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Query: UMLS:C0025202 (melanoma)
 69,561 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The authors report a case of a primary melanoma of the esophagus, which is a rare neoplasm with poor prognosis. The diagnosis of malignant melanoma was suggested, on endoscopic biopsies, because of the presence of large malignant cells with abundant cytoplasm containing melanin pigment positive in the Fontana-Masson's reaction. These cells were immunoreactive for S100 protein while they did not show staining for antiepithelial membrane antigen and anti-keratin antibodies. Moreover ultrastructural study of the tumor cells revealed cytoplasmic aberrant premelanosomas. An important histological feature of the present case, which confirmed the primary oesophageal nature of the tumor was the presence of foci of melanosis (benign melanocytes) within the oesophageal epithelium which was adjacent to the melanoma. The variation in the histology of malignant melanoma may provide difficulties in diagnosis especially if one is limited to study a small biopsy specimen. In such cases other diagnoses including epidermoid carcinoma with prominent spindle-cell features and sarcomas should be eliminated by means of immunohistochemical and ultrastructural studies. The particular feature of our case, which apparently has not been reported previously, is the identification of the melanosis two years prior to the diagnosis of the malignant melanoma. The present study indicates that the identification of this lesion is of important diagnostic interest and might lead to the follow-up surveillance of the melanosis by multiple biopsies.
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PMID:[Primary malignant melanoma of the esophagus arising in melanosis. Histological, immunohistochemical and ultrastructural study of a case]. 271 72

Five patients with penile melanosis are described. The lesions consisted of macular hyperpigmentation of the penile shaft and/or glans. Histologically only hyperpigmentation of the basal cell layer was observed with no melanocytic hyperplasia. Patients had follow-up for 3 to 13 years; enlargement of some lesions was observed, but the condition remained benign. The main differential diagnostic problem was with acral lentiginous melanoma. Penile melanosis shares clinical and microscopic features with Laugier-Hunziker syndrome of the buccal mucosa and vulvovaginal melanosis. We suggest that the three disorders be grouped as essential melanotic hyperpigmentation of mucosa.
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PMID:Penile melanosis. 271 3

Seventy-one conjunctival melanocytic proliferations in patients 20 years of age or younger were examined. Sixty-five (91.5%) were nevi; there were three cases (4.2%) of racial or acquired melanosis, and three patients were identified who had malignant melanoma of the conjunctiva. The melanoma patients are presented in detail, and additional cases of conjunctival melanoma in children and adolescents reported in the literature are reviewed to determine factors that might influence prognosis. The number of cases is so small, however, that factors cannot be identified with confidence. Follow-up data are presented. Conjunctival nevi are relatively common in children, and appear to carry no risk for the development of melanoma during childhood. However, -conjunctival melanomas do occur rarely in children and have a variable prognosis.
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PMID:Conjunctival melanocytic lesions in children. 277 64

Four patients had malignant melanoma involving the conjunctiva, nasal cavity, and paranasal sinuses. In each patient, the conjunctival melanoma preceded recognition of the lesion in the nasal cavity by months or years. Each patient had one or more conjunctival biopsy specimens that documented melanoma, and in each patient the melanomas evolved in primary acquired melanosis of the conjunctiva. Histologic examination of the epithelium adjacent to the tumor in the nasal cavity failed to show either atypia or diffuse melanosis. We believe that these melanomas in the nasal cavity and paranasal sinuses are most likely to evolve as regional metastases, although it is possible that they arise de novo or as related foci in accordance with the multicentric characteristics of conjunctival melanoma. If a patient with a conjunctival melanoma has symptoms referable to the nasal cavity or paranasal sinuses, ophthalmologists should refer the patient to an otolaryngologist.
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PMID:Malignant melanomas of the conjunctiva, nasal cavity, and paranasal sinuses. 280 64

Subungual melanomas are one of the most common types of malignant melanoma among the Japanese population. Although most pigmented nail streaks are benign and remain unchanged in their color and shape for a long time, rarely are they precursor lesions of subungual melanomas i.e., a rapid growing pigmented nail streak resulting in diffuse melanosis of the nail is thought to be an early stage of subungual melanoma in situ. We found four patients with these changes: three of these patients were children. The lesions occurred on the right index finger, right thumb, left middle finger, and right great toe, respectively. A slightly haphazard combination of colors ranging from dark brown to black, the important characteristic of subungual melanoma in situ, was observed in two cases. In the remaining two cases, although the haphazard combination of colors was not distinctive, many fine, dark longitudinal lines were seen within diffuse, light-brownish pigmentation. Serial histologic examination of the excised tissue specimens showed great proliferation of vacuolated melanocytes with variable nuclear atypicality along the entire basal layer in all cases. These histologic changes were compatible with those of atypical melanocytic hyperplasia or intraepidermal melanoma (in situ melanoma), which is an early lesion of subungual melanoma. An adult case is thought to be a definite example of a subungual melanoma in situ. We also made the diagnosis of melanoma in situ in the remaining three cases of children with rapidly growing pigmented nail streaks because their histopathologic features were distinguishable from those of the adult case. However, there remains some hesitation about this because invasive subungual melanoma is rare in children.
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PMID:A rapidly growing pigmented nail streak resulting in diffuse melanosis of the nail. A possible sign of subungual melanoma in situ. 280 9

Despite the frequency of cerebral metastases from melanoma, there have been very few papers on this subject in the radiological literature. We report one such case, original by its disseminated carcinomatosis appearance and by the disassociation between computed tomography and magnetic resonance imaging, illustrating the greater sensitivity of the latter examination. In view of the fact that 11 to 13% of patients with a cerebral metastasis from melanoma are asymptomatic, there may be a place for screening of these patients by MR imaging. The association of neurological lesions and cutaneous naevi raises the problem of neurocutaneous melanosis (degenerating phakomatosis).
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PMID:[The value of MRI in a case of cerebro-meningeal miliary carcinomatosis of melanotic origin]. 281 27

Once encountered, generalized melanosis as a consequence of disseminated melanoma is not easily forgotten. Cases in the literature usually have resulted from primary cutaneous melanoma. A case of generalized melanosis caused by an occult primary melanoma is reported in a patient who originally complained of increased pigmentation. Findings of light microscopic studies of involved skin, pathogenesis of generalized melanosis, and possible sites of origin of the primary neoplasm are discussed.
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PMID:Generalized melanosis in occult primary melanoma. 291 62

The urinary cytologic findings in a patient with metastatic malignant melanoma, diffuse melanosis and melanuria are presented. The melanosis was diagnosed from the clinical appearance of a generalized slate-blue skin discoloration, which is probably caused by dermal deposition of excess melanin pigment. The melanuria was characterized microscopically by the presence of amorphous, dark-brown casts, which stained positively for melanin pigment, and numerous pigment-laden macrophages.
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PMID:Melanuria. 293 35

Two patients presented with the unusual occurrence of isolated foci of malignant melanoma of the upper eyelid and ipsilateral inferior conjunctiva. Neither patient had clinical evidence of primary acquired conjunctival melanosis, but in one case there was histopathologic evidence of this condition. The clinical features, histopathologic findings, and possible significance of this unusual occurrence are discussed.
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PMID:Primary eyelid malignant melanoma associated with primary conjunctival malignant melanoma. 317 38

Sixty-two patients were treated by some combination of cryotherapy and surgery with an average follow-up of 3.3 years for one of the following diseases: focal or diffuse flat conjunctival primary acquired melanosis (PAM) with atypia but without a nodule of melanoma (10 cases); unifocal malignant melanoma with or without focal or diffuse PAM (30 cases); and multinodular/multicentric melanoma with and without PAM (22 cases). Of the ten patients who had PAM with atypia, invasive nodules of malignant melanoma did not develop. A second treatment was required to control the disease in four of the ten patients with extensive or diffuse lesions, and one has mild persistent disease. Of the 30 patients with unifocal nodules of malignant melanoma, 27 remained free of recurrence after one treatment, and 2 are asymptomatic after two treatments. One patient with a thick nodule at presentation required a parotidectomy and radical neck dissection for cervical metastases after recurrence in the conjunctival sac. In the group of 22 patients with multinodular malignant melanoma, only two did not have recurrent disease after one treatment. Of those who received multiple therapies, seven remained free of recurrence for at least 2 years after the last treatment; regional or distant metastases developed in nine; four required exenteration; and eight died. Conjunctival adjunctive cryotherapy avoids exenteration in extensive lesions of pure PAM and in unifocal melanoma, but even after multiple therapies, multinodular malignant melanoma had a 45% rate of metastasis. Metastasis was related to the presence of PAM sine pigmento in four patients (microscopically but not clinically detectable PAM); to the location of the nodules (9 of 10 patients who experienced metastases had forniceal, palpebral, and/or caruncular nodules); to the thickness or depth of invasion of the nodules (greater than 2 mm); and to the development of intralymphatic spread ("in-transit" local metastasis) within the conjunctival sac in six patients. No metastases were encountered among patients with strictly limbal nodules and among five patients with invasive nodules composed of spindle cells in part or in toto. Therapeutic success in this spectrum of melanocytic proliferations is closely correlated with the clinical extent of the disease when initiating definitive therapy.
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PMID:Cryotherapy for conjunctival primary acquired melanosis and malignant melanoma. Experience with 62 cases. 323 44


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