Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Recent studies suggest that a partial mole with a triploid karyotype has little tendency to invade and metastasize and usually requires no therapy other than evacuation. This report describes three patients with a mole of normal diploid karyotype coexisting with a living fetus. Each patient had persistent elevation of human chorionic gonadotropin. Two patients required chemotherapy; one of these had invasive mole. The partial mole with normal diploid karyotype is a distinct clinical entity with the potential for malignant sequelae. The possibility of twin gestation cannot be excluded.
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PMID:Partial hydatidiform mole with diploid karyotype: report of three cases. 650 34

The Merkel cell is a distinctive nondendritic, nonkeratinocytic, epithelial clear cell believed to migrate from the neural crest to the epidermis and dermis, which is usually located in or near the basal layer of the epidermis and associated with nerve terminations. Merkel first described these cells in 1875 as "Tastzellen" occurring in the snout of a mole. They are believed to function as slowly adapting mechanoreceptors that mediate the sense of touch. Tumors arising from Merkel cells have been reported to occur on the head and neck area, the trunk, arms, and legs, and resemble a primary cutaneous lymphoma or cutaneous metastasis of a lymphoma or a carcinoma. Electron microscopy, to locate the characteristic membrane-bound, dense core neurosecretory granules, is needed for accurate diagnosis. These tumors must be treated aggressively to minimize the chance of local recurrence and nodal or visceral metastases. The authors present a case of Merkel cell tumor occurring on the eyelid. The clinical history, light and electron microscopic findings are shown.
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PMID:A Merkel cell tumor of the eyelid. 667 39

In 585 cases with primary cutaneous stage I malignant melanoma (294 disease-free for at least 5 yr, 291 with later metastases) prognostic parameters were examined. The most effective proved to be tumor thickness and mitotic activity, particularly when combined as a prognostic index. Furthermore, vascular invasion, ulceration in thick tumors (thickness greater than or equal to 3.0 mm), severe cellular atypia, the small, lymphocytic-like cell type and the absence of an inflammatory reaction were closely associated with a high rate of metastatic cases. Less relevant prognostic factors were the level of invasion, sex, site, tumor breadth, clinical diameters and infiltrative growth. Tumor type, age, duration and an adjacent nevocellular nevus were not significantly associated with the occurrence of later metastases. Furthermore, the growth-type (exo- or endophytic) did not have a bearing on the prognosis.
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PMID:Low- and high-risk malignant melanoma--I. Evaluation of clinical and histological prognosticators in 585 cases. 668 68

We have embarked upon a pilot study of photoradiation therapy (PRT) in the treatment of persistent or recurrent cancer of the head and neck, utilizing the photosensitizing agent, hematoporphyrin derivative (HPD). This treatment is based upon selective concentration of HPD within malignant tissue, with resultant necrosis upon illumination with light of the appropriate wavelength (640 nm). Patients entered in this trial have failed all forms of conventional therapy. Twenty-one patients with local recurrence were treated. Sites of recurrence were: tongue (9); nasopharynx (3); floor of mouth (2); soft palate (2); oropharynx (1); buccal mucosa (1); maxilla (1); larynx (1); and basal cell nevus (1). There were six complete responses and twelve partial responses (greater than 50% reduction). These responses are clinically significant, with some complete responses lasting over 1 year after a single course of therapy. Ten patients with cutaneous metastases from head and neck primary tumors were also treated. There were two complete responses and three partial responses. However, these patients rapidly developed new tumors in areas adjacent to those previously treated. Less than complete responses could be augmented by repeated applications of this technique. The success of this pilot study combined with the accessibility of head and neck primaries suggest that there should be a clinical trial of HPD-PRT in early mucosal cancer of the head and neck region.
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PMID:Photoradiation therapy of head and neck cancer. 669 52

A case of giant hairy nevus is presented in which prominent experts on diagnosis of this type of lesion were consulted. About half were of the opinion that it had degenerated into a malignant melanoma, but nevertheless the patient is alive and relatively well sixteen years after this diagnosis. This is one more case that attests to the fact that a tumor can appear very malignant histologically but, for reasons still unclear, neither metastasize nor lead to the rapid demise of the patient.
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PMID:Malignant melanoma without metastasis in a giant nevus. 674 26

A model for a metastasizing melanoma was developed, and its characteristics were established. Sixty-five albino guinea pigs were painted with 7,12-dimethylbenzanthracene in acetone. There was evidence that, after 18 months, 40% of the animals developed melanomas. Melanomas arose by a malignant transformation of junctional nevus cells and/or by transformation of amelanotic melanocytes. Metastases to the skin and internal organs were multiple and eventually fatal for the animals. Histology and electron microscopy of induced melanomas were reviewed in detail. Clinical and histological events leading to development of melanoma in albino guinea pigs were found to be similar to human melanomas in a number of aspects. Fragments of melanomas were successfully transplanted to "nude" mice and healthy albino guinea pigs. The described model could be used for study of the various cellular and tissue events which precede nevus, lentigo maligna, and melanoma formation. It could also be useful in studying carcinogenic potential, for studying development of metastases, and presumably for trials of treatment.
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PMID:Skin melanoma induced by 7,12-dimethylbenzanthracene in albino guinea pigs and its similarities to skin melanoma of humans. 677 35

We studied 14 prognostic factors in 428 patients with clinical stage I melanoma to determine which factor or combination of factors was associated with death from melanoma from 24 to 60 months following diagnosis. Forty-eight patients (11 percent) died during this period. All 17 patients who had visceral metastases present at 24 months died during this period. All surviving patients were followed for at least 60 months. Individual high risk factors included ulceration width (as determined by histology), level IV or V tumor, recurrence other than visceral, 6 or more mitoses per square millimeter, presence of involved nodes on elective dissection, absent or slight lymphocyte response, tumor type other than superficial spreading, location other than extremities (excluding hands and feet), microscopic satellites, thickness, sex, and wide local excision. The presence of sex as a risk factor for patients dying from 2 to 5 years following diagnosis is noteworthy because no sex difference was noted in the early death (less than 24 months) group. Age, presence of a nevus, and histologic regression were not significant factors. A logistic regression analysis selected a combination of the following independent factors: (1) location on extremities excluding hands and feet (favorable), (2) thickness, (3) recurrence other than visceral, (4) positive elective nodal dissection, (5) 6 or more mitoses per square millimeter, and (6) moderate to marked lymphocyte response (favorable). Twenty-five percent of patients with level IV lesions died between 24 and 60 months compared with only a 6 percent death rate within the first 24 months.
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PMID:Factors associated with death from melanoma from 2 to 5 years following diagnosis in clinical stage I patients. 685 55

In a clinicohistopathologic study of 557 patients with primary cutaneous malignant melanoma, there were fewer metastases and/or deaths from melanoma when histologic evidence of a coexisting acquired melanocytic nevus was found. A total of 130 patients with melanocytic nevus and 427 cases of melanoma without histologic evidence of a nevus (denovo) were studied. Clinical follow-up evaluation for evidence of metastases and/or death was obtained. Only ten of the patients (7.7%) with nevus-associated melanoma had metastases and/or death v 78 (18.3%) with de novo melanoma. When stratified by lesion thickness, the logrank test for survival revealed a statistically significant difference between the two groups. An overall favorable outcome seen in patients with malignant melanomas associated with acquired melanocytic nevi was found, therefore, to be independent of lesion thickness as well as six other variables reported to be related to the biologic behavior of malignant melanoma. Thus, the presence of nevus cells in a specimen of malignant melanoma portends a better prognosis and may have important implications in the biology of this neoplasm.
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PMID:Favorable prognosis for malignant melanomas associated with acquired melanocytic nevi. 685 85

A congenital nevus removed from a 20-year-old woman was found to contain a minimum deviation melanoma. Subsequently, there were multiple nodular recurrences in the region of the excision as well as in the grafted skin. Microscopically the recurrent lesions closely resembled the original nevus, including the junctional activity and even the grafted skin. Lymph node metastasis occurred 5 1/2 years after excision of the nevus. This is the first report of a minimal deviation melanoma arising in a congenital nevus with epidermotropic metastases.
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PMID:Minimal deviation melanoma with epidermotropic metastases arising in a congenital nevus. 699 Aug 6

Of 3,305 patients with malignant melanoma seen at the Park Medical Group, New York, during the period from 1935-1975, there were 1,128 (34%) melanomas of the trunk. There were 646 melanomas of the skin of the chest wall (20% of all melanomas) and 482 melanomas of the abdominal wall (15%). Of 646 patients treated more than ten years ago, 138 were indeterminate as they were seen only in consultation or with evidence of blood-borne disseminated melanoma. Of the determinate 516 patients, 148 are free of evidence of melanoma after ten years, giving an absolute ten-year survival rate of 29%. All patients who died or who were lost to followup were considered to have died from the melanoma. Of 386 patients with melanoma of the thoracic wall, 296 were determinate, of which 88 (30%) have survived the ten-year period. Of the 260 patients with melanoma of the abdominal wall, 220 were determinate and 60 (27%) are alive and well ten years post treatment. Of 340 males, 74 survived the ten-year period (22%), much lower than the 32% ten-year survival of the 148 females. A preceding mole which existed in 254 patients resulted in a ten-year survival rate of 45%, much higher than the 116 patients whose moles arose de novo, of which 27% survived the ten year period. Of fifty patients with superficial melanomas, 34 (68%) survived ten years. The ten-year survival of 386 patients with infiltrating melanomas was 22%. The ten-year survival for patients in Stage I was 59%. Of 262 patients in Stage II, the ten-year survival rate decreased to 14% and for the 60 patients in Stage III, the ten-year survival rate was 7%. The situation was the same for melanomas of the chest wall as well as for the abdominal wall. Elective node dissection was performed in 122 patients with Stage I melanoma and in 42 (34%), microscopic evidence of melanoma was observed. The ten-year survival of patients with positive nodes was 38%. In 62 patients, no elective node dissection was performed and in 26 (42%), clinical evidence of metastases developed later. Of these, six (23%) survived the ten year period after a therapeutic lymph node dissection. We conclude that melanomas over 1 ml in depth (Breslow's classification), or Levels III, IV and V in Clark-Mihm's classification, elective regional lymph node dissection is warranted. Further studies are necessary to determine the exact treatment procedures for the superficial (Level II) melanomas. Level I melanomas should not be included in a report of metastasizing malignant melanoma.
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PMID:Malignant melanoma of the trunk: a retrospective review of 1128 patients. 705 34


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