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

The adaptation of the principles of electrocoagulation to controlling symptomatic cutaneous metastatic disease is discussed. The technique permits minimal anesthesia, excellent hemostasis, local control, satisfactory cosmesis with reduced hospitalization. Two illustrative cases are reported of metastatic malignant melanoma and metastatic leiomyosarcoma.
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PMID:Electrocoagulation: palliative surgery to control metastatic cutaneous malignancy. 8 49

An aged gray stallion was examined because of fullminating posterior paresis, bladder paralysis, and perineal anesthesia. Lower motor neuron dysfunction was detected at the lumbosacral level of the spinal cord, and cerebrospinal fluid was yellow. After brief supportive treatment, the horse died. Necropsy revealed a single epidural melanoma at L5-6. The absence of cutaneous melanotic growth, absence of organ involvement, and extensive vertebral remodeling indicated the neoplasm to have been primary and to have been present for an extended period. Neurologic dysfunction was acute and progressive, as a result of spinal cord compression by the neoplasm.
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PMID:Epidural melanoma causing posterior paresis in a horse. 87 44

Nail biopsy is a safe and useful diagnostic procedure for many nail disorders when routine clinical and laboratory methods fail to produce a diagnosis. Prerequisites for nail biopsy are an understanding of the surgical anatomy of the nail, adequate anesthesia and hemostasis, and a nail abnormality for which histopathology can provide the diagnosis. Indications and methods for nail biopsy vary according to the site and type of pathology in the nail unit. Nail bed and perionychial biopsies can be performed easily and with minimal scarring. They are most commonly used to diagnose tumors as well as infectious and inflammatory disorders of the nail. The most important reason to biopsy the nail matrix is to make or exclude the diagnosis of melanoma in a patient with longitudinal melanonychia. Great care must be taken in nail matrix biopsy to minimize the risk of permanent nail dystrophy.
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PMID:Nail biopsy. Indications and methods. 833 92

From January 1988 to December 1989, 920 patients with pigmented cutaneous lesions, clinically diagnosed as suspected or certain cutaneous melanoma (CM), underwent excision under local anaesthesia as outpatients. Histological examination confirmed CM in 135 patients. Patients in this group whose initial excision was for biopsy purposes only (extending 1-2 mm beyond the lesion margin) underwent a subsequent radical excision (extending greater than or equal to 10 mm from the neoplastic margin). The second resection was carried out within 10 to 15 days of the first, on an outpatient basis if the thickness of the CM was less than or equal to 2 mm, and in hospital if it was greater than 2 mm. The clinical diagnosis proved correct in 88 cases (65%) where exeresis was the definitive surgical treatment. Outpatient surgery seems to be the best method for easing a workload dominated by the need to examine a growing number of pigmented skin lesions, without altering the prognosis for CM.
Melanoma Res
PMID:Outpatient surgical treatment of cutaneous melanoma. 142 94

The outline of the surgical treatment of a primary cutaneous malignant melanoma may be divided into the problems of biopsy, definitive excision and reconstruction of the defect. An excisional, in contrast to an incisional, biopsy provides the full scope of prognostic parameters and should be used whenever possible. General anesthesia is not necessary, and frozen-section examination is inaccurate. An immediate excision biopsy should therefore be performed under local anesthesia as an outpatient procedure. Whenever possible, a margin of 10 mm should be used, as this would mean an adequate and definitive treatment in melanomas up to 1 mm, and possibly 2 mm, in Breslow thickness. In melanomas more than 1-2 mm in thickness a 3-cm free margin instead of a 5-cm free margin is recommended. Many patients, especially those with trunk lesions with a 3-cm free margin may not need a complicated repair, such as a skin graft or a flap. The excision in depth is recommended to be carried perpendicular to the skin and inclusion of underlying fascia is optional, as no study has proved it to be beneficial. The defect after the excision should whenever possible be closed directly. If this is not possible the defect is covered with either a skin graft or a flap and the latter is recommended from both a cosmetic and a functional point of view. If a skin graft has been used, the secondary defect may be reconstructed with a skin expansion technique.
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PMID:Surgical management of primary melanoma. 143 46

Melanoma is still the most frequent cause of death for diseases arising in the skin. The mortality rate is approximately 25%, tumor thickness, sex and localization being the most important prognostic factors. It is still unclear whether the margin of excision, type of anaesthesia and the pattern of follow-up should be taken into consideration in relation to the individual prognostic groups.
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PMID:[Controversial aspects of stage I skin melanomas]. 146 49

Fine-needle aspiration biopsy (FNAB) specimens obtained from nine consecutive iris lesions were examined. The lesions included primary malignant melanoma (four cases), metastatic melanoma, metastatic adenocarcinoma, leukemic infiltrate, lymphocytic infiltrate, and epithelial ingrowth. Subsequent histopathologic correlation was performed in all cases. Patient treatment influenced by the results of the FNABs included enucleation (three cases), clinical observation (two cases), external beam irradiation (two cases), resection, and radioactive plaque application. No complications occurred from the FNABs. Fine-needle aspiration biopsy of the iris can be performed with local anesthesia at the slit lamp as an outpatient procedure. In general, FNAB is a safe, effective method of obtaining diagnostic material from primary neoplastic, secondary neoplastic, and degenerative processes involving the iris. Limitations of the procedure include discrepancies in interpretation of the cytologic study and inadequate specimen.
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PMID:Fine-needle aspiration biopsy of the iris. 163 83

The authors report four patients whose initial symptom of tumor recurrence or progression was unilateral numbness of the chin. Two patients had Hodgkin lymphoma, one had malignant melanoma, and one had prostate cancer. Physical examination was notable only for unilateral anesthesia of the chin and lower lip. Diagnostic evaluation, including computed tomography (CT) scan and magnetic resonance imaging (MRI) of the brain, plain radiographs of the mandible, and cerebrospinal fluid analysis for protein, glucose, and cytology were normal. Bone scans revealed osseous lesions in the axial skeleton of all patients, whereas only two patients had abnormal uptake in the mandible. The authors conclude that in the setting of a negative evaluation for central nervous system (CNS) or local mandibular disease, mental neuropathy is associated with recurrent or progressive skeletal disease. In addition, to document relapsed or progressive cancer, the skeletal system may have to be examined at sites distant from the mandible.
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PMID:Mental neuropathy (numb chin syndrome). A harbinger of tumor progression or relapse. 843 71

As the incidence of melanoma continues to increase, so does the role of the dermatologist as both medical and surgical oncologist for these patients, especially those with stage I disease. The dermatologist holds a key role in all phases of care, including prevention, diagnosis, treatment, and follow-up. The dermatologist is best trained to complete a full and thorough skin examination and is best able to recognize a melanoma at its earliest stages of radial growth. In large part because of advances in dermatology, the dysplastic nevus syndrome has been identified as an important marker and precursor lesion for melanoma; the dermatologist has the best knowledge base for the recognition and management of both sporadic and familial dysplastic nevi. Dermatologists also have the unique opportunity (by virtue of their patient population concerned with skin problems) to prevent melanoma through patient education concerning sun protection, self-examinations, and the ABCDs of melanoma recognition. The dermatologist is well trained to obtain an appropriate, full-thickness skin biopsy specimen and is also knowledgeable to interpret the pathologist's report, understanding the significance of the various histologic prognostic indices. Because of the changing trends in excisional margin size and fewer recommendations for ELND, the dermatologist is becoming more active in the surgical management of melanoma patients. In the MDMC, the dermatologist was clearly recognized as a capable surgeon to perform the wide local excisions for stage I patients. Almost one half of the patients seen (49%) were surgically treated in the department of dermatology. Of group I patients, 78% were treated by dermatologists. The dermatologist as surgeon should be capable of performing a wide local excision to the level of deep subcutaneous tissue or muscle fascia with an appropriate primary layered closure, local flap, or graft. Our experience confirms that the majority of patients present with local disease and a thin Breslow depth and thus can be skillfully treated in an outpatient setting under local anesthesia by a dermatologic surgeon. In follow-up, the dermatologist should provide continuity of care and should be knowledgeable in appropriate interval examinations and tests. The dermatologist is thoroughly skilled at the cutaneous examination and has the knowledge base to perform a careful and competent lymph node examination. As primary medical oncologist to these patients, the dermatologist needs to recognize stage II and stage III disease and be able to comprehensively discuss with the patient the options for treatment and how they affect their prognosis.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Changing trends in melanoma treatment and the expanding role of the dermatologist. 193 41

The nails are the largest appendage of the skin. They provide protection of the tactile regions of the fingers; moreover, well cared-for nails are an attribute of beauty. Operations of the nails should, therefore, regard both functional and cosmetic aspects. Surgical procedures are indicated in the case of nail deformities, bacterial or mycotic infections, as well as pigmentation of the nail wall or plate, and periungual or subungual tumors, which are always suspicious of malignant melanoma. All operations of the nail region can be performed in Oberst's anesthesia. We recommend the preoperative application of a tourniquet to stop the blood flow.
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PMID:[Surgical interventions of the nail organ]. 229 Dec 86


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