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

Based on antitumor effects observed with vaccinia virus infected tumor cell lysate in animal models, adjuvant immunotherapeutic clinical trials were undertaken in patients with melanoma using vaccinia virus infected melanoma oncolysate (VMO). Preliminary clinical trials showed that the VMO is safe except minimal side effects such as mild fever, pain, and tenderness at the site of VMO injection, and mild lymphadenopathy. The effective dose of VMO was investigated in a following trial using 0.05 to 2.0 mg doses of VMO. Clinical responses and laboratory monitoring of melanoma-specific antibody responses decided the 2 mg dose of VMO is optimal for future trials. In all the clinical trials, patients showed moderate responses and their postimmune sera contained melanoma-specific antibodies. In a Phase II clinical trial completed August 1985 19 of 39 stage II patients had a disease-free mean survival time of 24.6 months, statistically significant compared with historical controls. Because of compelling evidence of significant clinical responses in patients treated with VMO adjuvant immunotherapy in the Phase II trial, a prospective randomized multi-institutional double-blind Phase III adjuvant VMO immunotherapeutic trial using adjuvant therapy of vaccinia virus alone as control, was recently initiated. Results of this trial are anxiously anticipated.
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PMID:Active specific immunotherapy with vaccinia melanoma oncolysate. 131 7

We report a case of anorectal melanoma, whose first manifestation was a carcinomatous meningitis. The anorectal melanoma is a rare tumor of great malignity which represents 1-3 per cent of melanomas and 0.5 per cent of anorectal tumors. The most frequent symptoms are non-specific: rectal bleeding, pain at defecation, changes in the intestinal rythm. Sixty per cent of cases presented metastasis at the moment of diagnosis limited to the regional lymph nodes. In none of the cases published did the metastasis present as the first symptom. The case presented here manifested itself only with neurologic symptomatology compatible with carcinomatous meningitis whose finding led to the search of the original tumor, and this is what makes this case exceptional since the infrequency of this tumor is united to an unusual clinical presentation, not previously described in the literature.
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PMID:[Leptomeningeal carcinomatosis as a form of presentation of anorectal melanoma]. 154 36

Presenting signs and symptoms of 193 patients with choroidal melanomas (followed for up to 152 months) were recorded using retrospective chart review. Eighty patients (41%) had no symptoms (the melanoma was found during routine ophthalmologic examination in 65 patients and during treatment for other eye problem in 15 patients). We found 113 patients (59%) had symptoms (visual acuity or visual field defects, 77 patients; flashes or floaters, 30 patients; pain, 5 patients, and metastatic disease, 1 patient). The tumor size was related to the presence or absence of symptoms (chi-square, 10.6; P = .005). More tumors that presented with symptoms were medium sized (64%) than large (27%). Men had significantly more symptoms (chi-square, 4.1; P = .04). The right eye was more likely to be involved in patients with symptoms (chi-square, 7.3; P = .007). Kaplan-Meier survival analysis for age, sex, presence of tumor or retinal detachment in the macula, tumor location, presence of symptoms, laterality, and tumor size showed that only tumor size was related to a difference in incidence of metastasis (log-rank chi-square, 12.9; P = .002). With increased tumor height, the probability of developing metastasis was greater.
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PMID:Presenting signs and symptoms of choroidal melanoma: what do they mean? 163 29

Palliative amputations were performed on 11 patients (7 men, 4 women) with disseminated disease to control local bony complications. The average patient age was 54 years (range 14-78 years). The primary diseases were melanoma/sarcoma (seven patients) and carcinoma (four patients). All had pain; eight had intractable pain that could not be controlled by analgesics. All 11 patients had additional severe local complications, which included recurrent pathological fracture (4), sepsis (2), hemorrhage (2), radiation necrosis (2), and iliofemoral thrombosis secondary to tumor (1). Previous attempts of palliation had been made in all 11 patients, and 8 had undergone previous operative procedures (5 had undergone two or more) prior to amputation. Three anterior hemipelvectomies, five posterior hemipelvectomies, two hip disarticulations, and one forequarter amputation were performed. All patients survived the surgery, and there were no intraoperative complications. All patients received dramatic relief of pain. Postoperative complications included two cases of flap necrosis and two infections; all resolved satisfactorily. The six patients who were nonambulatory before surgery ambulated postoperatively, and two eventually ambulated with a prosthesis. Six of 11 patients survived 1 year or longer, with a median postoperative survival period of 13 months (average 16 months). Although major amputations are viewed at times as offering little to already-compromised patients, they can improve dramatically the quality of life in selected patients.
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PMID:Major amputations done with palliative intent in the treatment of local bony complications associated with advanced cancer. 171 53

Malignant melanoma is the most common metastatic lesion of the intestine. Surgical consultation is often sought when bowel metastases become symptomatic. To determine the role of surgical intervention in such cases, a database of 6,000 melanoma patients was examined, and a subset of 102 patients with small intestinal or colonic metastases were identified premortem. Common presenting features included abdominal pain with or without acute symptoms (29% of patients), obstruction or intussusception (27%), and bleeding (26%). The presence of metastatic lesions was confirmed by surgical exploration in 80% of patients, endoscopic procedures in 11%, and percutaneous biopsy in 5%. Cure was achieved in 36 patients by resection, which resulted in the removal of all demonstrable disease. The subsequent mean length of survival in this group was 31 +/- 5.2 months. Forty-two patients underwent palliative enteric bypass or debulking procedures, and 24 patients received either chemotherapy alone or symptomatic treatment. The average length of survival in these latter groups was 9.6 +/- 15.9 and 9.6 +/- 3.6 months, respectively, both of which were significantly less than the duration of survival in the complete resection group (p less than 0.05). Small or large bowel resection for bleeding or obstruction and enteric bypass for obstruction provided symptomatic relief in 92% of patients thus treated. There was no operative mortality in the series. An aggressive search for resectable disease in patients with symptoms secondary to intestinal metastases from malignant melanoma should be performed. Surgical intervention may then allow the palliation of pain, obstruction, and bleeding. Survival can be significantly prolonged if it is possible to remove all demonstrable disease.
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PMID:Role of surgical intervention in the management of intestinal metastases from malignant melanoma. 171 36

A 49 year-old woman underwent a palliative abdominoperineal resection because rectal adenocarcinoma that produced pain, bleeding and transanal tumor protrussion. Histologic studies showed and amelanotic melanoma. She died 3 months later. Any pigmented lesion in the anorectum must be excised to rule out melanoma. In some cases abdominoperineal resection may be done but as the majority of patients have metastases at the time of diagnosis, paliative wide local excision is the preferred treatment of this highly letal neoplasm.
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PMID:[Non-pigmented melanoma of the rectum]. 181 13

We report a metastatic cutaneous melanoma of the medial rectus muscle of the right orbit which presented with diplopia, exophthalmos and retrobulbar pain. Radioimmunoscintigraphy using melanoma-specific monoclonal antibody was used to confirm the diagnosis and to show the presence of disseminated disease in other areas. Effective palliation was achieved with external beam irradiation.
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PMID:Metastatic melanoma of the orbit. A case report. 185 17

The association of choroidal detachment with malignant choroidal tumors is not well recognized. The authors' experience with six cases suggests that choroidal detachment may be associated with both metastatic tumors and choroidal melanoma. In two of these cases, the choroidal or retinal detachment was so massive that echography was necessary to detect the underlying tumor. Three patients presented with painful visual loss, and three patients presented with painless visual loss or a visual field defect. In one patient, the correct diagnosis and appropriate treatment of the choroidal metastasis with external radiation relieved the patient's pain and improved visual acuity from 1/200 to 20/35. Metastatic and primary uveal malignant tumors should be added to the list of causes of choroidal detachment and can be excluded only after thorough clinical, and often echographic, examination.
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PMID:Choroidal detachment associated with malignant choroidal tumors. 186 52

Selective heating of irregularly shaped tumors at depth can now be accomplished through focussing and controlled scanning of energy deposition patterns by ultrasound. A scanned focussed ultrasound (SFUS) hyperthermia system developed at the University of Arizona has been used to deliver 220 treatments to 87 tumors in 71 patients with extracranial malignancies between October 1986 and May 1990. Patients received an average of three SFUS hyperthermia treatments, spaced weekly, during ongoing fractionated radiotherapy. The most common anatomic sites treated were the pelvis (22 patients), chest wall or breast (14), neck (8), and axilla (7), while the most common histologies were adenocarcinoma (36), squamous cell carcinoma (11), and melanoma (10). Concurrent radiotherapy was delivered (range 1000-7640 cGy, mean 4320 cGy) to 67 SFUS hyperthermia patients; 4 received concomitant chemotherapy. Tumor volumes ranged from 1-2100 cubic centimeters (mean 325 cc), and 75% were located at depths greater than 3 cm from skin. A 62% overall response rate was observed, with 22% of treated tumors demonstrating a complete response (defined as complete disappearance of treated tumor), and 40% exhibiting a partial response (defined as greater than or equal to 50% reduction in tumor volume). Dramatic local pain reduction was achieved in 42% of the tumors treated. The acute tolerance of SFUS hyperthermia was quite good, and chronic toxicities (persistent skin blisters/burns) were identified in two patients. The versatility of the SFUS system is discussed, as well as its future potential for improving control of advanced loco-regional malignancies treated with curative intent.
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PMID:Development of scanned focussed ultrasound hyperthermia: clinical response evaluation. 186 73

Multiple cutaneous and superficial subcutaneous metastases from malignant melanoma in 30 patients were treated palliatively by carbon dioxide laser ablation when lesions were to numerous, too large or recurring too rapidly for multiple local excisions. The number of lesions per patient ranged from three to 250 (median 30). Patients were treated under local or general anaesthetic and as day cases or inpatients. After a median follow-up interval of 8 months fewer than 1 per cent of lasered metastases have recurred locally. Sixteen patients have developed cutaneous metastases at other sites requiring further treatment. Approximately 2000 lesions have been treated on 64 occasions. Patients reported little or no pain after the operation and required only simple dry dressings. Wounds were completely healed in 2-6 weeks with good cosmetic results. This simple and effective treatment is becoming an alternative to isolated limb perfusion.
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PMID:Carbon dioxide laser ablation of cutaneous metastases from malignant melanoma. 190 20


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