligna who had been treated successfully by cryosurgery between 1984 and 1990. The average follow-up period was 51.4 months, and the recurrence rate was 8.3 percent. Knowing that microinvasive components can be demonstrated in 15 percent of lentigo maligna lesions, we retrospectively reassessed our patients by immunohistochemical procedures with S-100 protein. Although intradermal microinvasion could be confirmed in one patient, no recurrence had been observed within 61 months of follow-up. Provided that patients are selected properly and extension of cryonecrosis is monitored, cryosurgery may prove an efficient alternative to conventional surgery in the treatment of lentigo maligna.
 ...
PMID:Cryosurgery of lentigo maligna. 151 89

23 melanomas having the thickness, according to Breslow, up to 1.5 mm and 12 benign melanocytic tumours are studied. Ultrastructural examination gives additional information for differentiating benign and malignant melanocytic tumours. It is necessary to take into consideration such signs as the number and qualitative properties of melanosomes and premelanosomes, structure of nuclear membrane, that of nucleoli, non-specific microfilaments and mast cell infiltration of the tumour stroma. Some ultrastructural difference between lentigo-melanoma and other histological tumour types are noted.
 ...
PMID:[Ultrastructural features of benign and malignant lesions of a melanocytic nature]. 152 1

The malignant melanoma mostly is situated on the skin, the vulva being more often affected then expected in relation to its share in the total body surface. The peak of incidence lies in the fifth and sixth life decade. Five types of the tumor are known: lentigo maligna melanoma, superficial spreading melanoma, nodular melanoma, acrolentiginous melanoma and non-classifiable melanoma. For estimation of prognosis and choice of adequate mode of therapy histopathological examinations with regard to the level of invasion according to Clark and Chung, histomorphometric evaluation of the depth of invasion suggested by Breslow and the pronostic index of Schmoeckel and Braun-Falco are useful. The operative therapy of choice is the extensive tumor excision. In case of extended local invasion radical vulvectomy is indicated, in certain cases combined with inguinal, sometimes even pelvic lymphonodectomy. In inoperable cases radiotherapy may be tried, but success seems to be poor. Polychemotherapy may induce remissions, but hardly a prolongation of survival. New therapy trials are dealing with immunmodulation, mostly using different substances of biological response modifiers. The prognosis of malignant melanoma of the vulva must be considered to be poorer than that of melanomas in other sites of the body, local recurrence is frequent, the five year survival rate being 30-35%. Whether pregnancy does have an effect on melanoma growth is still unknown. Early stages of melanoma disease may be treated without interrupting pregnancy, whereas advanced stages require termination of pregnancy, followed by specific tumor therapy.
 ...
PMID:[Malignant melanoma in gynecology]. 158 46

Pagetoid infiltration of the epidermis by melanocytes, also termed 'buckshot spread', is regarded by some as being essential for the confident histopathological diagnosis of primary cutaneous melanoma. We have reviewed 340 melanomas received over a 23 year period to assess the frequency of pagetoid infiltration and whether its presence bears any relationship with other histopathological features. Conspicuous pagetoid infiltration was present in 32.1% of the lesions and occasional melanocytes were observed within the stratum spinosum in a further 23.5% of cases. However, no melanocytes could be seen above the basal layer in 44.4% of the melanomas. The presence of pagetoid infiltration showed inverse correlation with tumour thickness, level of invasion, growth phase and mitotic count, and positive correlation with the presence and severity of regression. No association was found with the site of the primary lesion, melanocytic dysplasia or lentigo maligna in the adjacent epidermis, or with the presence of residual benign naevus cells in the epidermis. Thus, pagetoid infiltration of the epidermis was commonest in in situ or thin horizontal growth phase melanomas, and was conspicuous in only one-third of cases. While its presence is useful in the diagnosis of melanoma, its absence should not preclude it.
 ...
PMID:Pagetoid infiltration in primary cutaneous melanoma. 843 52

A retrospective descriptive study is carried out from the whole of malignant cutaneous melanomas diagnosed at the Dermatology Service of the General University Hospital of Valencia (HGUV), during the period 1977-1987, in which the 80% of the whole of the cases in the province of Valencia are diagnosed, specifically 247 patients are studied. The ones located on the leg stand out 21%, followed by posterior thorax 14% and face 12%. Likewise, differences statistically significant p less than 0.001 are observed among the distinct histological types of cutaneous malignant melanoma (CMM) with regard to the depth of the tumours invasion (measured in Clark levels and millimetres of depth), mitosis/area, mitosis index and prognosis index. Being the lentigo of malignant melanoma (LMM) the histological type diagnosed in earlier phases, hence it is the most capable variant of curative treatment, just the opposite that happens to the nodular malignant melanoma (NMM), that is normally diagnosed in more advanced phases of the illness.
 ...
PMID:[An epidemiological study of the distinct histological types of cutaneous melanoma in relation to other variables of the disease]. 158 11

The aetiological role of sunlight in the development of cutaneous malignat melanoma (CMM) is still controversial. The aim of the present review is to discuss the contradictory findings and to reinterpret them in the light of recent epidemiological results. The following clinical and epidemiological features have raised doubts on an aetiological impact of sunlight in CMM development: the anatomical distribution of CMM does not closely match the body areas most exposed to sunlight, and CMM is most common during the middle decades of life (except for the subtype of lentigo maligna melanoma, which accounts for 10% of all CMM). Furthermore, no elevated CMM risk after sunburns or increased sun exposure has been detected in most of the case control studies performed so far. The most important risk factors, however, were the total number of melanocytic naevi in whole-body counts followed by such pigmentation characteristics as skin type and hair colour. On the other hand, the CMM incidence increases in white populations with increasing proximity of domicile to the equator and thus with increasing intensity of UV irradiation, and 5-10 times higher incidence rates have been reported from Australia and the southern states of the USA than from Europe. In industrialized nations with white populations a steep increase in CMM incidence has been described, with the main rise in body regions more frequently exposed to the sun in the last decades (trunk in men and boys and lower extremities in girls and women). Two results from recent epidemiological studies may help to clarify the contradictory findings above: first, sunburn in childhood and adolescence was shown in several case control studies to significantly elevate the risk of melanoma development, but further sunburn during adulthood did not contribute to any further risk elevation. Secondly, a study in Canadian school children revealed significantly higher naevus counts in subjects with numerous or severe episodes of sunburn in the previous 5 years. In conclusion, exposure to the sun in childhood and adolescence induces melanocytic naevi, which are known as markers of an elevated melanoma risk as well as possible precursors of CMM. Strategies to reduce melanoma incidence should therefore begin by restricting exposure to sunlight in young children and adolescents.
 ...
PMID:[The sun and malignant melanoma]. 161 13


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>