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 case of an unusual variant of malignant melanoma resembling a papillomatous dermal nevus is presented here. The lesion was initially diagnosed as a Spitz nevus, and recurred locally five months after excision. The features which distinguish this lesion from the more common types of benign dermal nevi include the architectural atypia of the melanocytes, with a tendency for continuous proliferation of single cells along the dermoepidermal junction, as well as the presence of cytologic atypia with large hyperchromatic nuclei and mitoses. Despite its seemingly innocent appearance, distinction of this low-grade variant of melanoma from its benign counterparts is of importance in order to avert the possibility of recurrence and potential metastases.
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PMID:Verrucous pseudonevoid melanoma. 365 77

Five cases are described of a distinctive histologic variant of benign spindle and epithelioid cell nevus characterized by extensive and prominent stromal hyalinization. The lesions consisted of a proliferation of spindle or epithelioid nevocytes scattered singly or in small clusters in the dermis and surrounded by abundant paucicellular hyalinized or collagenous stroma. Three patients were men and two were women. Their age range was 23 to 45 years (mean, 32). Two of the lesions were located in the head and neck region, two in the lower extremities, and one in the trunk. Immunohistochemical strains showed positive staining of the spindle or epithelioid cells with S-100 protein and vimentin; stains for keratin, EMA, CEA, actin, and desmin were all negative. Van Gieson and trichrome histochemical reaction demonstrated the collagenous nature of the hyalinized intercellular matrix; Congo red, crystal violet, and alcian blue stains were all negative. The etiology and pathogenesis of the intercellular hyalin deposits are unknown, but they probably represent a regressive phenomenon in longstanding or involuting lesions. Hyalinizing Spitz nevus must be included in the differential diagnosis of cutaneous lesions exhibiting a prominent hyalinized stroma and must be differentiated from other dermal neoplasms, particularly cutaneous metastases from occult internal malignancies and malignant melanoma.
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PMID:Hyalinizing spindle and epithelioid cell nevus. A study of five cases of a distinctive histologic variant of Spitz's nevus. 753 78

Expression of the tumour suppressor protein, p53, was determined in 77 cutaneous melanocytic lesions, and in five lymph node metastases from malignant melanoma, in an immunohistochemical study employing CM-1, an antiserum raised against recombinant human p53 protein. Because wild-type p53 protein is rapidly degraded in normal cells, p53 immunoreactivity suggests the presence of an abnormally stable p53 protein. This may occur through either post-translational mechanisms or gene mutation. A highly significant correlation was found between p53 immunoreactivity and malignancy in melanocytic lesions (P < 0.0001). Overall, p53 immunoreactivity was observed in 63% of tumour specimens examined, but not in benign melanocytic naevi, although occasional foci of weak nuclear p53 immunoreactivity were observed in a minority of dysplastic naevi and a solitary Spitz naevus. A significant correlation was also found between strong p53 immunoreactivity and malignant melanomas associated with a poor prognosis (P = 0.008). These data suggest an important role for p53 tumour suppressor protein in the biology of human cutaneous malignant melanoma.
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PMID:p53 immunoreactivity in human malignant melanoma and dysplastic naevi. 833 44

We describe a 21-year-old female who presented with four agminate Spitz naevi close to the scar from a previously excised solitary Spitz naevus, and review the literature since 1987 on widespread and agminate Spitz naevi. Spitz naevi usually present as solitary firm red or brown papular lesions. Agminate Spitz naevi are unusual and they have been reported mainly in children. It is uncommon for Spitz naevi to recur after surgery and far more unusual for a recurrence to occur in an agminate form. Such lesions may mimic multiple satellite and in-transit metastases which can occur in malignant melanoma, and close follow up of any new lesions occurring in this case is intended.
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PMID:Agminate Spitz naevi occurring in an adult after the excision of a solitary Spitz naevus--report of a case and review of the literature. 891 59

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

Five cases of a distinctive variant of desmoplastic Spitz nevus are reported. To the best of our knowledge, this tumor has never been described previously. Clinically, it presents itself as a solitary papule on the extremities of young adults. Microscopically, it shows predominance of solitary melanocytes with epithelioid appearance over cell nests. They are embedded in a prominent fibrous stroma with many densely arranged, small blood vessels with plump endothelia not seen in other Spitz nevi. Because of its resemblance to a vascular tumor, the name angiomatoid Spitz nevus is proposed for this lesion. Absence of recurrences or metastases after complete excision in all cases supports the benign nature of the tumor.
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PMID:Angiomatoid Spitz nevus: a distinct variant of desmoplastic Spitz nevus with prominent vasculature. 2051 84

Both clinically and histopathologically, melanoma of childhood is a rarely encountered lesion. In addition, it has particular histopathologic diagnostic problems. Differential diagnosis of this lesion and Spitz nevus is at times very problematic, in that distant metastases and death of the patient may be the only diagnostic criteria for some cases. We present a 4-year-old girl with an atypical melanocytic neoplasm with Spitzoid features on the left subscapular region.
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PMID:A current dilemma in histopathology: atypical spitz tumor or Spitzoid melanoma? 1199 85

A melanocytic lesion was removed from each of three patients: 2 men aged 37 and 65 and 1 woman aged 45. The preferred diagnosis was 'Spitz naevus'. Subsequently, all three developed regional (sub)cutaneous and/or lymph node metastases, indicating that the lesions were melanomas. The histopathological distinction between Spitz naevus and melanoma is often very difficult. Classical Spitz naevi can be diagnosed correctly only if the entire lesion is available for histological examination. Incompletely removed lesions should be re-excised for further examination. Some melanomas resemble Spitz naevi, but can be recognised on the basis of well-defined histological indicators of malignancy. Some melanocytic lesions, however, cannot be categorised with confidence as being either benign (Spitz naevus) or malignant (spitzoid melanoma). Thus, a group of lesions with inconclusive histology remains and has been designated as 'atypical Spitz tumour' or 'Spitz tumour of uncertain malignant potential'. Generally, such lesions are best treated as melanomas.
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PMID:[Three patients with a Spitz naevus that later turned out to be a melanoma]. 1612 84

Spitz nevus is a clinico-pathologic entity that can cause diagnostic concern, particularly in adults. Many studies have been performed to establish reliable histologic criteria, in the attempt to differentiate this lesion from melanoma. A series of 247 Spitz nevi, 6 of which were formerly classified as melanomas, were reviewed for clinical and histopathological parameters. Patients older than 20 comprised 66% of cases, with a predominance of women. The lower extremity was more affected in females of any age, whereas the trunk was more frequently involved in men over 40. Histopathologic examination showed the following differences among Spitz nevi related to age: acanthosis, parakeratosis, pagetoid infiltration, and Kamino bodies were more frequent in young people, whereas multinucleated melanocytes were more frequent in adults. The latter also had lesions that were less pigmented, with less maturation and more desmoplasia. At a mean follow-up of 94 months (range 52-172), recurrence at the site of biopsy or metastases were absent. In our study, a greater proportion of Spitz nevi occurred in adults than in previous series. Moreover, the relative incidence of Spitz nevus compared with melanoma in our population was higher than in other studies. Histopathologic criteria elaborated to diagnose Spitz nevus, applied to our cases, appeared reliable, allowing a correct diagnosis, even in adults.
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PMID:Spitz nevus is relatively frequent in adults: a clinico-pathologic study of 247 cases related to patient's age. 1631 1

Cutaneous melanocytic proliferations are diverse morphologically, and their behavioral attributes may be difficult to discern with certainty. As a consequence, diagnostic anatomic pathologists regularly encounter problems in the interpretation of such lesions. This review considers several selected issues in that subject area, including proliferative congenital nevi, architecturally disordered (dysplastic) nevi, morphologic variants of Spitz nevus, atypical lentiginous melanocytic proliferations, nevoid melanoma, diagnostically deceptive histologic variants of melanoma, "epidermotropic" metastases of melanoma, and the relationship of melanoma microstages to tumor growth phases.
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PMID:Cutaneous melanocytic lesions: selected problem areas. 1646 18


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