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)

We examined 2,227 lymph nodes from 100 patients with clinical Stage I cutaneous melanoma for the presence of microscopic deposits of tumor. On examination of hematoxylin-and-eosin-stained sections, none had melanoma. Sixteen nodes from 14 patients had melanoma detectable by an antiserum to S-100 protein in a peroxidase-antiperoxidase (PAP) assay. The melanomatous nature of these cells was confirmed by their reaction with the melanoma-directed monoclonal antibody NKl/C3. The incidence of occult nodal metastases was highest in patients with deeply invasive and micrometrically thick primary tumors. The incidence of occult melanoma was not increased where additional serial sections were cut and semiserial sections examined. Pitfalls in the identification of occult melanoma cells (OMC) include S-100 protein-positive interdigitating dendritic cells, capsular nevus cells, a minority of sinus "macrophages," and the Schwann cells of node-associated nerves. Thus, we conclude that the incidence of early melanoma metastases in the regional lymph nodes of patients with clinical Stage I melanoma is greater than has previously been appreciated on the basis of assessment of routine hematoxylin-and-eosin-stained sections. Six of the 14 patients with OMC died of melanoma (41%), as compared to only 18 of 86 patients without OMC (21%; 0.10 greater than P greater than 0.05).
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PMID:Occult tumor cells in the lymph nodes of patients with pathological stage I malignant melanoma. An immunohistological study. 271 94

A retrospective evaluation of radionuclide liver and spleen scintigraphy (LS), ultrasonography (US), and computed tomography (CT) was performed in 88 patients who had pathologically proven cutaneous melanoma. In patients who had all three examinations (n = 24), the matrix analysis showed that CT was significantly more sensitive (0.94) in detecting intra-abdominal metastasis when compared to US (0.62, P less than 0.05) and LS (0.38, P less than 0.01). Sixty-four patients had only US and LS studies. In this group of patients US was found to be more sensitive than LS, 0.88 and 0.54 respectively (P less than 0.01). Furthermore, when CT was compared with US, CT was shown to detect metastases significantly earlier than US (P = 0.03). Overall, CT provided the most accurate means for detecting the intra-abdominal metastases of cutaneous melanoma.
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PMID:Multimodality detection of metastatic melanoma. 305 99

Cutaneous malignant melanoma (CMM) rates have been increasing in the United States at an average rate of about 4% per year. In 1987, it was estimated that there would be 25,800 cases and 5,800 deaths from CMM in the United States. The exact cause of the increase in unknown, but there is evidence to suggest that increasing exposure to the ultraviolet B (UVB) radiation present in sunlight may be partly responsible. The evidence includes: 1. the fact that higher CMM incidence rates are observed in people with lesser amounts of skin pigment (which blocks penetration of UV); 2. a correlation of higher CMM rates with decreasing latitude and increasing UVB levels; 3. the observation that freckles and nevi (precursors to CMM) are induced by solar exposure; 4. differences in CMM rates between natives and immigrants to sunny climates; 5. high rates of CMM in patients who cannot repair UVB-induced DNA damage; and 6. the indication that sun exposure at early ages and of an intermittent nature results in higher CMM risks. With the concern that depletion of stratospheric ozone could result in increasing levels of UVB, it has become important to understand the relationship between UVB and CMM in order to estimate the increases in CMM that would be expected with ozone depletion. When empirical relationships between UVB and CMM incidence and mortality rates were derived and used to estimate the impact of stratospheric ozone depletion, a 1% depletion of ozone was predicted to result in increases of 1%-2% in CMM incidence and 0.8%-1.5% in CMM mortality.
Cancer Metastasis Rev 1988 Dec
PMID:Cutaneous malignant melanoma and ultraviolet radiation: a review. 306 76

A total of 30 patients with progressively growing visceral and/or cutaneous malignant melanoma metastases were entered in a prospective phase II trial comparing three different therapeutic regimens of recombinant interferons (r-IFN). The first group of 12 patients received r-IFN alpha A 9-36 IU/day i.m. on 5 consecutive days/week. A second group of 11 patients was treated with r-IFN alpha A and oral cimetidine, 1000 mg/day. The third group of 7 patients had i.v. infusions of r-IFN gamma 0.25-0.5 mg/m2 on 3 days/week. Of the 12 r-IFN alpha A-treated patients, 1 responded (complete response, CR), 5 patients exhibited no change (NC), 3 patients had progressive disease (PD), and 3 patients could not be evaluated after therapy. In the group treated with r-IFN alpha A plus cimetidine 3 patients responded (1 CR, 2 partial responses) and 3 exhibited NC. The remaining patients showed PD. Treatment responses were found exclusively in patients with cutaneous and/or lymph node metastases. In contrast, none of the r-IFN gamma-treated patients responded to therapy. Known IFN side effects of varying degrees, sometimes severe, were observed in all patients. Despite the small numbers of patients treated, our preliminary data indicate that r-IFN alpha A therapy seems (1) to be of some therapeutic value in the treatment of cutaneous melanoma metastases, (2) to be superior to r-IFN gamma therapy, and (3) that overall response rates improve with the addition of oral cimetidine to r-IFN alpha A treatment.
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PMID:Comparison of the effects of three different treatment regimens of recombinant interferons (r-IFN alpha, r-IFN gamma, and r-IFN alpha + cimetidine) in disseminated malignant melanoma. 311 65

A review of 35 consecutive cases of tumors metastatic to the orbit revealed that the primary tumor site was breast in 18 cases (51%), prostate in 6 cases (17%), lung in 2 cases (6%), gastrointestinal tract in 2 cases (6%), kidney in 1 case (3%), cutaneous melanoma in 1 case (3%), contralateral choroidal melanoma in 1 case (3%), and unknown in 4 cases (11%). The most common presenting signs and symptoms included diplopia with noncomitant strabismus, proptosis, and a palpable mass. In nine cases (26%), the orbital metastasis was detected in patients with no prior history of cancer. The average patient survival after the diagnosis of orbital metastasis was 13 months. Orbital metastasis from lung carcinoma carried the worst prognosis, with an average survival time of only 4 months. A summary of the clinical features of these 35 cases and a review of the literature on orbital metastatic disease will be presented.
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PMID:Tumors metastatic to the orbit. 315 25

In 93 patients dying from metastatic melanoma the primary tumor was unknown in 13 (14%) after autopsy. There were no significant differences compared to cutaneous melanoma with respect to sex, age, organ distribution of metastases or final tumor load. An unknown primary was, however, significantly more common in cases presenting with general metastases compared to regional spread. The causes of death were similar to cutaneous cases. Our data suggest that melanoma of unknown origin has the same predilection and biology as metastatic cutaneous melanoma, supporting the view that regression of a cutaneous primary may be involved.
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PMID:Metastatic melanoma of unknown origin at autopsy. 318 40

Cutaneous malignant melanoma often metastasizes to the lung, bone, liver, subcutaneous tissue, and lymph nodes. Six cases of malignant melanoma metastatic to the orbit are presented, five from cutaneous melanomas and one from a contralateral choroidal melanoma. Melanoma rarely metastasizes to the orbit, but when orbital involvement occurs, widespread metastases are already present. Twenty-two cases were reviewed from the literature; 13 of 14 patients, with sufficient follow-up data, had widespread metastases when they presented with orbital disease. Extraocular muscles appear to be a favored site of metastases. The mean time from orbital presentation to death was 4 months. Orbital metastases from a distant melanoma is, therefore, part of a widespread metastatic process. Treatment should be directed toward palliation.
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PMID:Melanoma metastatic to the orbit. 323 41

Cutaneous melanoma is rapidly becoming a potentially curable cancer if it is detected and properly treated in an early phase of development. Unlike other cancers, which are usually hidden from detection until they are relatively large or metastatic disease has occurred, cutaneous melanoma is readily detectable simply by examining the skin. Information is now available that will be useful in selecting individuals at greatest risk. The most important melanoma risk factors (in decreasing order of importance) for a given individual are as follows: a persistently changed or changing mole, adulthood, irregular varieties of pigmented lesions (including dysplastic moles and lentigo maligna), a congenital mole, Caucasian race, a previous cutaneous melanoma, a family history of cutaneous melanoma, immunosuppression, sun sensitivity, and excessive sun exposure. Selective screening and appropriate treatment of individuals who have these risk factors may reduce the morbidity and mortality of cutaneous melanoma.
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PMID:Risk factors for cutaneous melanoma. A practical method of recognizing predisposed individuals. 331 89

Melanomas diagnosed in 29 cats over an 11 year period included 19 ocular (16 intraocular, three palpebral), five oral, and five dermal melanomas. Intraocular melanomas involved the ciliary body and iris in 12; the whole eye was involved in four. The average age of cats with intraocular melanomas was 11 years; the female : male ratio was 9 : 7. Histologically, eight intraocular tumors were mixed, six were epithelioid, and two were spindle cell. Ten of 16 cats (62.5%) with intraocular melanomas were killed because of the tumor at a mean of 156 days; four are living with no evidence of disease (average, 255 days). The mean time of death in cats with palpebral melanoma was 409 days. Metastasis occurred in 63% of cats with intraocular melanoma and all cats with palpebral melanoma. Four cats with oral melanoma were killed at a mean of 61 days; all had metastasis. Of five cats with cutaneous melanoma, one was killed with metastasis at 90 days; three cats were alive without evidence of recurrence or metastasis greater than 365 days after surgery. Results of this study indicate that in the cat, ocular melanomas are more common than oral and dermal melanomas, and ocular and oral melanomas are more malignant than dermal melanomas, with higher rates of mortality and metastasis.
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PMID:Feline melanoma: a comparative study of ocular, oral, and dermal neoplasms. 336 87

The authors have studied the natural history of 377 patients with Stage I cutaneous malignant melanoma followed at the Arizona Cancer Center, Tucson. Two hundred eight patients, or 55%, remained free of metastatic disease after a median follow-up of 30 months. The survival at 5, 8, and 10 years was 69, 65, and 63%, respectively. Natural breakpoints in Breslow thickness for survival occurred at 0.85, 1.95, and 4.00 mm. These are not significantly different from those found by other investigators. A step-down multivariate analysis using the Cox regression model yielded four factors as highly significant in predicting survival: Breslow thickness (P less than 0.001), an age/sex interaction (P = 0.0012), clinical ulceration (P = 0.0039), and a prophylactic node dissection (P = 0.019). No predictive value for a BANS or non-BANS location was detected. These results are discussed in reference to other large series which describe the natural history of cutaneous melanoma.
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PMID:Cutaneous malignant melanoma (Arizona Cancer Center experience). I. Natural history and prognostic factors influencing survival in patients with stage I disease. 340 89


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