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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

With cationized ferritin (CF) as an ultrastructural marker for anionic cell surface sites, cultured guinea pig melanocytes display a uniquely homogeneous labelling pattern and a striking absence of redistribution of marker material. In the present study, we applied the same technique to normal human melanocytes and melanoma cells. Unfixed primary human mixed epidermal cell cultures displayed CF labelling patterns identical to those in guinea pig epidermal cells: on keratinocytes, CF was found in distinct aggregations which, upon prolonged incubation, clustered and were shed. Melanocytes, in contrast, bound CF to the cell surface as a uniform diffuse monolayer. There were no signs of cluster formation or shedding. Melanoma cell cultures were derived from 10 primary (2 lentigo maligna, 1 lentigo maligna melanoma, 4 superficial spreading melanomas, 2 nodular portions of superficial spreading melanomas, 1 nodular melanoma) and from 7 metastatic melanomas (4 cutaneous, 3 lymph node metastases). The CF labelling patterns encountered were heterogeneous. Three out of 10 primary tumors and 5 out of 7 metastases showed alterations of the normal melanocyte labelling pattern: regions of typical CF distribution were irregularly interrupted by stretches of membrane free of marker. In some areas, CF occurred in small globular aggregates. There was considerable heterogeneity of CF labelling patterns in different clones of a given culture. Altered CF binding patterns in melanoma cells appear to be associated with high metastasizing protential of the cell clones and may thus represent an unfavourable prognostic sign.
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PMID:Distribution of anionic surface sites on human melanocytes and human melanoma cells in culture. 666 Sep 12

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

Melanoma is an especially important malignant disease for surgeons to know about, since it can be cured with surgical treatment if diagnosed at an early stage. In the American College of Surgeons Melanoma Survey of 4,545 melanoma patients diagnosed during 1980, the typical melanoma was relatively thin (less than 1.5 millimeters), not ulcerated (except in 9 per cent) and did not invade into the reticular dermis or beyond (level IV or V). The melanomas were most commonly located on the trunk in men and on the lower extremities in women. Eighty-eight per cent of the patients had no clinical evidence of metastases to regional nodes or to distant sites at the time of initial diagnosis. Only a small proportion (1 per cent) of patients in the survey were black and in most of these patients, their melanoma were located on the feet or hands. The treatment of melanoma was surgical in 92.5 per cent of the patients, with the majority of patients undergoing a wide excision of the melanoma as the initial form of treatment. Only one-fifth of the patients underwent elective regional node dissection for suspected micrometastases, and most of these patients had a tumor thickness exceeding 1.5 millimeters or a lesion invading to the reticular dermis (level III, IV or V). While the Breslow Microstaging Method is now recognized as the most important parameter that predicts the clinical course of the patient, this parameter was reported in only 45 per cent of the patients in the survey. The natural history of melanoma is changing, since the disease is increasing in frequency and becoming more curable. Surgical treatment should be tailored to the biologic aggressiveness of each individual patient's melanoma. This can be estimated by integrating such prognostic factors as the melanoma thickness, the presence or absence of ulceration, the level of invasion, the anatomic site and the gender of the patient.
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PMID:Management of cutaneous melanoma in the United States. 671 Feb 91

Cell-mediated hypersensitivity in 64 patients with melanoma was assessed by delayed-type skin reactivity to dinitrochlorobenzine (DNCB) and tubercullin as well as by lymphocyte enumerations. The immunological status of the patients was correlated with their clinical stage. The mean absolute and percentage counts of E rosette forming cells were lower in patients than in normal controls. Patients with distant metastases showed lower levels of E rosette forming cells than the patients with localized disease. No differences were found in number of EAC rosette forming cells between melanoma patients and controls. The mean absolute and percentage counts of null cells in melanoma patients in stages II and III were significantly higher than those in controls. Melanoma patients showed reduced skin reactivity to DNCB and normal reactivity to tuberculin. Patients with positive DNCB reactivity showed significantly higher total lymphocyte counts and higher percentages of E rosette forming lymphocytes than patients unreactive to DNCB.
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PMID:Some aspects of cell-mediated hypersensitivity in patients with melanoma. 697 28

553 patients with stage I malignant melanoma of the limbs entered a prospective randomized clinical trial carried out by the W.H.O. Collaborating Centres for Evaluation of Methods of Diagnosis and Treatment of Melanoma from September 1967 to January 1974. 286 patients were submitted to wide excision of primary and node dissection at the time as appearance of regional lymph node metastases and 267 to wide excision and immediate node dissection. Survival was identical in the 2 groups. Different subsets of patients were evaluated to assess whether some groups of patients may benefit from immediate node dissection. As regards sex, females and a significantly higher survival rate than males (p < 0.05), but results were not improved by immediate node dissection. Maximum diameter and elevation of primary melanoma were significantly related to survival but also in these cases immediate node dissection did not achieve better results. 63 patients had an excisional biopsy of their melanoma within 4 weeks before final treatment. This procedure did not worsen survival and also in this case immediate node dissection did not improve survival. 273 cases were classified according to histologic type: survival of superficial spreading and nodular melanoma was not different at a statistically significant level after the 2 treatment modalities. 325 cases were considered classifiable according to Clark's levels, out of these 165 were submitted to immediate node dissection. Neither level III nor level IV cases showed higher survival rate after immediate node dissection. Maximum tumor thickness according to Breslow was evaluated in 338 cases: 188 were submitted to wide excision and immediate node dissection. In no clusters of thickness did the enlarged surgical procedure achieve better results. The authors conclude that there is good evidence that in stage I melanoma of the extremities delayed dissection.
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PMID:Stage I melanoma of the limbs. Immediate versus delayed node dissection. 700 69

The main object of this review was to examine the various histogenetic types of melanoma in order to determine their nature. Nodular melanoma and superficial spreading melanoma differ in the more rapid growth of the former. For tumors of equal depth of invasion in patients of the same sex, the prognoses are similar. Clinical features with prognostic significance are sex, age, and site of the lesion. Women have a decided superiority in survival up to the age of about 50 years when their superiority declines. Survival rates for men also decline after the age of 50 years but to a lesser degree. Melanomas of the extremities have a better prognosis than melanomas of the axial regions. The histological feature of most prognostic significance is depth of invasion (thickness). Ulceration is partly bound to thickness of the lesion, but has an augmentative effect of its own which is related to rate of growth. Thin lesions with or without regression are often associated with metastases. Melanomas arising in Hutchinson's melanotic freckle have a better prognosis than nodular or superficial spreading melanoma but there has not been any series large enough for definitive markers with prognostic significance to be determined. A similar state pertains in palmar, plantar and subungual melanomas. The initial surgical approach in nodular and superficial melanoma should be based upon the thickness of the tumour, site of the tumour, and sex of the patient. The current classification of malignant melanoma is unsatisfactory. Melanoma arising in Hutchinson's melanotic freckle seems to be a distinct entity. Melanomas of other histogenetic types would be best classified according to site.
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PMID:The nature of melanoma. A critical review. 704 99

Malignant melanoma is considered unresponsive to conventional radiation therapy when it is delivered at a daily dose rate of 130--300 rad/fraction. Previous studies have suggested that this is in part due to a large shoulder on the radiation survival curve and that higher dose fractions might be beneficial. High-dose fraction therapy is effective for local control of cutaneous, lymph node, and soft-tissue metastases. Results in 46 patients treated with high- or low-dose fractions for intracranial metastases over the last decade in the Melanoma Unit and Department of Radiotherapy at Yale have been examined. Twenty-six patients received high-dose fraction therapy, generally 600 rad/fraction/week to 2400--3600 rad; 20 patients received low-dose fraction radiotherapy with 125--400 rad/fraction daily. All patients were given steroids, and most received chemotherapy. Results in both groups were similar. Comparison of high- and low-dose fraction patients revealed: improvement in 38 and 35%, respectively, stability in 23 and 25%, and deterioration in 38 and 40%. Median survival was three months in the high-dose fraction group and 2 1/2 months in the low-dose fraction group. Presence of hepatic metastases had no significant influence upon median survival in patients who received high-dose fraction radiotherapy. In patients receiving low-dose fraction, survival was 2 1/4 months with and three months without hepatic metastases. Death in most patients resulted from progression of central nervous system disease. Side effects, especially headache, were more prominent in the high-dose fraction group. However, in no instance did side effects require discontinuation of therapy. The greater ease of delivery for weekly high-dose fraction radiotherapy outweighed any other difference between the regimens.
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PMID:High-dose fraction radiation therapy for intracranial metastases of malignant melanoma: a comparison with low-dose fraction therapy. 707 45

Cross-lymphatic metastasis from one breast to the other is the most frequent type of metastatic involvement of the breast. Melanoma, lung, ovary, and sarcoma are the most common types of blood-borne metastases to the breast from extramammary sites. The most common radiographic findings in patients with blood-borne metastases to the breast are single or multiple discrete nodules. Lymphoma or leukemia may involve the breast primarily but more often as part of a widespread process. Their presentation varies from discrete to ill-defined masses and may be obscured by underlying benign proliferative changes.
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PMID:Metastasis to the breast. 711 7

Melanoma in black patients is uncommon but not rare. This paper reports six cases seen in one general surgeon's practice in Arkansas during a 14-year period. A review of the current literature regarding melanoma in blacks is given.Characteristically, melanoma in blacks is found on the soles of the feet, palms of the hands, or mucous membranes. The tumor has a deadly potential unless it is treated at an early stage; four of the patients reported have died of metastatic disease. A public health program is needed to make physicians and the public aware of the incidence and location of this tumor.
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PMID:Melanoma in black patients. 712 Apr 73

A case report is given of a malignant melanoma of the esophagus and the symptoms of this tumor are reviewed on the basis of 62 cases from the world literature. Males were afflicted 1.7 times as often as females. 85% of all patients were between the ages of 50 and 75. Symptoms, localization, and pattern of metastases are essentially similar to esophageal carcinoma. Melanoma grows like polyps in most cases and does have the typical histological pattern with differing amounts of pigmentation; pigmentation may be difficult to diagnose endoscopically. The esophageal melanoma apparently originate from intraepithelial foci of melanoma cells, which can be found in the neighbourhood of melanomas in macroscopically intact mucosa.
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PMID:[Malignant melanoma of the esophagus (author's transl)]. 721 12


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