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

The incidence of metastasis in cutaneous melanoma is proportional to maximal tumor thickness. The relationship is linear for extremity melanoma but not for tumors from all body sites, probably due to intrinsic differences in tumors from different sites. The level of invasion of the tumor is an indirect measure of tumor thickness and is not as accurate in predicting metastases because of the marked variation in thickness within each level. The implications of these observations for the treatment of melanoma are discussed.
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PMID:Prognostic factors in the treatment of cutaneous melanoma. 47 39

From 1964 to 1976 a number of 131 patients, suffering from melanoma of the choroid have been treated with 106Ru/106Rh beta-ray applicators. In 81 cases (61.8%) this treatment has been successful. 26 eyes (19.9%) had to be enucleated in spite of the irradiation. 24 patients (18.3%) died, 13 of them of metastases. Only in 46 patients, out of 81, we have reached total destruction of the tumor with flat chorioatrophic scar. In 27 cases visual acuity of 1.5 to 0.5 could be preserved. Radiogenic late complications in the capillary system with disturbances of the retinal blood circulation were the cause of visual deterioration. The 107 surviving patients were controlled during a period of 6.5 years in the average. Survival rate 91.2% after 5 and 84% after 10 years. Another group of 214 patients with melanoma of the choroid, who had been treated from 1955 to 1970 by enucleation reached a survival rate of 72% after 5 years. Treatment with 106Rh beta-irradiation therefore leads to no increased danger of metastases. The following indications for this treatment are suggested: 1. Prominence of the tumor not exceeding 5 mm, largest diameter at its base not more than 15 mm. 2. Distance of the dorsal edge of the tumor at least 1-2 optic disc diameters from the nerve head. 3. Peripheral delimitation against the ciliary body. 4. No tumor growth outside the eye.
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PMID:[Radiotherapy of intraocular tumours, particularly of melanoma of the choroid (author's transl)]. 48 Aug 51

In an attempt to define the role of scintiscanning in patients with a malignant melanoma, 349 liver, bone and brain scans in 136 patients have been reviewed. No patient with clinical Stage I or II disease was found to have occult metastases detected by scintiscans. All patients with proved positive scans demonstrated clinical symptoms consistent with the results of scintiscanning. Scintiscans in patients with a malignant melanoma are most effectively used to evaluate the symptomatic patient with Stage I or II disease and all patients with Stage III disease. Histologic verification of positive scans in patients with Stage I and II disease avoids unwarranted therapeutic decisions. There is, however, practical value in being able to predict accurately the absence of metastatic involvement. In only two of 249 examinations did the scans fail to detect metastases. A normal scan is a strong indicator of the absence of metastatic disease.
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PMID:Scintiscans in the evaluation of patients with malignant melanomas. 48 38

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

4 cases with intraocular metastases of primary skin melanoma are described. In 2 patients the diagnose could be confirmed by histological examination of the primary skin tumor and the involved eye. The poor prognosis of patients suffering from melanotic intraocular metastases indicates only a palliative ophthalmological treatment.
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PMID:[Intraocular metastases of primary malignant melanoma of the skin. Observation of 4 cases (author's transl)]. 49 41

Sinclair swine melanoma usually regresses in vivo. In the present study, swine melanoma cells were adapted to long-term growth in culture. The morphology of cultured melanoma cells ranged from dendritic to cuboidal, similar to that described for human melanoma cells. Doubling times of the swine melanoma cells were also similar to those of human melanoma cells in vitro. 3,4-Dihydroxy-L-phenylalanine oxidase-positive cells were detected by light microscopy, and melanin and premelanosomes were detected by electron microscopy. Cell cultures could be propagated from progressing, partially regressed, and primary cutaneous lesions, as well as from visceral metastases. Thus, it appears that, under these cell culture conditions, Sinclair swine melanoma cells can be adapted to prolonged growth in vitro.
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PMID:Adaptation of Sinclair swine melanoma cells to long-term growth in vitro. 49 21

A retrospective study of the clinical findings and natural history of 140 patients with disseminated malignant melanoma treated at Wayne State University over a ten year period was done. Multiple organ metastases were diagnosed clinically in 78 per cent of all patients and seen at all autopsies. Routine roentgenograms of the chest did not diagnose metastases to the lung in 27 per cent of the patients. The concimitant elevation of alkaline phosphatase, serum glutamic-oxalacetic transaminase and serum glutamic-pyruvic transaminase enzymes is suggestive of underlying metastases to the liver even with a negative liver scan or normal liver size. Electroencephalography was found to be sensitive in predicting and confirming metastases to the central nervous system prior to clinical manifestation with a 97 per cent accuracy rate in clinically confirmed instances as compared with a 60 per cent accuracy rate with brain scan. Age, sex and primary site of melanoma did not influence the survival once the disease became disseminated. Patients with a disease-free interval of more than six months statistically have a better chance of survival from the onset of systemic metastases, p = 0.001. Patients with a poor performance status of less than or equal to 40 per cent had a median survival period of one month as compared with six months with 90 per cent performance, p = 0.001. Patients who initially presented with metastases to the skin or lymph nodes without other visceral involvement had a 14 month median survival rate as compared with eight months in patients with metastases to the central nervous system only, four months with metastases to the liver and only one month in patients with multiple organ involvement, p = 0.0001.
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PMID:Clinical presentation, natural history and prognostic factors in advanced malignant melanoma. 50 43

A case of metastatic tapioca melanoma of the iris in a 12-year-old girl is reported. The patient had heterochromia, a red painful eye, and was treated for iritis with secondary glaucoma. In the course of 5 months iris lesions with the clinical appearance of tapioca pudding developed, and biopsy disclosed a melanoma. The eye was immediately enucleated, and pathological examination showed a melanoma with predominantly epithelioid-type cells which had infiltrated the angle, the posterior chamber, and the surgical wounds. Conjunctival extension was noted 10 months after enucleation, and regional lymph node metastases were found 4 months later. Previously reported cases are reviewed and compared with the present case.
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PMID:Metastatic tapioca iris melanoma. 50 89

Three instances of malignant melanoma of the larynx are reported. Tumour localization and infiltration are described and the differentiation from normal and pathological tissue changes is discussed. It is noted that distant metastases present late.
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PMID:[Malignant melanoma of the larynx (author's transl)]. 52 38

Since May 1968 a total of 2.108 regional lymph nodes (l.n.) dissected from 201 melanoma patients (86 axillary, 107 groin, and 8 neck) have become available for study. The purpose was to detect histological differences between the l.n. of 134 patients lacking and those of 67 patients exhibiting l.n. metastases, histologically verified in 104 of 706 nodes. The main finding is a more than six-fold increase in number and an eleven-fold increase in total area (evaluated by a microscope micrometer) of germinal centers in the lymph follicles of patients with, as compared to those without, l.n. metastases (P less than or equal to 0.05). Paracortical areas were found to be diminished in 56.7% of cases with metastatic spread. Accumulations of plasma cells were mainly seen in the nodes of elderly patients (48.4%) and of those exhibiting regional metastases (47.8%). The observation of numerous and dilated blood vessels in the interfollicular regions noticeably corresponded to the occurrence of lymphatic metastases (P less than or equal to 0.01), suggesting a "tumor angiogenic factor". A negative correlation with metastatic involvement was found as to histiocytosis of marginal sinuses and with respect to the observed fibrinoid hyalinosis of pulp vessels (P less than or equal to 0.01). The marked hyperplasia of lymph node B-lymphocyte regions as opposed to diminished T-lymphocyte areas prevailing in cases with metastatic melanoma is in accord with findings of humoral immunologic blocking activity and impaired T-cell response in advanced malignant melanoma.
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PMID:Comparative histological studies of regional lymph nodes of 201 melanoma patients. (Microscopic features in relation to individual age, site, and metastatic spread). 52 44


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