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

Seven patients with both melanoma and sarcoma were seen at the Dana Farber Cancer Institute (Boston, MA) over a 4-year period. Three had additional malignant neoplasms; one of these patients also had the hereditary cutaneous malignant melanoma, dysplastic nevus syndrome. These observations suggest the possibility of a biologic relationship between melanoma and sarcoma, the nature of which remains unknown.
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PMID:Melanoma and soft tissue sarcoma in seven patients. 224 1

In melanoma kindreds the presence of dysplastic nevi correlates with greatly increased melanoma risk. The relative importance of sporadic, nonfamilial dysplastic nevi as a risk factor for melanoma is less certain. Although the clinical features of dysplastic nevi have been well described, the histologic basis for the diagnosis is not as firmly established. This study examines the degree of correspondence between the clinical and histopathologic diagnosis of dysplastic nevus. Histologic review of nevi with clinical features of dysplasia from 1,000 individuals demonstrated classic histologic features of dysplasia (as previously demonstrated in melanoma kindreds) in 54.7%. In 20.4% of patients, nevi displayed less convincing or only partially developed features of dysplasia. The remaining patients (24.9%) had nevi of other types. Correspondence between the clinical and histologic diagnosis of dysplasia was best for lesions from the trunk and in individuals beyond the age of 20 years. This study supports the validity of the dysplastic nevus as a clinical and pathologic entity.
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PMID:Histologic correlations with the clinical diagnosis of dysplastic nevus. 229 80

Although screening for melanoma/skin cancer is theoretically of value, few data are available to evaluate its effectiveness or the value of a visual exam by a dermatologist as a cancer screening tool. From the 2560 persons screened for melanoma/skin cancer in Massachusetts in 1986 and 1987, the authors followed the positive screenees to determine their final diagnosis. The authors obtained information on 85% of these persons, and found nine malignant melanomas, 91 non-melanoma skin cancers, 39 dysplastic nevi, and three congenital nevi. The sensitivity of the visual exam by a dermatologist was 89% to 97% and the predictive value positive was 35% to 75% for skin cancer. The authors conclude that the yield of screening is equivalent to that of other major cancer screening efforts and that the sensitivity and predictive value of the visual examination by the dermatologist is appropriate for a cancer screening tool.
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PMID:Evaluation of melanoma/skin cancer screening in Massachusetts. Preliminary results. 229 61

The dysplastic nevus in nonfamilial melanoma is a clinicopathologic entity consistently demonstrating an eightfold or greater association with malignant melanoma. The present report quantifies the relationship between nuclear atypia and 16 architectural and cytoplasmic features in 153 pigmented nevi removed from a similar number of patients with newly diagnosed nonfamilial melanoma. All lesions were evaluated by one dermatopathologist, and most lesions were reviewed by a second dermatopathologist. Nuclear atypia of nevomelanocytes was defined as at least three of the following: nuclear enlargement, pleomorphism, hyperchromatism, and prominent nucleoli easily observed throughout each lesion. Seventeen percent of the total nevi had such atypia. On univariate analysis, 11 parameters (lentiginous hyperplasia of the epidermis, basal melanocytic hyperplasia, junctional nest disarray, fusion [bridging] of theques, suprabasal melanocytes, lymphoid response, prominent vascularity, fibroplasia, abundant cytoplasm, "dusty" cytoplasm, and large melanin granules) showed an association with nuclear atypia (P less than .05). However, on multivariate analysis only five parameters continued to be important: basal melanocytic hyperplasia, junctional nest disarray, melanophages (inverse correlation), prominent vascularity, and large melanin granules. These data support the idea that multiple histopathologic characteristics, correlating objectively with nuclear atypia, are important for the diagnosis of dysplastic nevi. In our view, the minimal essential histologic criteria for dysplastic nevi based on these findings include nuclear atypia and abnormal patterns of intraepidermal nevomelanocytic proliferation (ie, basal melanocytic hyperplasia and/or junctional nest disarray).
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PMID:Correlation of histologic architectural and cytoplasmic features with nuclear atypia in atypical (dysplastic) nevomelanocytic nevi. 203 99

Four cases of malignant melanoma in children younger than 17 years of age are presented. Several preexisting conditions increase the risk of development of melanoma during childhood. These include giant congenital melanocytic nevi, the familial dysplastic nevus syndrome, and xeroderma pigmentosum. The role of small congenital lesions and sporadic dysplastic nevi in the development of melanoma in children is less clear. The signs and symptoms associated with melanoma in children are similar to those in adults, as are the histopathologic features, biologic behavior, and treatment of this tumor. The inadequacy of available therapy for metastatic melanoma underscores the necessity for the early diagnosis and prompt surgical treatment of melanomas in children.
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PMID:Melanoma in children. 203 58

All cutaneous nevomelanocytic specimens accessioned for histopathologic examination at Massachusetts General Hospital, Boston, in 1950, 1960, 1970, and 1987 were reviewed. The specimens were categorized as malignant melanoma, acquired or congenital benign nevi, blue nevi, spindle and epithelioid cell nevi, and dysplastic nevi. Other processes such as lentigines were excluded. There was a threefold increase in percentage of patients having nevomelanocytic lesions removed (1.5% in 1950 to 4.6% in 1987) compared with total surgical cases over the 37-year period. A progressive increase in numbers and percentages of dysplastic nevi (among nevomelanocytic surgical cases) was noted over a 37-year interval--2 cases (1% of nevomelanocytic cases) in 1950, 4 cases (2%) in 1960, 23 cases (5%) in 1970, and 189 cases (12%) in 1987. These findings confirm the existence of dysplastic nevi by histopathologic criteria as early as 1950 and illustrate the frequencies of various nevomelanocytic surgical specimens among all surgical specimens at four points in time over a 37-year period at a major referral center for pigmented lesions.
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PMID:Frequency of dysplastic nevi among nevomelanocytic lesions submitted for histopathologic examination. Time trends over a 37-year period. 232 91

A lentiginous pattern of intraepidermal melanocytic hyperplasia, with mild to moderate, random cytologic atypia, forms the conventional basis for the histologic definition of a dysplastic nevus. It is proposed here that these changes actually represent the histologic pattern of a nevus in an active phase of radial growth. The lesser degrees of atypia considered by others to be required for the diagnosis are suggested to overlap changes commonly seen in banal nevi and lentigines. This hypothesis allows the parsimonious concept that a nevus, originating as a lentigo, can at the later sequential junctional, compound, or intradermal stages expand peripherally by a resumption or persistence of the lentiginous pattern of proliferation. The random atypia that is seen in such lesions is suggested to be incidental to the proliferative process rather than indicative of dysplasia as conventionally defined. A familial melanoma-associated phenotype could be accommodated in this model by postulating a heritable defect in mechanisms that control the number or sizes of these hyperplastic lesions.
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PMID:A hypothesis incorporating the histologic characteristics of dysplastic nevi into the normal biological development of melanocytic nevi. 232 96

Incidence of malignant melanoma of the skin has risen rapidly during the last decades. Mortality rates are also rising, although not so much as incidence rates. There is strong evidence that exposure to sunlight is a major factor in the etiology of melanomas. There appears to be no direct cumulative dose-response relationship, except in the case of lentigo maligna melanoma. Episodes of sunburn among children and young individuals seem to be more important as an etiologic factor for melanoma than chronic exposure to the sun. Very high risk of melanoma exists in persons with dysplastic nevus syndrome. Persons with giant congenital nevi are also at increased risk. However, many melanomas arise de novo. It is our intention to reduce mortality by screening families at risk, by early detection and treatment of melanomas, and by education.
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PMID:[Malignant melanoma--a warning. How to reduce mortality?]. 233 44

Malignant melanoma is increasing in frequency and is becoming one of the leading causes of cancer death. Early recognition and treatment is often curative. Recognition includes the identification of malignant precursors, the dysplastic nevus. Prognosis for survival and disease is dependent upon tumor thickness, level of invasion, anatomic location, growth pattern, ulceration as well as age and sex. Adequate biopsy of suspicious lesions is critical to both diagnosis and prognosis. Wide excision is the treatment of choice, with margins determined by tumor thickness. The management of regional lymph nodes remains controversial. Radical lymphadenectomy is indicated for clinically suspect adenopathy and may improve survival. There does not appear to be significant benefit of elective lymph node dissection for melanomas less than 0.76 mm or greater than 4 mm in thickness. Intermediate lesions may be managed in one of two ways: through careful follow-up with node dissection performed if clinical change is evident; or ELND may be performed. Ongoing trials to determine the benefit of ELND are presently under way. Isolated limb perfusion may be a desirable option for adjuvant therapy in the treatment of extremity melanomas, especially in patients with high-risk lesions or with disease recurrence since improved survival may be achieved. The role of surgical intervention in the management of distant metastases is limited but may have a role in palliation.
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PMID:Malignant melanoma: current management. 233 75

The reported linkage between cutaneous melanoma and the dysplastic nevus syndrome (CM/DNS) to markers located on the distal portion of the short arm of chromosome 1 was examined in three Utah kindreds ascertained for multiple cases of melanoma. Family members in these kindreds were genotyped for the two markers reported to be most closely linked in the Bale study, PND and D1S47. Both melanoma alone and a combined melanoma/DNS phenotype were analyzed; no evidence for linkage was found. By multipoint linkage analysis the CM/DNS locus was excluded from an area of 55 cM containing the PND-D1S47 region. Diagnostic or genetic heterogeneity are alternate explanations for the discrepancy between our observations and those of Bale et al.
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PMID:Evidence against the reported linkage of the cutaneous melanoma-dysplastic nevus syndrome locus to chromosome Ip36. 233 90


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