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Query: UMLS:C0027960 (mole)
 21,279 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Choroidal melanoma is a rare and deadly cancer. Nursing care for these patients involves ophthalmic clinical expertise as well as psychosocial and emotional support. Although past research has been helpful in determining the prognosis of these patients, it is impossible to predict with certainty which patients have tumors or nevi that will grow, will compromise their vision, or will kill them. Providing emotional support, establishing a good rapport with the patients and their support persons, and encouraging patients to schedule and adhere to their mutually agreed on follow-up appointments are nursing interventions that may save or prolong a patient's life.
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PMID:Choroidal melanoma. 150 46

The Swedish Melanoma Study Group runs a programme aimed at prevention and early detection of premalignant and malignant melanoma in families with two or more members having malignant melanoma. Psychological consequences of participation in this programme were studied. A questionnaire containing items concerning cognitive and emotional responses to the programme was completed by 115 consecutive individuals at their first visit to the clinic. The same questionnaire was administered by mail 7 months later. The levels of psychological and psychosomatic problems were relatively low at both points of assessment. No negative psychological effects were found, neither in the group with dysplastic naevus syndrome (DNS) with increased risk for malignant melanoma, nor in the group without dysplastic naevi. Only one variable, "emotional responses to the visit" differentiated between the groups, with higher scores in the group without DNS. A majority of the individuals expressed positive attitudes to the clinic.
Eur J Cancer 1992
PMID:Psychological effects of participation in a prevention programme for individuals with increased risk for malignant melanoma. 151 45

We describe two instances of a previously unrecognized variant of congenital giant pigmented naevus (GPN), presenting as a bulky naevocytic tumour in the perineal region. In both cases the lesion was present at birth and attained massive dimensions. In addition to the characteristic histological patterns found in GPN, which included extensive areas with a neural appearance, these tumours presented an uncommon tendency to form pseudo-follicular structures lined by naevus cells. No features suggestive of malignant transformation were found. Because GPN may associate with an underlying malignancy, accurate diagnosis of this lesion is important in clinical practice.
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PMID:Bulky naevocytoma of the perineum: a singular variant of congenital giant pigmented naevus. 153 54

Large congenital nevi present a difficult therapeutic problem, since the surgeon must seek to achieve two objectives: To minimize the risk of malignancy; To obtain an acceptable cosmetic result. The first objective calls for early and radical excision of all pigmented areas; this may be impossible because of the operative risk, and the risk of leaving the patient with a deformity or disfiguring scars. The cosmetic indication may justify less aggressive surgery. Relatively new experience indicates that removal of the superficial layers of the nevus shortly after birth is followed by healing with non-pigmented or much less pigmented skin. By combining the removal of the superficial layers of skin with full-thickness resections and reconstructive plastic surgery, it is possible in most cases to achieve a favourable cosmetic result and, at the same time, reduce risk of early malignancy. Wherever possible, the surgical treatment should be completed before the age of five or six years in order to prevent long-lasting psychologic and social effects of the nevus deformity.
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PMID:[Treatment of large congenital pigmented nevi]. 156 95

The clinical and histological features of 13 malignant melanomas in children less than 13 years of age in New South Wales, Australia, were compared with those in a control group of children with 15 Spitz nevi, 4 of which were considered atypical, and 2 unusual compound nevocellular nevi. Six of the controls had been previously diagnosed histologically as malignant melanoma. The objective observations made by one or more histopathologists experienced in reporting melanocytic lesions, and the clinical details, mainly from the Sydney Melanoma Unit files, were entered on a detailed protocol. Evaluation was assisted by the use of SPSS-X software on a mainframe VAX computer. Six of the 13 children with malignant melanoma died with their disease. The most frequent clinical features found in the malignant melanomas were bleeding, ulceration, itching, and black or variegated color. Recent enlargement and darkening were noted in the majority of both the malignant melanomas and the Spitz nevi. Histological features favoring malignancy in this series were mitoses within 0.25 mm of the dermal margin of the melanoma, a dermal mitotic rate exceeding 2/mm2, ulceration, surface exudate, large pigment granules, and clear-cell differentiation. The median thickness of the malignant melanomas was 1.3 mm but in the 4 children who died with melanoma the median thickness was 2.9 mm. Absence of mitoses, predominance of spindle cells, and diffuse maturation favored Spitz nevus. The median thickness of the Spitz nevi was 0.7 mm.
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PMID:Malignant melanoma in childhood: a clinicopathologic study of 13 cases and comparison with Spitz nevi. 156 97

Melanoma is a malignant skin tumour. If detected and surgically removed early whilst residing in the superficial part of the skin the prognosis is excellent. A seven-point check-list of signs and symptoms has been adopted by the Cancer Research Campaign to help non-dermatologists distinguish benign pigmented lesions from melanoma. The presence of irregularity in shape or outline of a mole is one of these important signs. However, it has recently been shown that not only patients, but also clinicians have difficulty in agreeing upon whether a mole exhibits irregularity or not. Computer image analysis methods have been developed to derive quantitative measures of those shape parameters which dermatologists appear to use in their assessment of shape irregularity. The overall shape of the lesion is expressed by the 'bulkiness' measure. Irregularity of the border is expressed by two fractal dimension measures, one for the 'structural' aspect of the shape and the other for the 'textural' aspect. These measures were used in combination to classify melanomas in the study containing silhouettes of 43 melanomas and 45 benign lesions producing correct classification with 91% sensitivity and 69% specificity. This paper describes computer image analysis aspects of the study.
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PMID:Shape analysis for classification of malignant melanoma. 158 80

Balloon cell malignant melanoma (BCMM) is a rare histologic variant of malignant melanoma (MM). Thirty-four patients with BCMM from the files of the Armed Forces Institute of Pathology (AFIP) were studied by means of clinicopathologic correlation and histochemical, immunohistochemical, and ultrastructural methods to better define this entity. The cytoplasmic features of the balloon cells observed in BCMM resemble those noticed in balloon cell nevus (BCN), but the presence of nuclear pleomorphism, atypia, and mitoses and the absence of intervening stroma help distinguish BCMM. The cells also show many histochemical, immunochemical, and ultrastructural features of conventional melanoma cells. Although it is generally believed that balloon melanoma cells represent a degenerative change, the immunohistochemical and electron microscopic findings suggest that the balloon tumor cells are most likely metabolically active melanocytic cells. Microscopically, BCMM also must be differentiated from other clear cell tumors such as clear cell sarcoma (MM of soft parts), hibernoma, xanthoma, sebaceous neoplasms, metastatic renal cell carcinoma, (malignant) clear cell acrospiroma, (malignant) granular cell tumor, granular (clear) cell basal cell carcinoma, clear cell syringoma, and atypical fibroxanthoma. The prognosis of BCMM usually correlates with the tumor thickness similar to that in other histologic types of cutaneous MM. Nineteen (57.5%) of 33 patients with adequate follow-up information died of disseminated tumors from 2 months to 12 years after the initial treatment. Six (18.2%) patients developed local recurrences: four of these patients died of metastasis and two were alive with metastatic tumor at last contact. Five (15.2%) patients were alive with metastatic tumors, and seven (21.2%) were alive without evidence of disease at last contact. Recognition of BCMM is important because of its malignant biologic behavior.
Cancer 1992 Jun 15
PMID:Balloon cell malignant melanoma of the skin. A clinicopathologic study of 34 cases with histochemical, immunohistochemical, and ultrastructural observations. 159 88

The association between melanoma and giant congenital nevocellular nevus has been well documented, although controversy still exists regarding the precise incidence. The following patient report illustrates the excision of malignant melanoma arising from a giant congenital nevocellular nevus in a 4-month-old infant. The child had malignant melanoma with deep dermal involvement diagnosed by incisional biopsy with positive margins. She underwent subsequent en bloc resection of the original biopsy site and nevus. The reexcision specimen showed no evidence of malignancy. No adjuvant chemotherapy was used. The child is disease free at 5 years. It is possible that very young children (infants) with melanoma arising in a giant congenital nevocellular nevus may have a good prognosis.
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PMID:Malignant melanoma with evidence of maturation arising from a giant congenital nevocellular nevus. 159 74

The epidemiology and outcome of basal cell carcinoma (BCC) in adults aged 15-34 years were examined. Northern Region Cancer Registry data from 1979 to 1989 revealed a crude annual incidence of 37/100,000 total population and the incidence was constant in all age-groups during this period; 150 patients (1.2%) were aged 15-34 years. There was a small excess of females in the young age-group. The outcome of BCC in young adults was determined using records of all patients registered over 5 years ago and additional information from family doctors where required. Patients with BCC in naevus sebaceous or with syndromes of which BCCs are a feature were excluded. Median duration of BCC pre-diagnosis was 3 years. Of 39 patients with completed 5-year follow-up data, 21% had either incomplete excision requiring further early treatment (n = 4), a later local recurrence (n = 2), metastatic BCC (n = 1) or a subsequent further primary tumour (n = 1); an additional three patients had two primary tumours at initial presentation. Median hospital follow-up was 12 months but the apparent disease-free interval in patients with recurrent or new BCC was frequently over 2 years. BCC in young adults may not be suspected because it is uncommon. However, the high frequency of local recurrence and of multiple primary tumours indicates that careful follow-up is prudent in young patients with this tumour.
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PMID:Basal cell carcinoma in young adults. 163 90

The silver staining of nucleolar organizer region-associated proteins is an objective method that has been used to differentiate benign from malignant neoplasms. Recently this method was used to distinguish benign choroidal nevi from malignant choroidal melanomas. We studied 24 iris melanocytic lesions to assess the applicability of this technique for differentiating benign from neoplastic iris tumors. Masked observers determined the number of silver-stained nucleolar organizer region dots per cell for silver-stained specimens. Iris nevi contained a mean of 1.6 silver-stained nucleolar organizer region dots per cell, whereas iris (spindle A and B, spindle B, epithelioid, mixed cell) malignant melanomas contained a mean of at least 3.5 silver-stained nucleolar organizer region dots per cell (P less than .0001). All iris nevi demonstrated counts lower than 1.9, whereas all iris melanomas demonstrated counts greater than 2.8. Silver-stained nucleolar organizer region counts were also compared with the clinicopathologic variables of gender, age, and largest specimen dimension. Only the largest specimen dimension correlated with silver-stained nucleolar organizer region counts (P less than .0029). The silver-stained nucleolar organizer region method is a simple technique for differentiating iris nevi from iris melanomas. The silver-stained nucleolar organizer region technique may aid in the assessment and treatment of iris lesions by confirming the malignancy of biopsy specimens.
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PMID:Nucleolar organizer regions in iris nevi and melanomas. 164 96


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