The role of preoperative 18F-FDG PET-CT in lymphatic metastasis diagnosis of cutaneous malignant melanoma on extremities and trunk / 中华肿瘤杂志

Objective@#To evaluate the clinical value of preoperative 18F-Fludeoxyglucose (18F-FDG PET-CT) in lymphatic metastasis diagnosis of cutaneous melanoma on extremities and trunk.@*Methods@#112 patients with cutaneous melanoma pathologically of extremities and trunk from January 2006 to December 2016, who received 18F-FDG PET-CT examination preoperatively, were retrospectively reviewed. The correlations between the maximal diameters of lymph nodes, the maximal standard uptake value (SUV) and the diagnostic impression grades of PET-CT examination, and the final pathological diagnosis were analyzed. The correlations between Breslow thickness of primary lesions and the diagnostic impression of PET-CT examination were also analyzed. All the above were analyzed with Receiver Operating Characteristic (ROC) curve to get the cut-off value. Based on the final results of pathological diagnosis of lymph nodes as the golden standard, the statistically significant indicators of ROC curve analysis were used to evaluate the diagnostic effect, as well as to calculate the sensitivity, specificity and accuracy. With gender, age, maximal diameter of lymph nodes, maximal SUV, diagnosis impressions, and Breslow thickness as the independent variables and pathological diagnosis results of lymph nodes as the dependent variable, two-class stepwise Logistic regression analysis was used to determine the independence of diagnostic indicators. ROC curve analysis and log rank test were used to analyze the relationship between Breslow thickness and patient survival.@*Results@#To evaluate melanoma patients′ lymph node status, the results of ROC curve analysis showed that the area under the curve of lymph node maximal diameter, maximal SUV, diagnosis impression of PET-CT examinations were 0.789, 0.786 and 0.816, respectively (all P<0.05). The cut-off values were 0.85 cm, 1.45 and 2.5, respectively. The sensitivity of the cut-off values to determine the status of lymph nodes in melanoma patients were 71.4%, 64.9% and 72.1% respectively, and the specificities were 85.2%, 88.7% and 87.0% respectively. Multivariate Logistic regression analysis showed that PET-CT diagnosis impressions had independent diagnostic significance for the lymph node status of melanoma patients (OR=11.296, 95%CI: 2.550~50.033). The area under the curve of Breslow thickness evaluating PET-CT diagnostic impression is 0.664 (P=0.042) and the cut-off value was 4.25 mm. The survival rate of the patients with Breslow thickness ≥ 4.25 mm was lower than that in the group <4.25 mm (P=0.006).@*Conclusions@#18F-FDG PET-CT can help to evaluate metastases and make treatment decisions for cutaneous melanoma of extremities and trunk, especially for patients whose primary lesion′s Breslow thickness has reached more than 4.25 mm. For the patients whose maximal SUV of regional lymph node is higher than 1.45 and short diameter of the largest lymph node is larger than 0.85cm, the possibility of metastases should be considered.

Cutaneous Melanoma in Asians / 전남의대학술지

Malignant melanoma is a rare disease in Asians but potentially the most aggressive form of skin cancer worldwide. It can occur in any melanocyte-containing anatomic site. Four main cutaneous melanoma subtypes are recognized: lentigo maligna melanoma, superficial spreading melanoma, acral lentiginous melanoma (ALM), and nodular melanoma. Generally, excessive exposure to ultraviolet (UV) radiation increases the risk of melanoma. The exception is ALM, which is the most common melanoma subtype in Asians and is not associated with UV radiation. ALM presents as dark brownish to black, irregular maculopatches, nodules, or ulcers on the palms, soles, and nails. The lesions may be misdiagnosed as more benign lesions, such as warts, ulcers, hematomas, foreign bodies, or fungal infections, especially in amelanotic acral melanomas where black pigments are absent. The aim of this brief review is to improve understanding and the rate of early detection thereby reducing mortality, especially regarding cutaneous melanoma in Asians.

Cutaneous Melanoma in Asians / 전남의대학술지

Malignant melanoma is a rare disease in Asians but potentially the most aggressive form of skin cancer worldwide. It can occur in any melanocyte-containing anatomic site. Four main cutaneous melanoma subtypes are recognized: lentigo maligna melanoma, superficial spreading melanoma, acral lentiginous melanoma (ALM), and nodular melanoma. Generally, excessive exposure to ultraviolet (UV) radiation increases the risk of melanoma. The exception is ALM, which is the most common melanoma subtype in Asians and is not associated with UV radiation. ALM presents as dark brownish to black, irregular maculopatches, nodules, or ulcers on the palms, soles, and nails. The lesions may be misdiagnosed as more benign lesions, such as warts, ulcers, hematomas, foreign bodies, or fungal infections, especially in amelanotic acral melanomas where black pigments are absent. The aim of this brief review is to improve understanding and the rate of early detection thereby reducing mortality, especially regarding cutaneous melanoma in Asians.

Cutaneous malignant melanoma: clinical and histopathological review of cases in a Malaysian tertiary referral centre

Melanoma is a lethal skin cancer that occurs predominantly among Caucasians. In Malaysia, the incidence of melanoma is low. This is a retrospective study of clinical and histopathological features of patients with cutaneous melanoma who were seen at the University Malaya Medical Centre from 1998 to 2008. Thirty-two patients with cutaneous melanoma were recorded during that period. Of these, 24 had sought treatment at the onset of disease at our centre. Chinese patients constituted the largest group (19 cases). The median age of these 24 patients at the time of presentation was 62 years. 16 patients had melanoma involving the lower limb with 12 affecting the sole of the foot. None had melanoma arising from the face. Histopathology showed nodular melanoma in 22 cases (91.6%), with superfi cial spreading and acral lentiginous melanoma diagnosed in 1 case each. The majority of patients (62.5%) were found to be in Stage III of the disease at the time of diagnosis.

Comportamiento del carcinoma basocelular facial en Artemisa durante la última década / Behavior of facial basocellular carcinoma in Artemisa during the last decade

El carcinoma basocelular representa aproximadamente entre un 70 a un 80 por ciento de los cánceres cutáneos no melanoma, en la población de color de piel blanca y su tasa de incidencia ha incrementado un 20 por ciento en las últimas 2 décadas. Se realizó un estudio observacional de tipo descriptivo y de corte transversal desde enero de 2000 a diciembre de 2009, para determinar el comportamiento del carcinoma basocelular en los pacientes anotados en el registro de solicitud de biopsias del Servicio de Cirugía Máxilofacial del municipio Artemisa. El universo fueron 1 287 individuos y constituyeron la muestra 607 pacientes con diagnóstico clínico e histopatológico de carcinoma basocelular. Se registraron las siguientes variables: grupo de edad, sexo, color de la piel, ocupación, localización del tumor, formas clínicas de presentación y tipo histopatológico. Se confeccionó un formulario y los datos se procesaron estadísticamente por cálculo porcentual. Los resultados se presentaron en tablas. Se obtuvo un 47,1 por ciento con diagnóstico de carcinoma basocelular en ambos sexos, con ligero predominio en el género masculino, los campesinos y constructores resultaron ser los más afectados. La población de piel blanca constituyó el 98,8 por ciento de los pacientes con carcinoma basocelular y el grupo de edad más afectado fue el de 70 años en adelante. La principal región fue la nasal, la forma clínica de presentación nodular perlada fue la más frecuente. Predominó el tipo histopatológico sólido y tres cuartas partes de los pacientes fueron tratados con exéresis simple. Se concluyó que el carcinoma basocelular constituyó la entidad de mayor prevalencia al afectar casi la mitad de la población objeto de estudio(AU)

The basocellular carcinoma account for approximately the 70-80 percent of non-melanoma cutaneous cancer in white persons and its incidence rate has increased in a 20 percent in the two past decades. A cross-sectional, descriptive and observational study was conducted from January, 2000 to December, 2009 to determine the basocellular carcinoma's behavior in patients registered for biopsy of the maxillofacial service of Artemisa municipality. Universe included 1 287 patients and sample 607 patients with a clinical and histopathologic diagnosis of basocellular carcinoma. The following variables were registered: age group, sex, skin color, occupation, tumor location, clinical forms of presentation and histological type. A form was designed and data were statistically processed by means of percentage calculation. Results were presented in tables. There was a 47,1 percent diagnosed with basocellular carcinoma in both sexes with a slight predominance of male sex including peasant farmers and builders as the more involved. The white persons were the 98,8 percent of patients presenting with basocellular carcinoma and the more involved age group was that aged 70 and more. The main region was the nasal one, the more frequent was the clinical form of pearly nodular presentation with predominance of the solid histopathologic type and the three-quarter of patients were treated with simple exeresis. We conclude that the basocellular carcinoma was the more prevalent entity involving almost the half of study population(AU)