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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This review of 117 melanomas occurring in 115 patients treated by a single surgeon suggests the appropriateness of the therapeutic decisions to be mentioned based upon tumor behavior, determined by microstaging. Local control of level II lentigo maligna melanoma was achieved, in most instances, by local excision with visibly free margins and primary closure. In most of the other instances of melanoma, adequate local control was accomplished by wide three-dimensional excision, 5 centimeter margins--closure usually required grafting. Minor amputation was performed with satisfactory results in those patients with appropriate lesions in the volar-subungual area. Regional lymphadenectomy in patients with level IV and V disease in whom the tumors drained to a single node basin revealed occult metastases in 25 per cent of the patients and, therefore, appears warranted as prophylactic treatment. Preliminary data on recurrences suggest that the frequency of the recurrence paralleled the biologic aggressiveness of the tumor, determined by microstaging in association with the presence or the absence of lymph node metastases.
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PMID:The treatment of malignant melanoma of the skin. 34 7

The results of treatment of 42 cases of lentigo maligna and 16 of lentigo maligna melanoma at the New York University Medical Center was reviewed. The recurrence rate after surgical excision of 22 lesions of lentigo maligna was 9% (2/22), but after treatment of 20 such lesions with destructive techniques (X rays, curettage-electrodesiccation, cryosurgery), it was 35% (7/20). Of 11 cases of lentigo maligna melanoma that were excised, none recurred locally, but fatal metastases ensued in one case. Five patients who were eventually classified as having lentigo maligna melanomas had been treated by destructive techniques. In four of them there were local recurrences and in two, metastases as well; the fifth patient had metastases without local recurrence. On the basis of this review of these 58 cases, we conclude that surgical excision and careful histologic study of step sections through the entire lesion insure accurate diagnosis and provide the highest cure rates for lentigo maligna and lentigo maligna melanoma.
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PMID:Treatment of lentigo maligna and lentigo maligna melanoma. 48 14

We report a group of neuroid, cutaneous tumors that are usually associated with, or preceded by a melanocytic dysplasia. For this clinicopathologic entity we have chosen the term neurotropic melanoma. The neurotropic melanoma is a cutaneous fibrous tumor whose clinical course is characterized by local infiltration, multiple recurrences, and commonly by metastases. Its microscopic picture is characterized by atypical "neuroma-like" patterns, by poorly defined margins, and by neurotropism. Its early or precursory melanocytic dysplasias include lentigo maligna (actinic or lentigo maligna variant), and a melanoma with borderline cytologic characteristics (minimal deviation variant). A third type is not preceded by a recognizable melanocytic dysplasia: it has "neuroma-like" qualities at its inception (de novo variant). In our 22 cases, the preponderant sites were the head, neck, and lip. The patients were fair-faced, and 18 of the patients were over 40 years old. Seventeen patients had one or more recurrences. Of 16 patients with follow-up, nine died with evidence of disease, five are alive with active disease, and seven are apparently free of disease.
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PMID:Neurotropic melanoma. A variant of desmoplastic melanoma. 53 14

Cutaneous malignant melanoma occurs in three forms: lentigo maligna melanoma, superficially spreading melanoma, and nodular melanoma. The histology, the clinical development and the biological malignancy of these tumours differ. The purpose of the study reported here was to provide a clearer picture of the surface morphology of the malignant cells and to relate their fine structure to both the tumour type and the clinical development of the malignant melanoma. This investigation of 28 tumours from 22 patients of Scandinavian origin shows that at the electron microscope level there is no difference between malignant cells in the invasion nodulus of superficially spreading melanoma and nodular melanoma. The primary tumours were often built up of 2 or 3 differently differentiated cell clones. Metastases were built up of the same cells or cell clones that were found in the primary tumour. In several cases the surface of the malignant cells was folded, and covered with microvilli, microblebs and blebs. These surface alterations could be related in several cases to changes in the cytoskeleton of the cell (microtubuli and microfilament complexes). The clinical course of the malignant melanoma could best be correlated to the histogenetic type of tumour, depth of invasion, nucleus polymorphy and the quantity and arrangement of the microfilament complexes.
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PMID:Cutaneous malignant melanoma. Studies on the find structure of cells and their surface morphology in relation to tumour type and clinical course. 54 76

The neoplastic system of human cutaneous melanoma includes three generaly recognized variants: lentigo maligna, superficial spreading melanoma, and nodular melanoma. Lentiginous melanomas other than lentigo maligna constitute a fourth group, of which plantar lentiginous melanoma qualifies as an anatomic subgroup. Histologically and clinically, plantar lentiginous melanoma (PLM) is characterized by a period of radial growth and often by one or more foci of regression. In 27 of 33 plantar melanomas, a characteristic lentiginous, radial component of melanocytic proliferation was noted. In the remaining six cases, histological material failed to document a radial component. Eighteen of the 27 patients with PLM were blacks, and 18 patients died of distant metastasis. Tumors invasive to level II did not metastasize, but at levels IV and V and in tumors with a high mitotic rate, the prognosis was poor. The presence of lymph node metastases at the time of initial therapy correlated with a poor prognosis group.
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PMID:Plantar lentiginous melanoma: a distinctive variant of human cutaneous malignant melanoma. 60 75

We have attempted to describe virtually all forms of malignant melanoma which affect man except those arising in the eye. The vast majority of malignant melanomas clearly fall into one of three kinds: (1) malignant melanoma of the superficial-spreading type, (2) malignant melanoma of the lentigo-maligna type, and (3) malignant melanoma of the nodular type. The developmental biology of a primary neoplasm is illustrated by discussing and illustrating the evolution of these three dominant forms of melanoma. Primary malignant melanoma of the superficial-spreading type and of the lentigo-maligna type develop through a characteristic biphasic growth pattern: an initial radial-growth phase, followed by a vertical-growth phase. The radial-growth phase of these melanomas is only rarely associated with the development of metastases, while the vertical-growth phase is commonly associated with subsequent metastatic disease. The phenomenon of the vertical-growth phase is apparently, therefore, a qualitative step in the development of a primary malignant melanoma. Malignant melanoma of the nodular type is an example of a primary tumor without a precursor developmental stage such as a radial-growth phase.
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PMID:The developmental biology of primary human malignant melanomas. 79 May 75

Sixteen patients were treated for melanotic freckle of Hutchinson (lentigo maligna) with the Miescher technique of x-ray therapy. Eleven patients had no local cutaneous recurrences of persistence following x-ray therapy. Five patients had local recurrence or persistence of their lesions. Three patients developed metastatic malignant melanoma. The first of these three patients had lentigo maligna melanoma, and the second patient had a melanotic freckle with atypical cells extending down the adnexae, including the sweat apparatus to the level of the coiled portion of one sweat gland. The third patient was considered to be in a precancerous phase at the time of irradiation. Nevertheless, metastases occurred. European colleagues indicate that they have not experienced such problems in using the Miescher technique. The procedure has been abandoned in our department, pending further clarification of the discrepancy between our results and those reported by our European colleagues.
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PMID:Treatment of melanotic freckle with x-rays. 94 13

In a total of 70 malignant melanomas we searched for dendritic-branched fluorescent pigment cells. Hereby we found that dendritic-branched tumor cells are especially characteristic in cases of lentigo maligna. In the flat parts of these lesions, these cells are the predominant cell type. Dendrites in the pseudonests or nodular parts of lentigo maligna can only seldom be detected. The prevailing cell type in superficial spreading melanoma and in primary nodular melanoma is the round or oval unbranched tumor cell. In some cases of nodular melanoma, cells with short dendrites could be seen. In superficial spreading melanoma, dendritic tumor cells could be observed particularly in such tumor parts, in which the malignant cells were scattered between the keratinocytes. Melanocytes can evidently produce dendrites between cells of the sebaceous gland. In the marginal parts or in parts of regression of some superficial spreading melanomas, a great area of dendritic tumor cells could also be detected in the basal parts of the epidermis. Altogether, however, in superficial spreading melanoma and in nodular melanoma they occur only rarely. Dendritic-branched cells are also visible in lymph-node metastases of SSM and NM. The fact that the dendritic tumor cells can be observed in all 3 types of tumors (according to Clark and coworkers) gives a rise to a new discussion of the dualistic theory of melanoma-histogenesis of Mishima. Although this theory could not be disproved, up to now on the basis of the present results, an unitarian development of all types of mnelanoma from melanocytes seems to be possible.
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PMID:Melanin-producing dendritic cells and histogenesis of malignant melanoma. 100 13

Three patients with biopsy-proven lentigo maligna were treated with topical 5-fluorouracil. Treatment consisted of twice daily application of 5% 5-fluorouracil cream for 13, 6, and 9 weeks, respectively. Two patients demonstrated presence of invasive melanoma; in one the melanoma was evident before chemotherapy, and in the other the lesion became evident after chemotherapy. In both the lentigo was treated topically and the melanoma excised locally. Posttreatment followup times through April 1, 1974 have been 42, 24, and 22 months, respectively. There has been no evidence of metastases in any patient. Topical chemotherapy with 5-fluorouracil cream appears to offer an encouraging alternative method of therapy for lentigo maligna of the face.
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PMID:Topical chemotherapy of lentigo maligna with 5-fluorouracil. 111 40

By labelling dermal infiltrate cells with H3-thymidine, two types of skin tumours can be distinguished: one type with many labelled cells in the infiltrate (H3-thymidine labelling index, H3-I), the other with few labelled cells. Type I includes malignant melanoma (H3-I = 2.2%) and hemangioendothelioma (2.8%). Type II includes metastases of malignant melanoma (1%), squamous cell carcinoma (1.1%), basel cell epithelioma (0.5%), nevus cell nevus (0.6%), and nevoid lentigo (0.4). The number of labelled cells in the cellular reaction of Type II tumours does not differ significantly from that in normal human corium (0.75%), though there may be a dense cellular reaction. DNA-synthesizing cells were classified with the aid of characteristical stainings and histochemical methods. A vast majority of them were found to be lymphocytes. Our research underlines the special importance of cellular inflammatory reaction, i.e. cellular immunity, im malignant melanoma and probably in hemangioendothelioma.
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PMID:Lymphocyte stimulation in the cellular inflammatory reaction of some human skin tumours. 120 Jul 1


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