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)

Metastatic malignant melanoma to the jaws is uncommon and is usually accompanied by generalized involvement. Hematogenous dissemination with deposition and growth in areas of hematopoietic marrow (that is, the mandibular molar region) is the accepted mechanism for involvement of the jaw. Clinical and radiographic findings are nonspecific. Comprehensive history, physical examination, and tissue microscopy are essential to accurate diagnosis and management of the patient. Radiotherapy for palliation is the accepted mode of therapy for symptomatic metastatic melanoma. Prognosis in cases with secondary jaw involvement is grave. A case of malignant melanoma with metastases to the mandible is presented and the literature is reviewed.
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PMID:Malignant melanoma metastatic to the mandible. 28 Jun 55

Metastatic malignant melanoma requires sophisticated delineation of therapeutic approaches in order that palliation of the disease should be managed effectively. To date, systemic chemotherapy for melanoma metastases appears to be of only limited benefit, since tumoricidal drug levels can hardly be achieved in a way to overcome primary or secondary drug resistance of melanoma cells. With respect to topographically defined patterns of metastasis, therapeutic approaches introducing regional chemotherapy have recently promised improved palliation in the management of advanced solid tumors including melanoma. Among these approaches, isolated limb perfusion has become a well-established procedure in the treatment of melanoma which has metastasized to the extremities. The adjuvant setting of this technique is currently under investigation, and suggests a beneficial outcome in perfused high-risk patients. Intraarterial infusion techniques with or without regional venous drug hemofiltration might provide high cytotoxic tissue levels at the target region, thus subsequently leading to enhanced cell kill rates evidenced in terms of clinical responses. Angioocclusive approaches using persistent (chemoembolization) or transient (microspheres, liposomes) blocking techniques with subsequent reduction of the arterial/arteriolar blood flow may optimize the pharmacological advantage of regional drug delivery. In addition to cytoreductive surgery and systemic chemotherapy, the above-mentioned approaches of regional chemotherapy offer a new perspective in the palliative management of metastatic melanoma.
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PMID:Impact of regional chemotherapy for melanoma metastases. 245 71

Tumor-to-tumor metastases are rare occurrences. A 75-yr-old male presented with an enlarging axillary mass. Further investigation revealed an adenocarcinoma of the colon and a colonic polyp. Metastatic malignant melanoma was present within the colonic polyp and in axillary lymph nodes. In the polypectomy specimen, the distinctly dimorphic histologic appearance was the best clue to the metastatic nature of the malignant component of the polyp. The diagnosis was confirmed by histochemistry and immunocytochemistry. This is the third reported instance of a colonic polyp acting as the host in a case of tumor-to-tumor metastasis.
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PMID:Malignant melanoma with metastasis to a colonic polyp. 305 48

Metastatic malignant melanoma is notoriously resistant to chemotherapeutic agents, but the exact mechanisms involved in this drug resistance are unknown. One recently defined major mechanism of multidrug resistance involves the overexpression of P-glycoprotein on cell membranes. In order to evaluate the significance of this putative drug efflux pump for chemoresistance of malignant melanoma, five different antibodies were employed to examine P-glycoprotein expression on tissue from 33 primary malignant melanomas and 35 metastases, before and after chemotherapy, using immunohistological techniques. The expression of P-glycoprotein was low on primary cutaneous melanomas (three of 33), and on metastases (one of 35). Normal tissue in and around the melanoma showed reactivity of endothelial cells, stromal cells and eccrine sweat glands with several antibodies tested. Chemotherapy with drugs commonly used in metastatic melanoma, including agents known to induce P-glycoprotein expression in other tumours (vindesine, cisplatin) had no effect on P-glycoprotein expression in human melanoma metastases. The high chemoresistance of human melanoma cells in vitro and in vivo is probably not mediated via P-glycoprotein, and other possible mechanisms involved will have to be explored in future studies.
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PMID:P-glycoprotein expression in primary and metastatic malignant melanoma. 774 45

Although malignant melanoma is known to metastasize to various sites including the temporal bones, there have been few studies on temporal bone histopathology in malignant melanoma. Here we describe the temporal bone histopathology of 5 patients (10 temporal bones) who died of malignant melanoma with multiple metastasis to many internal organs and bones. We investigated the temporal bone based on the following three points: 1) the presence of metastatic lesions in the temporal bone, 2) inner ear pathology, and 3) the distribution of melanin in the inner ear. Normal melanin distribution was also studied in 35 temporal bones of patients without malignant melanoma. Metastatic malignant melanoma was observed in 5 temporal bones from 3 patients, in two of whom the internal auditory canal was involved bilaterally by melanoma cell infiltration. In the remaining patient (one ear), metastatic melanoma was found along the dura mater of the posterior cranial fossa to the mastoid air cells. In the former two patients, the inner and outer hair cells as well as the stria vascularis showed degenerative changes to various extents. In particular, the inner ear changes were severe in the ear with the decongestion of the inner ear vessels. Melanin was found in the modiolus, stria vascularis, osseous spiral lamina, membranous labyrinth, and endolymphatic sac, as previously reported. The amount of melanin in the inner ear increased with age in the control patients, but was greater than in the controls, in all of the cases of malignant melanoma except one, in which metastatic lesions were present in the internal auditory canal with marked congestion of the inner ear vessels.
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PMID:[Histopathological studies of temporal bones of patients with malignant melanoma]. 924 77

Malignant melanoma occurs only rarely as a primary tumour in the oral cavity, with an incidence of 1-2 percent. Oral melanomas are predominantly to be found in the hard and soft palate, and less often in the gingiva and mandible. Mucosal malignant melanomas are much more aggressive than those situated in the skin. In two-thirds of the cases the route of formation of the metastases is lymphogenic, and haematogenic in the remainder. The typical sites of the distant metastases are the skin, the lungs, the brain, the liver, and the bones. Metastatic malignant melanoma in the oral cavity, a rarity in the literature, is associated with a very poor prognosis. This paper reports on two cases in which an isolated distant metastasis developed in the oral cavity.
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PMID:[Malignant melanoma metastasis in the oral cavity]. 1701 22

Metastatic malignant melanoma of the urinary bladder is a rare clinical finding suggestive of advanced disease. Only 17 cases have been described in the English literature. We present a case of an 84-year-old male who was referred to the urology department with the incidental finding of bladder metastases on computed tomography (CT) one year following the diagnosis of malignant melanoma of the skin. Herein, we will discuss epidemiology, prognosis, and management options of metastatic malignant melanoma based on literature review.
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PMID:Metastatic malignant melanoma of the urinary bladder: Case report and literature review. 2457 71

Aims. Metastatic malignant melanoma of the urinary bladder is a rare clinical entity, with only twenty-three published cases to date. We present a case of this rare entity, a thorough review of the literature, and differential diagnosis of melanoma in the bladder. Methods and Results. A 55-year-old woman with a history of malignant melanoma of the right thigh, excised eight years ago, presented with back pain, fatigue, and hematuria. She underwent computed tomography (CT) scan and was found to have metastases within the liver, spleen, lungs, and urinary bladder. She underwent cystoscopy and transurethral resection of three polypoid lesions. Histologic and immunohistochemical examination revealed metastatic malignant melanoma involving bladder mucosa. Conclusions. This case illustrates the importance of including malignant melanoma in the differential diagnosis of high grade neoplasms of bladder, especially in cases where the relevant clinical history is not available.
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PMID:Metastasis of Malignant Melanoma to Urinary Bladder: A Case Report and Review of the Literature. 2610 99

Metastatic malignant melanoma is notorious for its phenotypic diversity and loss of differentiation markers. We herein summarized our experience with 14 metastatic melanomas showing complete loss of immunohistochemical melanocytic markers (with or without heterologous differentiation). Patients included 11 men and 3 women aged 24 to 78 years (median, 67 y). Thirteen patients had histologically confirmed primary skin melanoma, and 1 had metastatic melanoma of unknown primary. Undifferentiated metastasis was diagnosed synchronous to primary tumor (n=1), following skin melanoma by 3 months to 9 years (n=11) and preceding it by 1 year (n=1). Sites of undifferentiated metastases were axillary (3), inguinal (1), or submandibular (1) lymph nodes, digestive tract (2), bone/soft tissue (2), lung/pleura (2), and disseminated (n=3). Histology of metastases mimicked undifferentiated pleomorphic or spindle cell sarcoma with variable myxoid and giant cell areas (n=10) and cytokeratin-positive undifferentiated small cell sarcoma (n=1). Three cases showed heterologous dedifferentiation: pleomorphic rhabdomyosarcoma (n=1), teratocarcinosarcoma-like with prominent rhabdomyoblasts (n=1), and adenocarcinoma-like with metaplastic bone (n=1). All cases were negative for S100, melanoma cocktail, HMB45, Melan A, and SOX10. Other markers showed following results: smooth muscle actin (1/14), p16 (1/14), TP53 (2/12), pancytokeratin (4/14), desmin (5/14), h-caldesmon (0/9), and MDM2/CDK4 (0/5). SMARCB1 was intact in 8/8 cases. Genotyping showed BRAF(V600E) mutation (5/14), NRAS mutation (5/14), and BRAF/NRAS wild-type (4/14). In conclusion, undifferentiated/dedifferentiated metastatic melanoma is likely underrecognized and frequently mistaken for undifferentiated sarcoma or other neoplasms. Diagnosis of undifferentiated sarcoma at sites where melanoma metastasis are frequent (eg, inguinal and axillary region) should be made with great caution and warrants exploration of the remote history. Genotyping is a helpful surrogate marker in classifying such difficult cases. In the light of available targeted therapies, recognition of undifferentiated/dedifferentiated metastatic melanoma is mandatory for appropriate treatment.
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PMID:Metastatic Malignant Melanoma With Complete Loss of Differentiation Markers (Undifferentiated/Dedifferentiated Melanoma): Analysis of 14 Patients Emphasizing Phenotypic Plasticity and the Value of Molecular Testing as Surrogate Diagnostic Marker. 2703 13