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)

A rare observation of melanoma developing in the presence of the cellular blue nevus of the ear lobe with a comparatively favourable course is presented. Melanoma metastases appeared in the right parotid salivary gland and lymph nodes 25 years after removal of the primary tumor and 7 years of survival after parotidectomy and fascial dissection of the cervical adipose tissue.
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PMID:[Melanoma developing from a cellular blue nevus]. 666 Oct 77

We report a case of malignant blue nevus (MBN) of the foot with unusual morphologic presentation of nodal metastases. Their structure resembled neurosarcoma, and differed from the appearance of the primary tumor. This case confirms the mutual close histogenic relationship between MBN and neurosarcoma, both tumors originating from the structures of the neural crest. We also discuss the problem of so-called "benign" metastases of malignant melanoma.
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PMID:Malignant blue nevus with neurosarcoma-like lymph node metastases. 778 Jun 99

Blue nevus is an uncommon pigmented lesion of dermal melanocytes. By convention, two well defined histologic variants, designated as "common" and "cellular", have been recognised. In the last few years, these lesions have attracted much attention due to the recognition of news entities and to its confusion with malignant melanoma. In the present review, we point out the more striking features of new related entities (combined nevus, deep penetrating nevus, compound blue nevus) and establish the differential diagnosis with conflictive lesions such as atypical blue nevus, locally aggressive blue nevus, congenital giant melanocytic nevus with nodular growth and melanocytic dermal tumor of unpredictable outcome. We also review the concept of malignant blue nevus and the significance of lymph node metastases. The blue nevus is an uncommon pigmented lesion consisting of dermal melanocytes that can appear in diverse forms: dendritic, spindle-shaped, oval-shaped, or polyhedral. Although it usually occurs in skin, it has been reported in other locations, such as oral mucosa, sclera, uterine cervix, vagina, prostate, spermatic cord, pulmonary hilus, orbit, conjunctiva, maxillary sinus, breast, and lymph nodes 3,8,42,49. Generally, it occurs in adults as a single, acquired, intensely pigmented lesion, although familial and multiple nevi have been reported 7,39. By convention, there are two well-defined histologic variants, designated as "common" and "cellular", but lesions often manifest intermediate features. In the last few years, blue nevus has attracted much attention due to the recognition of new (clinical and histologic) entities and to its confusion with malignant melanoma.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Blue nevus: classical types and new related entities. A differential diagnostic review. 798 22

A 65-year-old man presented with a history of a giant blue plaque of the parietal scalp since childhood. Biopsy revealed a cellular blue nevus. The blue nevus was observed for 10 years and thought to be unchanged until a new adjacent lesion was noted. Biopsy of the new lesion revealed metastatic malignant melanoma. A wide excision was performed of the original lesion which revealed malignant melanoma arising in a blue nevus. Areas within the blue nevus were consistent with a pilar neurocristic hamartoma, whereas other areas were consistent with a common blue nevus. Subsequent satellite metastases developed, with early metastases resembling blue nevi except for the absence of a stromal component and the presence of hyperchromatic nuclei. Later metastases were typical of metastatic melanoma. This case illustrates the uncommon evolution of malignant melanoma from a blue nevus. The histological features and relationship between melanoma, blue nevus, and pilar neurocristic hamartoma are reviewed.
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PMID:Malignant melanoma arising in a blue nevus with features of pilar neurocristic hamartoma. 830 Sep 32

The malignant blue nevus is an aggressive dermal melanocytic neoplasm. The lesion occurs most frequently on the scalp of men in their fifth decade of life, often metastasizes to the regional lymph nodes, and commonly results in fatality. Controversy exists as to whether this lesion is a malignant melanoma in the dermis or a separate neoplasm arising in the architecture of a cellular blue nevus. The lesion is treated with wide local excision and close monitoring for the occurrence of metastatic disease.
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PMID:A pigmented scalp nodule: malignant blue nevus. 882 47

We report a patient who developed malignant transformation of a cellular blue nevus. At the age of 19 years the congenital, pigmented tumor on the left buttock was histopathologically diagnosed as cellular blue nevus. Thirty years later the tumor dramatically increased in size, involving the entire left buttock within several months. Multiple biopsies revealed the presence of a cellular blue nevus within the papillary dermis and an invasive, pleomorphic pigmented sarcoma in the depth of the tissue spreading into subcutis and skeletal muscle. Both benign and malignant cells were S100+, vimentin+ and HMB-45+, but only the malignant tumor cells stained positive for the proliferating cell nuclear antigen. General examination disclosed multiple metastases in the paraaortal lymph nodes and the retroperitoneum as well as a single brain metastasis. Despite palliative therapy with ionizing radiation and chemotherapy, the patient developed generalized metastases and died within weeks. This case clearly confirms that cellular blue nevi have the potential for malignant transformation and that the malignant variant may behave aggressively just as a malignant melanoma.
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PMID:[Malignant blue nevus with metastasis to lymph nodes and brain]. 899 29

The current classification of malignant melanomas gives recognition to superficial spreading melanoma, lentigo maligna melanoma, acral lentiginous melanoma, and nodular types. In addition, neurotropic and desmoplastic types are recognized. The relativity inherent in the diagnosis of melanoma, provides the basis for the classification of melanomas on the basis of size. Lesions measuring 1 mm or less in vertical dimensions are unlikely to metastasize; they qualify as borderline melanocytic neoplasia of indeterminant malignant potential. The current classification has little relevancy to the category of variant nevi with the exceptions of malignant cellular blue nevus and melanoma arising in giant congenital nevi. A classification of variant melanomas as related to variant nevi is proposed. From a different perspective, a classification of melanomas with attention to nesting and cytological patterns in vertical growth is proposed: this alternate approach gives recognition to lesions that might otherwise be classified as "nevoid" melanomas. It also provides a default category for lesions that might otherwise be assigned to the Spitz nevus-like category. All of these tools for the manipulation of the real and virtual images of melanomas have been emphasized in the concept of minimal deviation melanoma.
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PMID:Variants of melanoma. 922 May 53

A 70-year-old woman had noticed, at the age of 30, a single blue nodule of about 1 cm in size on her scalp. The lesion remained stable until 1991, when it became larger and ulcerated and, because of the sudden onset of additional macules and nodules around it, the patient presented at our Dermatological Division in August 1992. Physical examination showed a blue-black plaque, 2 x 2 cm in size, on the left parietal area of the scalp, surrounded by several blue-grey pigmented nodules and macules (Fig. 1). Chest X-ray, abdomen scan, and a total body computed tomography (CT) scan were negative for metastatic disease. A wide resection of the scalp lesion was performed. The histologic evaluation revealed a dense collection of spindled melanocytes in the dermis and in the subcutaneous fat. Nuclear and cytoplasmic pleomorphism, some mitotic figures, and necrosis foci were present (Figs 2 and 3). Pictures of cellular blue nevus were found in the surrounding lesions. Ten months later, new blue macular and papular lesions appeared in proximity to the surgical scar. The patient refused any additional surgery, and so was treated with dacarbazine (DTIC) 800 mg intravenously (every 20 days) and 2 alpha interferon (3 million units subcutaneously, three times weekly). The growth of the lesions slowed down for a few weeks, and then increased again to become a wide, blue-black vegetating mass (Fig. 4). In June 1995, a total body CT scan revealed multiple focal nodules on the lungs and two metastatic masses on the eighth segment of the liver. A palliative polychemotherapy, with vindesin 3 mg/m2 and DTIC 400 mg/m2, was started, but did not stop the progression of the disease, and the patient died in December 1996.
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PMID:Malignant blue nevus of the scalp. 954 69

Carney complex, a familial multitumoral syndrome, comprises spotty skin pigmentation (lentigines and blue nevi), myxomas (heart, skin, and breast), endocrine tumors (adrenal cortex, pituitary, testis, and thyroid), and schwannomas. The skin pigmentary abnormality included two unusual conditions, epithelioid blue nevus and psammomatous melanotic schwannoma. The former tumor occurred on the extremities and trunk, less frequently on the head and neck; was multiple; and did not recur or metastasize. Clinically, it was pigmented, domed, and small (< 1 cm). Microscopically, it displayed two types of melanocytes--one intensely pigmented, globular, and fusiform and the other lightly pigmented, polygonal, and spindle. Nuclei of the latter cells were vesicular, with pale chromatin and single prominent nucleolus. None recurred or metastasized. The psammomatous melanotic schwannoma occurred in posterior spinal nerve roots, upper alimentary tract, bone, and skin. Microscopically, it was circumscribed but incompletely encapsulated and contained spindle and epithelioid cells, melanin, psammoma bodies, and fat. The spindle cells were arranged in interlacing fascicles, with whorling and occasional nuclear palisading. Twenty-one patients (68%) were alive without evidence of the neoplasm; two of these each had two local recurrences. Seven patients died, three (10%) as a result of metastasis.
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PMID:Epithelioid blue nevus and psammomatous melanotic schwannoma: the unusual pigmented skin tumors of the Carney complex. 971 72

Cutaneous metastases from melanoma can mimic primary melanoma and melanocytic nevi. Recognition of a metastatic lesion is of great importance for proper staging and treatment decisions. In this study, a potential diagnostic pitfall is described and discussed: dermal metastases from cutaneous melanoma simulating blue nevus, a phenomenon that has received little attention. Ten blue nevus-like lesions from three patients are presented. All contained pigmented melanocytes and melanophages in variable proportions arranged in a blue nevus-like growth pattern. The blue nevus-like metastases occurred in the same anatomic region as the primary tumor or, as in one patient, near the skin scar of a dissected lymph node metastasis. Histologic clues of metastatic melanoma included the presence of atypical epithelioid melanocytes, mitotic figures, and an associated inflammatory cell infiltrate at the periphery of the lesion. Although such histologic features facilitate the recognition of a metastasis, clinical correlation is essential for a definitive diagnosis.
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PMID:Metastatic melanoma to the skin simulating blue nevus. 1007 17


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