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

A case is presented highlighting the unusual features and the value of MRI in the assessment of metastatic malignant melanoma of the parotid gland.
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PMID:MRI and malignant melanoma of the parotid gland. 1158 3

Magnetic resonance imaging with dedicated surface coils plays a pivotal role in differential diagnosis and staging of intraocular tumors. The purpose of this study was to establish MRI criteria for the differential diagnosis of uveal melanomas and intraocular metastases. In a prospective study 44 eyes in 36 patients with intraocular metastases and 200 patients with uveal melanomas were investigated with MRI using a 1.5-T scanner and a 5-cm surface coil. Both quantitative and qualitative evaluation of the resulting images was performed. The MR signal intensities typically expected for metastases (slightly hyperintense on non-contrast T1-weighted images and hypointense on T2-weighted images compared to the vitreous body) were seen in only 23.1%. The typical melanoma signal of either moderate or strong hyperintensity on T1-weighted images and hypointensity on T2-weighted images was seen in 69.4% of the proven melanomas. Contrast enhancement was observed in both metastases and melanomas. Morphological differences between metastases and melanomas were detected in tumor size, shape, position, frequency of retinal detachment, and homogeneity of the tumor. Differentiation between intraocular metastases and uveal melanoma is limited by overlap of signal intensities. Some improvement is achieved with morphologic criteria.
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PMID:Intraocular metastases: differential diagnosis from uveal melanomas with high-resolution MRI using a surface coil. 1173 65

Because the tongue is superficially located and the initial manifestation of most diseases occurring there is mucosal change, lingual lesions can be easily accessed and diagnosed without imaging analysis. Some lingual neoplasms, however, may manifest as a submucosal bulge and be located in a deep portion of the tongue, such as its base; their true characteristics and extent may be recognized only on cross-sectional images such as those obtained by CT or MRI. Some uncommon tongue neoplasms may have characteristic radiologic features, thus permitting quite specific radiologic diagnosis. Lipomas typically manifest at both CT and MR imaging as homogeneous nonenhancing lesions. Relative to subcutaneous fat they are isoattenuating on CT images, and all MR sequences show them as isointense. Due to the paramagnetic properties of melanin, metastases from melanotic melanoma usually demonstrate high signal intensity on T1-weighted MR images and low signal intensity on T2-weighted images. Although the radiologic findings for other submucosal neoplasms are nonspecific, CT and MR imaging can play an important role in the diagnostic work-up of these unusual tumors. Delineation of the extent of the tumor, and recognition and understanding of the spectrum of imaging and the pathologic features of these lesions, often help narrow the differential diagnosis.
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PMID:Radiologic-pathologic correlation of unusual lingual masses: Part II: benign and malignant tumors. 1175 68

Lymph node size, the accumulation of a nodal lymphotrophic contrast agent (LCDIO), and MRI were compared as methods for detecting nodal metastases in an experimental murine model. Lymph node metastases (B16-F1 melanoma expressing green fluorescent protein (GFP) and C57BL/6 mice) were generated to obtain a wide spectrum of nodes, including normal nodes and nodes bearing micrometastases, small metastases, or large metastases. Nodal uptake of LCDIO was measured using (111)Indium-labeled LCDIO and was found to be lower in micrometastastic nodes (4.20 +/- 1.4%ID/gm) than in normal nodes (8.60 +/- 0.22% ID dose/gram, P < 0.005). Nodal tumor burden was quantified from the amount of GFP present in nodes measured using the Western blot method, and was found to correlate with the decrease of LCDIO uptake. By MRI, nodes bearing small and large metastases contained regions of high signal intensity (SI) that corresponded to the visual pattern of tumor in nodes. Micrometastatic nodes were distinguishable from normal nodes based on a diffuse pattern of inhomogeneous SI. The signal-to-background ratio (SBR) of normal nodes (0.0112 +/- 0.0061) was different from micrometastatic nodes (0.179 +/- 0.080, P < 0.00046) and nodes bearing small metastases (0.723 +/- 0.269, P < 0.00013), with high degrees of significance.
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PMID:Detection of lymph node metastases by contrast-enhanced MRI in an experimental model. 1181 Jun 72

A thirty-five year old woman presented with bilateral neck, chest wall and back masses. She was 16 weeks pregnant. Lymph node excision revealed metastatic poorly differentiated adenocarcinoma of unknown primary. Abdominal ultrasound showed a mildly enlarged spleen and a 2-3 cm porta hepatis node. All other investigations were negative. The lymph node and cutaneous metastases progressed rapidly so it was decided to initiate systemic chemotherapy with a view to delivery at 28 weeks gestation by Caesarean section. Shortly after the second 3-weekly cycle of cisplatinum chemotherapy the patient suffered severe lower back and hip pain with MRI scan showing multiple bony metastases in the pelvic girdle. Ultrasound revealed the fetus to have been dead for at least 10 days. The products of conception were delivered following medical induction of labour. Two days later the patient suffered a cardiac arrest from which she could not be resuscitated. Placental histology revealed extensive metastases. With the exception of melanoma this has rarely been reported in solid adult malignancy. As a cause of fetal death, placental metastases are extremely rare.
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PMID:Intra-uterine death resulting from placental metastases in adenocarcinoma of unknown primary. 1210 24

The localisation of metastasis in muscle is rare and is discovered mainly during autopsy. Skeletal muscle metastasis may occur in the case of leukaemia, lymphoma, melanoma, thyroid, gastrointestinal tract and breast carcinoma. However the most frequent aetiology is lung cancer. We describe the case of a 67-year-old woman, suffering from epidermoid lung carcinoma localised in both upper right lobes, treated surgically with success. Two months after surgery, she complained of pain and a sensation of swelling in the adductor muscles of the left hip with important restriction of mobility. A MRI scan of the hip showed an ovoid mass between the obturator extemus and the adductors muscles on the left side. Biopsy of the infiltrated muscles showed proliferation of carcinomatous tissue.
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PMID:Muscular metastatic infiltration from pulmonary epidermoid carcinoma. 1218 41

The hypothesis that solid tumors are dependent on angiogenesis, the formation of new vessels, for outgrowth and metastasis has acquired a central position in cancer research and has since inspired many scientists for several decades. Among the various angiogenic stimuli that are secreted by tumor cells, members of the Vascular Endothelial Growth Factor (VEGF) family are most prominent. More recently it has become clear, however, that tumors may use alternative ways to obtain blood supply. Vessel co-option, the use of pre-existent vessels, was described first in the brain, one of the most densely vascularized organs in the body. Thus, brain tumors may develop without the need of an angiogenic switch to occur. Obviously, this way of blood supply will not be affected by angiogenesis inhibition. In addition, it is predicted that tumors with this type of behavior will be less visible in contrast-enhanced MRI. In this article we present our recently developed mouse brain model of vessel co-option in melanoma. The effects of expression of VEGF on tumor vascularity, and on MRI visualization of these brain lesions are described. Possible consequences of anti-angiogenesis therapy are discussed.
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PMID:Vessel co-option: how tumors obtain blood supply in the absence of sprouting angiogenesis. 1220 Sep 59

Brain metastases occur in 20-40% of patients with cancer and their frequency has increased over time. Lung, breast and skin (melanoma) are the commonest sources of brain metastases, and in up to 15% of patients the primary site remains unknown. After the introduction of MRI, multiple lesions have outnumbered single lesions. Contrast-enhanced MRI is the gold standard for the diagnosis. There are no pathognomonic features on CT or MRI that distinguish brain metastases from primary malignant brain tumors or nonneoplastic conditions: therefore a tissue diagnosis by biopsy should be always obtained in patients with unknown primary tumor before undergoing radiotherapy and/or chemotherapy. Some factors are prognostically important: a high Performance Status, a solitary brain metastasis, an absence of systemic metastases, a controlled primary tumor and a younger age. Based on these factors, subgroups of patients with different prognosis have been identified (RPA class I, II, III). Symptomatic therapy includes corticosteroids to reduce vasogenic cerebral edema and anticonvulsants to control seizures. In patients with newly diagnosed brain metastases prophylactic anticonvulsants should not be used routinely. The combination of surgery and whole-brain radiotherapy (WBRT) is superior to WBRT alone for the treatment of single brain metastasis in patients with limited or absent systemic disease and good neurological condition. Complete surgical resection allows a relief of intracranial hypertension, seizures and focal neurological deficits. Radiosurgery, alone or in conjunction with WBRT, yields results which are comparable to those reported after surgery followed by WBRT, provided that lesion's diameter does not exceed 3-3.5 cm. Radiosurgery offers the potential of treating patients with surgically inaccessible metastases. Still controversial is the need for WBRT after surgery or radiosurgery: local control seems better with the combined approach, but overall survival does not improve. Late neurotoxicity in long surviving patients after WBRT is not negligible; to avoid this complication patients with favorable prognostic factors must be treated with conventional schedules of RT, and monitoring of cognitive functions is important. WBRT alone is the treatment of choice in patients with single brain metastasis not amenable to surgery or radiosurgery, and with an active systemic disease, and in patients with multiple brain metastases. A small subgroup of these latter may benefit from surgery. The response rate of brain metastases to chemotherapy is similar to the response rate of the primary tumor and extracranial metastases, some tumor types being more chemosensitive (small cell lung carcinoma, breast carcinoma, germ cell tumors). New radiosensitizers and cytotoxic or cytostatic agents, and innovative technique of drug delivery are being investigated.
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PMID:Management of brain metastases. 1238 50

We performed conventional and dynamic susceptibility-contrast MRI imaging in 38 patients with brain tumours: 20 with metastases (breast carcinoma: two; renal carcinoma: five; colorectal carcinoma: one; lung carcinoma: seven; melanoma: five), and 18 with high-grade astrocytomas. We obtained cerebral blood volume (CBV) maps and calculated the relative CBV (rCBV) in different areas using the ratio between the CBV in the pathological area (CBVp) and in the contralateral white matter (CBVn). We calculated the maximum rCBV (rCBVmax) for each tumour and compared the mean rCBVmax in each group of tumours. The mean rCBV of melanoma metastases (5.35+/-2.32, range 3.14-9.23) and of renal carcinoma metastases (8.17+/-2.39, range 5.41-11.64) were significantly greater than those of high-grade astrocytomas (2.61+/-1.17, range 1.3-5.0) ( P=0.002 and <0.001, respectively) and of lung carcinoma metastases (2.94+/-0.86, range 1.43-4.04) ( P=0.003 and 0.002). There was no statistically significant difference between the mean rCBV of lung metastases and of high-grade astrocytomas ( P=0.59). Large, solitary, necrotic metastases can be indistinguishable from high-grade astrocytomas using conventional MRI. Demonstration of an elevated rCBV which may suggest a hypervascular lesion such as renal carcinoma or melanoma.
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PMID:Dynamic contrast-enhanced MRI: differentiating melanoma and renal carcinoma metastases from high-grade astrocytomas and other metastases. 1252 54

The clinical and hematologic features in 22 patients with metastatic carcinoma of bone marrow were observed and analyzed. Morphology of bone marrow cells, bone marrow biopsy and other accessory examinations were performed. The primary or cardinal symptoms of metastatic carcinoma of bone marrow included anemia (17 cases, 77.3%), ostealgia (10 cases, 45.5%), fever (8 cases, 36.4%), hemorrhage (4 cases, 18.2%) and complicated hemolytic anemia (4 cases, 18.2%). The primary carcinomas, diagnosed by pathologic and accessory examinations, include gastric carcinoma (6 cases, 27%), lung cancer (3 cases, 13.6%), ovarian cancer (2 cases, 9%), mammary cancer, prostatic carcinoma, osteocarcinoma and metastatic malignant melanoma (1 case, respectively), and unknown primary lesion (7 cases, 31.8%). The hematologic features were decrease of hemoglobin (17 cases, 77.3%) and blood plate count (16 cases, 72.7%), leukocytosis (11 cases, 50%), immature leukocytes (14 cases, 63.6%) and erythrocytes (9 cases, 40.9%) seen on the peripheral blood smear, and reticulocytosis (4 cases, 18.2%). Masses of metastatic carcinoma cells can be frequently seen at two sides and tail of bone marrow smear. Bone marrow biopsy of 8 cases demonstrated the infiltration of carcinoma cells with nest-like distribution in the bone marrow cavity. Examination of MRI in 6 case showed destruction of bone and corpus vertebra and abnormal signal focus. Bone marrow biopsy could contribute to improve the accuracy of diagnosis and determine the origin of primary carcinoma. MRI plays an important role in diagnosis of metastatic carcinoma in bone marrow.
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PMID:[Analysis of Clinical and Hematologic Features in 22 Patients with Metastatic Carcinoma of Bone Marrow] 1257 68


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