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Query: UMLS:C0677930 (primary tumor)
 20,210 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The results of treatment of 25 cases of malignant cutaneous melanoma of the floor of the auricle are presented. The involvement of the central area of the organ was matched by the least favorable clinical course. All patients of the latter group developed regional metastases. Therefore, a simultaneous removal of primary tumor and fascial-capsular excision of regional lymph nodes should be carried out unless the lymphatics are involved. The involvement of lymphatics makes the case for Crile's operation. In cases of peripheral position of melanoma, the approach to lymph node treatment should consider such factors as tumor invasion degree, growth pattern, histological type, patient's age and condition.
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PMID:[Melanoma of the skin of the concha auriculae]. 646

The level of invasion of the primary tumor is a reliable criterion of prognosis for cutaneous melanoma. Hence it follows that a differential surgical treatment is possible especially in the clinical stage I. Primary treatment of malignant melanoma consists of three-dimensional excision. The width of excision is determinated by the microstage. The elective regional lymphadenectomy shows an apparant benefit for stage I melanoma with a level between 1.5 and 4.0 mm. The value of added treatments (radiotherapy, systemic, and local chemotherapy, immuntherapy) is still controversial, but should be considered in the future clinical and therapeutical research.
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PMID:[Surgical treatment of malignant melanoma of the skin with special reference to the vertical tumor diameter]. 648 96

The authors present a case of secondary melanoma of the gallbladder, surgically discovered during a laparotomy for assumed biliary tract pathology. The primary tumor was a cutaneous melanoma at the right leg treated by surgery, four years before. At the laparotomy, the pancreas and the omentum contained also metastases. After cholecystectomy the cancerous evolution quickened and led to death after one year. The exceptional character of this observation lead the authors to review the literature.
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PMID:[Malignant melanoma of the gallbladder]. 671 Dec 34

Intermittent or recreational exposure to sunlight is thought to contribute to development of human cutaneous melanoma. We investigated the incidence of ras oncogene mutation in human cutaneous melanoma in connection to sun-exposed body sites in the patient, using a large series of DNA samples derived from paraffin-embedded material as well as from fresh tumor samples and cell lines. We first show that, of the ras family, predominantly N-ras is activated (15%), whereas rarely H-ras or K-ras are mutated. The occurrence of N-ras mutations correlates with continuous exposure to sunlight of the primary tumor site. Of all tumors initiated on chronically sun-exposed body sites, 26% contained mutated N-ras, in contrast to 0% of sun-protected melanomas. Melanoma lesions obtained from patients from North or Central Europe contained fewer N-ras mutations (12%) as compared with patients from Australia (24%). Mutations were specifically associated with nodular melanoma and to a lesser extent with lentigo malignant melanoma. N-ras mutations did not correlate with metastasis or survival parameters. This study identifies a subset of cutaneous melanomas that contain in the primary lesion ultraviolet-induced N-ras mutations, which are maintained through further progression.
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PMID:Relevance of ultraviolet-induced N-ras oncogene point mutations in development of primary human cutaneous melanoma. 878 Mar 77

Patients with melanoma metastatic to the skin show variable prognosis. Though some may survive for quite a long time, some die of disseminated disease within 1 year of removal of cutaneous metastases. The aim of this study was to find out whether there are any histological criteria indicating particular poor outcome. Clinical and histological features of 344 melanoma lesions metastatic to the skin were assessed and their prognostic relevance was investigated. H&E stained histological slides were scanned for the presence of morphological criteria expressing certain tumor cell-stroma interactions: capsule formation (CAPSULE), formation of intratumoral septa (NEWSEPTA), simple invasion between collagen of reticular dermis (DERM-SIMPLE), or subcutis (SCSIMPLE), preservation of preexistent collagen (PRECOLL) or fatty tissue (PREFAT) and, finally, histological site of metastasis. Additionally, anatomical location of the metastases, time between removal of primary tumor and metastases age and sex of patients were recorded. The metastases were divided into two groups: lesions of patients who died within 1 year after resection (n = 59) and lesions from patients with a longer survival (n = 285). Metastases which were associated with death within one year were significantly more often found in male patients (54.2% versus 34.7%), in younger patients (mean age 51.1 +/- 14.1 years versus 58.8 +/- 15.3 years), had developed earlier after the primary tumor (mean time of 21.7 +/- 19.9 months versus 43.3 +/- 27.4 months) and were more often found at distant sites than in localregional sites (45.7% versus 30.5%), and were more often involved in the subcutis (74.5% versus 56.1%). From a histological point of view, DERMSIMPLE (80% versus 46%; p < 0.001) and PRECOLL (82.8% versus 57.6; p < 0.01) were more frequent in metastases of poor outcome. The same was true for SCSIMPLE (50% versus 25.6%; p < 0.01) and PREFAT (68.1% versus 46.8%; p < 0.05) in lesion with subcutaneous growth, whereas CAPSULE (54.5% versus 75%) was less frequently seen. In conclusion, melanoma deposits metastatic to the skin with particular poor outcome differ clinically and histologically from other cutaneous melanoma metastases. This should be taken into account in the design of therapeutic clinical trials.
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PMID:Clinical and histological features of poor prognosis in cutaneous metastatic melanomas. 879 53

Melanomas of the vulva and vagina comprise < 2% of melanomas in women. Although their biologic behavior appears to be similar to that of cutaneous melanoma, vulvar and vaginal melanomas appear to have a different etiology. Women presenting with pigmented vulvar lesions should undergo expedited examination and full-thickness biopsy. Vulvar and vaginal melanomas should be staged surgically using the AJCC system, which incorporates Breslow and Clark microstaging. Adverse prognostic factors include advanced age at diagnosis, central location of tumor, capillary lymphatic space involvement, ulceration, high mitotic rate, and aneuploidy. Primary surgery should include radical local excision with 1-cm skin margins for melanomas < 1 mm thick and 2-cm margins for melanomas 1 to 4 mm thick. Deep margins should be at least 1 to 2 cm. Femoral inguinal lymphadenectomy should be performed in patients at increased risk of lymph node metastases on the basis of primary tumor characteristics. Adjuvant interferon-alfa appears to confer survival benefits in patients with regional nodal disease. Effective salvage therapy has not yet been identified.
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PMID:Melanomas of the vulva and vagina. 883 19

The presence or absence of regional nodal metastases is one of the most important prognostic factors for the survival of patients with primary cutaneous melanoma. The successful outcome of treatment is thus critically dependent on accurate staging of the primary tumor and detection of any occult micrometastases in the regional lymph nodes draining that tumor. Preoperative cutaneous lymphoscintigraphy to identify and visualize the lymphatic drainage patterns from primary tumors and intraoperative lymphatic mapping to identify the first ("sentinel") lymph node in direct communication with the primary tumor are valuable diagnostic tools. These techniques have greatly enhanced the oncologist's ability to identify occult lymph node metastases and to select patients with cutaneous melanoma who may potentially benefit from adjuvant therapy with recombinant interferon alpha-2b.
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PMID:The role of lymphoscintigraphy and sentinel node mapping in assessing patient risk in melanoma. 912 35

Contrary to the trend of early diagnosis observed in other parts of the world, in Florida melanoma is still being discovered in the more advanced stages. This is characterized by thicker lesions at diagnosis, which are hallmarked by bleeding, itching, ulceration, and increased vertical growth. In a study of 1,626 cutaneous melanoma patients at the H. Lee Moffitt Cancer Center in Florida, three prognostic factors, tumor thickness, Clark level, and presence of ulceration in the primary tumor, have remained relatively constant over an eight-year period (1987-1994). Despite the lack of change in tumor thickness in the last four years, mortality rate is decreasing, possibly due to more effective treatments. Regardless of these apparent improvements in mortality rates, definite progress must be made in the early detection of malignant melanoma through the initiation of statewide programs of lay public and professional education. In addition, it is proposed that the establishment of statewide screening programs of the Caucasian population with skin phenotypes 1 and 2 will also facilitate the early diagnosis of melanoma in the future, improve the outlook for these patients, and begin to address a major public health problem in the state of Florida.
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PMID:Florida's undeclared epidemic: malignant melanoma. 914 67

The chromosomal alterations of iris melanomas are poorly characterized, only one report has been detailed. Cytogenetic analysis was performed on the tumors and heparinized blood samples of three patients with iris melanomas; in one case a primary tumor and its related seedling were examined. On analysis of lymphocytes, two of the patients were found to experience a low level fragility of chromosome 9, in the region of a cutaneous melanoma susceptibility gene. All iris melanoma lesions were karyotyped. Clonal abnormalities of chromosomes 3, 5, 6, 7, 8, 9, 12, 15, 17, 18, 19, and Y were found, and in one case a large number of marker chromosomes were observed. No specific chromosomal change was common to the iris melanomas, but two cases had different abnormalities of chromosomes 5 and 18. Variations between the primary tumor and its related seedling were the acquisition of an additional chromosome 15, and a polyploid form of the cell line in the seedling. This study suggests that the most common chromosomal changes of posterior uveal melanomas are less frequent in iris melanomas. Iris melanomas also appear to experience relatively high levels of chromosomal alterations, including the formation of marker chromosomes, which is perhaps reminiscent of cutaneous melanoma.
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PMID:Cytogenetics of iris melanomas: disparity with other uveal tract melanomas. 949 14

The 12-year end-results of standard "wide" and sparing "narrow" excision of superficial skin melanoma are compared. The results were contributed by a joint study of the WHO Collaborating Centers for Evaluation of Methods of Diagnosis and Treatment of Melanoma headed by Dr. U. Veronesi and Dr. N. Cascinelli and 23 other centers in different countries (the Blokhin and Petrov Centers in Russia). The investigation comprised 612 patients. After randomization, "narrow" excision of primary tumor with 1 cm-wide margins was performed in 305 patients. In the remaining 307 patients, "wide" excision left margins within 3 cm. Tumor was identified as superficial on the basis of thickness (Breslow), the threshold being 2 mm-thick invasion. This same prognostic indicator was used in both groups. Another one was 12 year-long recurrence-free survival. The sparing excision of primary cutaneous melanoma with a thickness under 2 cm proved effective.
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PMID:[Surgical treatment of superficial melanoma of the skin]. 961 16


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