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1.
Rev. Assoc. Med. Bras. (1992) ; 68(2): 170-175, Feb. 2022. tab, graf
Article in English | LILACS | ID: biblio-1365349

ABSTRACT

SUMMARY OBJECTIVE: A growing volume of literature has suggested long noncoding RNAs (lncRNAs) as important players in tumor progression. In this study, we aimed to investigate the expression and prognostic value of lncRNA LINC00173 (LINC00173) in melanoma. METHODS: LINC00173 expression was measured in 163 paired cancerous and noncancerous specimen samples by real-time polymerase chain reaction. The correlations between LINC00173 expression with clinicopathological characteristics and prognosis were analyzed by chi-square test, log-rank test, and multivariate survival analysis. Receiver-operating characteristic curves were used for the assessment of the diagnostic value of LINC00173 for melanoma patients. RESULTS: The expression level of LINC00173 in melanoma specimens was distinctly higher than that in adjacent non-neoplasm specimens (p<0.01). Besides, LINC00173 was expressed more frequently in patients with advanced melanoma than in patients with early melanoma. Multivariate assays confirmed that LINC00173 expression level was an independent prognostic predictor of melanoma patients (p<0.05). CONCLUSION: Our data indicated that LINC00173 expression could serve as an unfavorable prognostic biomarker for melanoma patients.


Subject(s)
Humans , RNA, Long Noncoding/genetics , RNA, Long Noncoding/metabolism , Melanoma/diagnosis , Melanoma/genetics , Prognosis , Biomarkers, Tumor/genetics , Gene Expression Regulation, Neoplastic , Kaplan-Meier Estimate
2.
An. bras. dermatol ; 96(4): 451-453, July-Aug. 2021. graf
Article in English | LILACS | ID: biblio-1285104

ABSTRACT

Abstract Melanoma in childhood is rare and its diagnosis is more difficult than in adults, as it often presents histologic features overlapping with the Spitz nevus. The authors report the case of a 17-year old boy who was first diagnosed with Spitz nevus, however, the final diagnosis made after the excision of the tumor arising in the scar was changed to melanoma. The case in this present study emphasizes the importance of the differential diagnosis of skin tumors in young patients.


Subject(s)
Humans , Male , Child , Adolescent , Adult , Skin Neoplasms/surgery , Skin Neoplasms/diagnosis , Nevus, Epithelioid and Spindle Cell/surgery , Melanoma/surgery , Melanoma/diagnosis , Cicatrix , Diagnosis, Differential , Neoplasm Recurrence, Local/surgery
3.
An. bras. dermatol ; 96(4): 472-476, July-Aug. 2021. tab
Article in English | LILACS | ID: biblio-1285093

ABSTRACT

Abstract Total body mapping comprises photographic documentation of the entire body surface followed by digital dermatoscopy of selected melanocytic lesions, aiming to compare their evolution over time and identify new lesions. As this is an exam based on comparative analysis of serial dermoscopic body images, standardization of the technique for performing total body mapping is essential. Prepared by specialists from the Brazilian Society of Dermatology, using the modified Delphi method, this article provides recommendations for carrying out total body mapping in Brazil, regarding its indications, technical aspects, and the issuing of the report.


Subject(s)
Humans , Skin Neoplasms/diagnosis , Dermatology , Melanoma/diagnosis , Nevus, Pigmented/diagnosis , Brazil , Follow-Up Studies , Dermoscopy , Diagnosis, Differential
4.
Rev. cuba. med ; 60(2): e1402, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1280357

ABSTRACT

Introducción: El melanoma maligno es un tumor de etiología multifactorial, cuando afecta al sistema respiratorio su origen es casi siempre metastásico, y como tumor primario es muy infrecuente, constituye el 0,07 por ciento de los tumores pulmonares malignos. Objetivo: Presentar un caso clínico con diagnóstico de melanoma maligno primario de pulmón. Presentación del caso: Se presenta el caso de una mujer de 64 años de edad, exfumadora, sin antecedentes de melanoma, que presenta tos seca asociada a disnea, los esfuerzos físicos y dolor torácico. Además de astenia y pérdida de peso. Se le realizó biopsia pulmonar mediante broncoscopia y se le diagnosticó melanoma. Conclusiones: El melanoma primario pulmonar es uno de los más raros del tipo de melanoma visceral, es una entidad neumológica infrecuente y el diagnóstico preciso requiere una investigación detallada y el cumplimiento de criterios clínicos y anatomopatológicos específicos(AU)


Introduction: Malignant melanoma is a tumor of multifactorial etiology, when it affects the respiratory system its origin is almost always metastatic, and as a primary tumor it is very infrequent, it constitutes 0.07 por ciento of malignant lung tumors. Objective: To report a clinical case with a diagnosis of primary malignant melanoma of the lung. Case report: We report the case of a 64-year-old woman, former smoker, with no history of melanoma, who had dry cough associated with dyspnea with physical exertion and chest pain. In addition to asthenia and weight loss, she had a lung biopsy by bronchoscopy and was diagnosed with melanoma. Conclusions: Primary pulmonary melanoma is one of the rarest of the visceral melanoma type, this is an infrequent pneumological entity and the precise diagnosis requires detailed investigation and the fulfillment of specific clinical and pathological criteria(AU)


Subject(s)
Humans , Female , Bronchoscopy/methods , Lung Neoplasms/diagnosis , Melanoma/diagnosis
5.
Rev. medica electron ; 43(2)mar.-abr. 2021. graf
Article in Spanish | LILACS, CUMED | ID: biblio-1251945

ABSTRACT

El melanoma subungueal es un subgrupo del melanoma acral lentiginoso. Con frecuencia se diagnostica en etapa avanzada, dada la escasez de síntomas; de ahí que la evaluación y el tratamiento oportuno mejoran el pronóstico. Se presenta el caso de un paciente de 44 años de edad, que acude a consulta de Ortopedia con melanoniquia de tres meses de evolución. Había sido tratado en la atención primaria de salud por un hematoma secundario a un trauma directo sobre la falange distal del primer artejo del pie izquierdo. Fue seguido por consulta externa de Ortopedia y, al no experimentar una evolución adecuada, fue evaluado por la Comisión Provincial de Tumores Periféricos. Se le realizó una biopsia por punch (sacabocado), que arrojó el resultado de melanoma subungueal. Se realizó la amputación del primer artejo y del proximal del primer metatarsiano, una vez verificada la no existencia de lesiones metastásicas, con excelente resultado estético y funcional, sin mostrar recidiva en su seguimiento, a dos años de su intervención(AU)


Subungual melanoma is a subgroup of lentiginous acral melanoma. It is often diagnosed in an advanced stage by a shortage of symptoms, so timely evaluation and treatment improve prognosis. This is the case of a 44-year-old patient who goes to orthopedics with melanonichia 3 months of evolution. He had been treated for a bruise secondary to direct trauma to the distal phalanx of the first left foot ailre in primary health care. It was followed by external orthopedic consultation and by not following an adequate evolution was evaluated by the provincial commission of peripheral tumors. He was given a punch biopsy resulting in a subungual melanoma. The amputation of the first artejo and proximal first metatarsal was carried out, once verified the non-existence of metastatic lesions, with excellent aesthetic and functional result, without showing relapse in its follow-up to two years(AU)


Subject(s)
Humans , Male , Adult , Catastrophic Illness/classification , Melanoma/diagnosis , Orthopedics/methods , Signs and Symptoms , Therapeutics , Biopsy , Amputation/methods , Melanoma/surgery
6.
Dermatol. argent ; 27(1): 20-24, ene.-mar. 2021. il, graf
Article in Spanish | LILACS, BINACIS | ID: biblio-1361641

ABSTRACT

Antecedentes: El reconocimiento de los melanomas de diámetro pequeño (MDP) a menudo plantea un desafío. Objetivos: Analizar el papel de la dermatoscopia y el seguimiento con dermatoscopia digital en el diagnóstico de los MDP. Diseño: Análisis retrospectivo, observacional, descriptivo, de una serie de 50 MDP diagnosticados entre 2015 y 2019. Resultados: De los MDP, 9 fueron motivo de consulta del paciente (MMC), 30 se detectaron durante el control rutinario de nevos (MMCR) y 11 se diagnosticaron por los cambios observados durante el seguimiento con dermatoscopia digital (MMDD). Cerca del 45% de los MMC fueron clasificados correctamente como lesiones malignas según la "regla ABCD de dermatoscopia"; esto se observó solo en el 20% de los MMCR y en ninguno de los MMDD. El algoritmo "caos y pistas" condujo a la extirpación en casi el 90% de los MMC, el 60% de los MMCR y el 50% de los MMDD. Los porcentajes de melanoma in situ fueron: 55% entre los MMC, 73,3% entre los MMCR y 72,9% entre los MMDD. En los melanomas invasores, el grosor de Breslow medio fue de 0,62 mm en el grupo MMC, de 0,5 mm en el MMCR y de 0,4 mm en el MMDD. Conclusiones: El uso rutinario de la dermatoscopia permite la detección de melanomas con bajo índice de sospecha que los pacientes podrían desconocer. Mediante el seguimiento digital es posible la detección de los melanomas incipientes que carecen no solo de criterios clínicos, sino también dermatoscópicos de malignidad.


Background: Recognition of small-diameter melanomas (SDM) is often challenging. Objective: To analyze the role of dermoscopy and follow-up with digital dermoscopy in the diagnosis of SDM. Design: Retrospective, observational, descriptive analysis of a series of 50 SDM diagnosed between 2015 and 2019. Results: Among the SMD, 9 cases were the patients' reason for consultation (MMC), 30 were detected during routine nevi control (MMCR) and 11 were diagnosed due to changes observed during followup with digital dermoscopy (MMDD). Near 45% of the MMC were correctly classified as malignant lesions according to the "ABCD rule of dermoscopy"; this was observed only in 20% of the MMCR and in none of the MMDD. The "chaos and clues" algorithm led to excision in almost 90% of MMC, 60% of MMCR, and 50% of MMDD. The percentages of in situ melanoma were: 55% in the MMC, 73.3% in the MMCR and 72.9% in the MMDD. Among invasive melanomas, mean Breslow thickness was 0.62 mm in the MMC group, 0.5 mm in the MMCR, and 0.4 mm in the MMDD. Conclusions: The routine use of dermoscopy allows for the detection of melanomas with a low index of suspicion that patients may not be aware of. The use of digital follow-up enables the detection of incipient melanomas that lack not only clinical but also dermoscopic criteria of malignancy.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Young Adult , Skin Neoplasms , Dermoscopy/methods , Melanoma/diagnosis , Skin , Retrospective Studies , Aftercare
7.
Ciudad Autónoma de Buenos Aires; Comisión Nacional de Evaluación de Tecnologías de Salud; Marzo 2021. 28 p. (Informe de Evaluación de Tecnologías Sanitarias N°13, 13).
Monography in Spanish | LILACS, BINACIS, ARGMSAL | ID: biblio-1151676

ABSTRACT

El presente informe es producto del trabajo colaborativo de la Comisión Nacional de Evaluación de Tecnologías de Salud (CONETEC), dependiente del Ministerio de Salud de la Nación y creada por RM N° 623/2018. La CONETEC realiza evaluaciones y emite recomendaciones a la autoridad sanitaria sobre la incorporación, forma de uso, financiamiento y políticas de cobertura de las tecnologías sanitarias desde una perspectiva global del sistema de salud argentino. En sus evaluaciones y recomendaciones, la CONETEC tiene en cuenta criterios de calidad, seguridad, efectividad, eficiencia y equidad, evaluados bajo dimensiones éticas, médicas, económicas y sociales. Sus resultados son consensuados mediante discusiones públicas y ponderados a través de un marco de valor explícito, con la participación de todos los actores involucrados en el proceso de toma de decisiones en salud. Los informes y recomendaciones de esta comisión surgen de este proceso público, transparente y colaborativo, siendo de libre consulta y acceso para toda la sociedad


Subject(s)
Nivolumab , Melanoma , Melanoma/diagnosis , Melanoma/epidemiology
8.
An. bras. dermatol ; 96(1): 64-67, Jan.-Feb. 2021. graf
Article in English | LILACS | ID: biblio-1152784

ABSTRACT

Abstract External ear melanoma is rare, and early diagnosis and treatment are paramount for the patient's survival. Four clinical cases are reported, emphasizing the importance of the routine clinical examination of the ears in the dermatological consultation. The study included male and female patients, aged 60 to 81 years old, with melanocytic lesions in the outer ear, evaluated with detailed physical and dermoscopic examination, leading to the identification of lesions suggestive of melanoma. The cases were treated surgically with excision of the lesion, and the diagnoses were confirmed by histopathological study. The therapeutic approach was instituted early as most cases were diagnosed at an early stage, which directly impacted global survival.


Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Skin Neoplasms/surgery , Skin Neoplasms/diagnosis , Melanoma/surgery , Melanoma/diagnosis , Ear, External , Melanocytes , Middle Aged
9.
Arq. bras. oftalmol ; 84(1): 22-30, Jan.-Feb. 2021. tab, graf
Article in English | LILACS | ID: biblio-1153093

ABSTRACT

ABSTRACT Purpose: The aim of this study was to present our own experience with the use of thermography as a complementary method for the initial diagnosis and differentiation of intraocular tumors, as well as for the evaluation of the efficacy of treatment of intraocular melanomas. Methods: The study group comprised 37 patients with intraocular tumors, including 9 with uveal melanoma, 8 with uveal melanoma after I125 brachytherapy, 12 with a focal metastasis to the uvea, and 8 with retinal capillary hemangioblastoma. A FLIR T640 camera was used to capture images in the central point of the cornea, eye area, and orbital cavity area. Results: Eyes with uveal melanoma had higher temperature compared with the fellow normal eye of the patient in the range of all measured parameters in the regions of interest. In the group of patients with melanoma after unsuccessful brachytherapy, higher temperature was observed at the central point of the cornea. In patients with tumor regression, all measured parameters were lower in the affected eye. We observed lower tempe­ratures in the range of all tested parameters and areas in eyes with choroidal metastases. Eyes with diagnosed intraocular hemangioblastoma were characterized by higher parameters for the regions of interest versus eyes without this pathology. Conclusions: A thermographic examination of the eye can be used as an additional first-line diagnostic tool for the differentiation of intraocular tumors. Thermography can be a helpful tool in monitoring the treatment outcome in patients with intraocular melanoma.


RESUMO Objetivo: O objetivo deste estudo foi de apresentar a nossa experiência no uso da termografia como método complementar para o diagnóstico inicial e a diferenciação de tumores intraoculares, bem como para a avaliação da eficácia do tratamento de melanomas intraoculares. Métodos: O grupo estudado compunha-se de 37 pacientes com tumores intraoculares, sendo 9 com melanoma uveal, 8 com melanoma uveal após braquiterapia com I125, 12 com metástases focais na úvea e 8 com hemangioblastoma capilar retiniano. As imagens do ponto central da córnea, da área do olho e da área da cavidade orbital foram obtidas com uma câmera FLIR T640. Resultados: Os olhos dos pacientes com melanoma uveal tinham temperaturas mais elevadas do que as dos olhos normais dos mesmos, em toda a faixa dos parâmetros medidos nas regiões de interesse. No grupo de pacientes com melanoma após braquiterapia mal sucedida, encontrámos temperaturas maiores no ponto central da córnea. Nos pacientes com regressão do tumor, todos os parâmetros medidos foram menores no olho acometido. Encontrámos temperaturas mais baixas em toda a faixa dos parâmetros testados e das áreas medidas nos olhos com metástases na coroide. Os olhos com hemangioblastoma intraocular diagnosticado caracterizaram-se por parâmetros mais elevados nas regiões de interesse, em comparação com olhos sem essa patologia. Conclusões: O exame termográfico do olho pode usar-se como ferramenta de diagnóstico adicional de triagem na diferenciação de tumores intraoculares. A termografia pode ser uma ferramenta útil no acompanhamento do des­fe­cho do tratamento em pacientes com melanoma intraocular.


Subject(s)
Humans , Uveal Neoplasms , Brachytherapy , Melanoma , Uvea , Uveal Neoplasms/diagnosis , Uveal Neoplasms/radiotherapy , Thermography , Melanoma/diagnosis
10.
Rev. Hosp. Clin. Univ. Chile ; 32(1): 78-84, 2021. tab, graf
Article in Spanish | LILACS | ID: biblio-1252508

ABSTRACT

Skin cancer is usually classified into melanoma (SCM) and non-melanoma (SCNM), with different cell origins; being the SCM responsible for the highest mortality. In Chile, an incidence (2008) of 434 new cases is estimated, obtaining a standardized rate of 2.2 cases per 100,000 habitants. There are multiple associated risk factors, the main ones being exposure to UV radiation and sunburn. The strategies to prevent this pathology fall on these same factors. The clinical evaluation of the lesions with ABCD mnemonics added to the use of dermoscopy increases the diagnostic sensitivity and specificity; however, the definitive confirmation is through biopsy, which must include the necessary parameters to define prognosis of disease. The definitive treatment is Surgical. There are alternatives such as the use of the sentinel lymph node to define lymph node dissections. Regarding systemic therapies, the use of immunotherapy has shown results that improve survival in these patients.


Subject(s)
Humans , Male , Female , Melanoma/diagnosis , Melanoma/therapy , Skin Neoplasms , Melanoma/prevention & control , Melanoma/diagnostic imaging
11.
Rev. bras. cancerol ; 67(2): e-101239, 2021.
Article in Portuguese | LILACS | ID: biblio-1291145

ABSTRACT

Introdução: O melanoma cutâneo é um tumor com grande capacidade de metastização. Um dos quadros possíveis, mas bastante raro, é quando a metástase se aloja em peritônio (carcinomatose peritoneal). Relato do caso: Paciente feminina, 61 anos, encaminhada por massa inguinal esquerda suspeita e lesão hipercrômica de 2 cm, com área de regressão em membro inferior esquerdo. A paciente foi submetida à linfadenectomia inguinal esquerda e ressecção da lesão de pele, que evidenciou melanoma maligno cutâneo extensivo superficial invasor, de espessura de Breslow 1,2 mm, e nível de Clark II, bem como metástase linfonodal. O tratamento adjuvante incluiu radioterapia e quimioterapia. Durante follow-up, oito meses depois, ultrassonografia e tomografia computadorizada de abdome evidenciaram imagem nodular sólida hipoecoica, heterogênea e bosselada, mal definida e mal delimitada em projeção para-aórtica à esquerda, com 12,7x6,7x4,8 cm. Em laparotomia exploradora, encontrou-se massa volumosa retroperitoneal em flanco esquerdo, com envolvimento do ângulo de Treitz e presença de carcinomatose peritoneal. O laudo anatomopatológico evidenciou neoplasia maligna pouco diferenciada epitelioide infiltrativa, compatível com história clínica de melanoma. A paciente evoluiu a óbito após consulta com oncologia clínica. Conclusão:Existem poucos casos de metástase peritoneal de melanoma relatados na literatura. Contudo, deve-se levar em consideração sua possibilidade de ocorrência e as opções terapêuticas disponíveis, além de também compreender seu impacto no prognóstico do paciente. Apesar de rara, a carcinomatose peritoneal deve ser considerada quando pacientes com histórico pessoal de melanoma apresentarem queixas abdominais inespecíficas, como a paciente do caso relatado.


Introduction: Cutaneous melanoma is a tumor with great capacity for metastasis. One of the possible but quite rare scenarios is when the metastasis is lodged in the peritoneum (peritoneal carcinomatosis). Case report:61-year-old female patient, referred by a suspected left inguinal mass and 2 cm hyperchromic lesion, with regression area in the left lower limb. The patient underwent left inguinal lymphadenectomy and resection of the skin lesion, which revealed invasive extensive superficial cutaneous malignant melanoma, Breslow depth 1.2 mm and Clark II level, as well as lymph node metastasis. Adjuvant treatment included radiotherapy and chemotherapy. During follow-up, 8 months later, abdominal ultrasound and computed tomography showed hypoechoic, heterogeneous, and beveled solid nodular image, poorly defined and delimited in left para-aortic projection, with 12.7x6.7x4.8 cm. In exploratory laparotomy, a large retroperitoneal mass was found on the left flank, involving the Treitz angle, and revealed the presence of peritoneal carcinomatosis. The anatomopathological report showed a poorly differentiated malignant infiltrative epithelioid neoplasm, compatible with the clinical history of melanoma. The patient died after consultation with clinical oncology. Conclusion: There are few cases of peritoneal metastasis of melanoma reported in the literature. However, its possibility of occurrence and the therapeutic options available must be taken into account, in addition to understanding its impact on the patient's prognosis. Although rare, peritoneal carcinomatosis should be considered when patients with a personal history of melanoma have non-specific abdominal complaints, such as the patient in the case reported.


Introducción: El melanoma cutáneo es un tumor con gran capacidad de metástasis. Una de las situaciones posibles, pero bastante rara, es cuando la metástasis se aloja en el peritoneo. Relato del caso: paciente femenina de 61 años, remitida por sospecha de masa inguinal izquierda y lesión hipercrómica de 2 cm, con área de regresión, en miembro inferior izquierdo. La paciente fue sometida a linfadenectomía inguinal izquierda y resección de la lesión cutánea, que demonstró melanoma maligno cutáneo superficial extenso invasivo, Breslow 1,2 mm y nivel de Clark II, así como metástasis ganglionares. El tratamiento adyuvante incluyó radioterapia y quimioterapia. Durante el seguimiento, 8 meses después, la ecografía y la tomografía computarizada de abdomen mostraron una imagen nodular sólida hipoecoica, heterogénea y biselada, mal definida y delimitada en proyección para-aórtica izquierda, con 12,7x6,7x4,8 cm. En la laparotomía exploradora se encontró una gran masa retroperitoneal en el flanco izquierdo, involucrando el ángulo de Treitz y presencia de carcinomatosis peritoneal. El informe anatomopatológico mostró una neoplasia epitelioide infiltrativa maligna mal diferenciada, compatible con la historia clínica de melanoma. El paciente falleció tras consulta con oncología clínica. Conclusión: Hay pocos casos de metástasis peritoneal de melanoma reportados en la literatura. Sin embargo, se debe tener en cuenta su posibilidad de ocurrencia y las opciones terapéuticas disponibles, además de comprender su impacto en el pronóstico del paciente. Aunque es poco común, la carcinomatosis peritoneal debe considerarse cuando los pacientes con antecedentes personales de melanoma tienen molestias abdominales inespecíficas, como la paciente del caso.


Subject(s)
Humans , Female , Middle Aged , Peritoneal Neoplasms/secondary , Skin Neoplasms/diagnosis , Melanoma/diagnosis , Peritoneal Neoplasms/diagnosis , Peritoneal Neoplasms/therapy , Neoplasm Metastasis
13.
Rev. cir. (Impr.) ; 72(5): 464-467, oct. 2020. graf
Article in Spanish | LILACS | ID: biblio-1138740

ABSTRACT

Resumen Objetivos: El melanoma cutáneo presenta un alto potencial metastásico y constituye la fuente extraabdominal más frecuente de lesión del intestino delgado. El diagnóstico de metástasis gastrointestinales es a menudo una expresión de enfermedad avanzada, con una supervivencia media de entre 6 y 9 meses. Materiales y Método: Presentamos el caso de un paciente varón de 63 años diagnosticado de melanoma cutáneo que acudió a urgencias por dolor abdominal y estreñimiento. Se realizó una TC abdominal donde se informó de la existencia de 2 lesiones metastásicas a nivel de intestino delgado que condicionaban oclusión intestinal. Resultados: El paciente fue intervenido quirúrgicamente bajo abordaje laparoscópico con resección de los dos segmentos intestinales afectos y anastomosis intracorpórea. El informe histopatológico confirmó que se trataban de metástasis de melanoma. Discusión: La oclusión intestinal por metástasis de melanoma maligno es muy infrecuente. La cirugía es el tratamiento de elección en pacientes con metástasis intestinales de melanoma. El tratamiento quirúrgico puede mejorar el pronóstico y estaría indicado casos de metástasis únicas o pacientes sintomáticos con intención paliativa. El abordaje mínimamente invasivo ofrece resultados oncológicos similares a la laparotomía.


Aim: Cutaneous melanoma has a high metastatic potential, being the most frequent extra-abdominal source of small bowel metastasis. The diagnosis of gastrointestinal metastases is often an expression of advanced disease, with an average survival of 6-9 months. Materials and Method: We herein present the case of a 63-year-old male patient diagnosed with cutaneous melanoma who arrived to the emergency department complaining of abdominal pain and constipation. An abdominal CT scan was performed, it revealed two metastatic lesions in the small bowel which marked the mechanical obstruction. Results: Patient underwent a laparoscopy and both involved segments were removed. Pathology exam confirmed the diagnosis of melanoma metastases. Discussion: Surgery excision is the treatment of choice in patients with small bowel metastases from melanoma. Surgical management can improve the prognosis and it would be indicated in cases of single metastases or symptomatic patients with a palliative intention. Minimally invasive approach provides similar oncological results as conventional laparotomy. Small bowel obstruction due to metastases of malignant melanoma is extremely rare.


Subject(s)
Humans , Male , Middle Aged , Skin Neoplasms/diagnosis , Melanoma/diagnosis , Skin Neoplasms/pathology , Biopsy , Tomography, X-Ray Computed , Laparoscopy , Gastrointestinal Neoplasms/secondary , Intestinal Obstruction/surgery , Melanoma/pathology
14.
Medicina (B.Aires) ; 80(3): 280-284, jun. 2020. ilus
Article in Spanish | LILACS | ID: biblio-1125080

ABSTRACT

El melanoma desmoplásico es una variedad infrecuente de melanoma que se distingue por su presentación clínico-patológica y su comportamiento biológico. El diagnóstico temprano es un desafío por su presentación clínica variable, con predominio del componente dérmico y la frecuente ausencia de pigmento. En la histología se lo divide en puro y mixto y esta clasificación tiene importantes implicancias pronósticas. El espesor de Breslow promedio al momento del diagnóstico es mayor que en otras variantes de melanoma, sin embargo, la tendencia a generar metástasis ganglionares es menor.


Desmoplastic melanoma is a rare presentation of melanoma with a different clinical behavior compared to other histological variants. Its diagnosis in early stages is a challenge due to its variable clinical presentation, with a predominant dermal component and the frequent absence of pigment. Its histology is divided into pure and mixed type, and this classification has important prognostic implications. The average Breslow thickness at diagnosis is higher than in other melanoma variants. However, the tendency to lymph node metastasis is low.


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Skin Neoplasms/diagnosis , Skin Neoplasms/pathology , Melanoma/diagnosis , Melanoma/pathology , Biopsy , Diagnosis, Differential
15.
Dermatol. argent ; 26(1): 23-25, 2020. ilus, tab
Article in Spanish | LILACS | ID: biblio-1146359

ABSTRACT

Antecedentes: En la octava edición del manual de estadificación del cáncer del American Joint Committee on Cancer (AJCC), se introdujeron cambios importantes en las categorías T, N y M. Al entrar en vigencia la octava guía de la AJCC, se modificó no solo el T, sino también la indicación de biopsia del ganglio centinela (BGC). Entre los cambios más significativos en la estadificación se encuentran: la exclusión del índice mitótico (IM) de la categoría T en los melanomas finos (de hasta 1 mm de espesor) y el cambio del punto de corte para el espesor tumoral para discriminar un T1a (< 0,8 mm sin ulceración) de un T1b (≥ 0,8 mm). Objetivo: Comparar la estadificación inicial de los melanomas finos según el criterio utilizado en la séptima edición, con la que tendrían de acuerdo con la perspectiva actual del AJCC, con especial atención en el índice mitótico. Diseño y métodos: Estudio observacional, de corte transversal, realizado mediante la recolección de datos de las historias clínicas desde el 1 de enero de 2000 hasta el 31 de diciembre de 2017. Resultados: De 131 melanomas finos incluidos, 28 tendrían cambios en su estadificación. Al considerar el nuevo punto de corte para el espesor tumoral, 22 melanomas T1a pasarían a T1b. Asimismo, se detectaron 20 melanomas con un IM ≥ 1 mitosis/mm2, de los cuales solo 6 tuvieron indicación de BGC por este criterio exclusivamente y serían clasificados como T1a en la actualidad. De estos, en 2 no se realizó la BGC por autodeterminación de los pacientes y en los 4 restantes el resultado fue negativo. Conclusiones: Veintiocho de nuestros pacientes tendrían hoy diferencias en la indicación de BGC: 22 serían considerados con mayor riesgo de metástasis ganglionares y serían candidatos a su pesquisa. Los otros 6 pacientes ya no tendrían indicación de ese estudio por la baja posibilidad de encontrar metástasis ocultas, lo cual coincide con el resultado negativo de la BGC en los 4 pacientes que se sometieron al procedimiento. (AU)


Background: In the 8th edition of the cancer staging manual of the American Joint Committee on Cancer (AJCC), important changes were made in the T, N and M categories. When the 8th guideline of the AJCC came into effect, not only was the T stage modified, but also the indication for sentinel lymph node biopsy (SLNB). The most significant changes in staging included: the exclusion of the mitotic index (MI) as a determinant of the T category and the change of the threshold of tumor thickness to discriminate a T1a (< 0.8 mm without ulceration) from a T1b (≥ 0.8 mm). Objective: To compare the initial staging of thin melanomas according to the criteria used in the 7th edition, with the one that would have been used according to the current AJCC recommendations, with special focus on MI. Design and methods: Observational, cross-sectional study, carried out through the collection of data from medical records from January 1, 2000 to December 31, 2017. Results: There were 131 thin melanomas included, 28 of which would have had changes in their staging. When considering the modified threshold for tumor thickness, 22 T1a melanomas would be classified as T1b. Among 20 thin melanomas with a MI ≥ 1, only 6 had an indication for SLNB solely due to the MI criterion and would be now classified as T1a. Two of these did not undergo SLNB because they rejected the procedure, and in the remaining 4, there were no SLN metastasis. Conclusions: Nowadays, 28 of our patients would have differences in the indication for SLNB: 22 would be considered to be at greater risk of lymph node metastasis and would be candidates for screening. The other 6 patients would no longer have an indication for this procedure due to the low probability of clinically occult metastases, which seems to concur with the negative result of SLNB in the 4 patients who underwent the procedure. (AU)


Subject(s)
Humans , Skin Neoplasms/pathology , Practice Guidelines as Topic , Sentinel Lymph Node Biopsy , Melanoma/pathology , Mitotic Index , Neoplasm Staging/methods , Skin Neoplasms/diagnosis , Cross-Sectional Studies , Risk Factors , Lymphatic Metastasis , Melanoma/diagnosis
16.
Cienc. tecnol. salud ; 7(1): 47-52, 2020.
Article in Spanish | LILACS | ID: biblio-1120310

ABSTRACT

Los estudios de melanoma en Guatemala han sido pocos y únicamente se ha evaluado el aspecto clínico e histológico. El objetivo del presente estudio fue determinar la proporción de casos de melanoma cutáneo por morfología, inmunohistoquímica y mutación del gen BRAF en pacientes con diagnóstico de melanoma en dos centros de referencia, Instituto de Cancerología e Instituto de Dermatología en Guatemala. El estudio es de tipo descriptivo, retrospectivo, transversal. El tipo de muestreo es no probabilístico, con una muestra por conveniencia de 100 casos de tejidos de piel de pacientes, caracterizados por edad, sexo y localización del tumor. Los estudios moleculares incluyeron la determinación de la mutación de la proteína BRAF, por la técnica de PCR-RT. Los resultados muestran que el sexo más afectado es el femenino (54 %). El grupo etario con mayor número de casos es entre 56-75 años (44 %). El tipo histológico predominante es el melanoma lentiginoso acral (59 %) y la localización más frecuente es en miembro inferior (71 %). No se encontraron casos de melanoma lentigo maligno. La mutación del gen BRAF se encontró en el 6 % de los casos, lo que representa un dato importante para el pronóstico y tratamiento del paciente. Por ser uno de los primeros estudios que incluyen el factor molecular, abre paso a una línea de investigación que permita dar continuidad a los pacientes con melanoma en Guatemala, lo que permitirá determinar factores pronóstico y predictivos, así como tratamientos de los casos en estudio.


Studies of melanoma in Guatemala have been few and only the clinical and histological aspects have been evaluated. The objective of this study was to determine the proportion of cases of cutaneous melanoma by morphology, immunohistochemistry and mutation of the BRAF gene in patients diagnosed with Melanoma in two important reference centers, Institute of Cancerology (Incan) and Institute of Dermatology of Guatemala (Inderma). The study is descriptive, retrospective, transversal. The type of sampling is non-probabilistic, with a convenience sample calculation of 100 cases of patient skin biopsies, characterized by age, sex and tumor anatomic location. Molecular studies included the determination of the BRAF protein mutation by means of the RT-PCR technique. Results show that the most affected sex is the female (54 %). Age group with the highest number of cases is between 56 and 75 years old (44 % of cases). The histological type that predominated is acral lentiginous melanoma (59 %) and the most frequent location is in the lower limb (71 %). No cases of malignant lentigo melanoma were found in the cases studied. The BRAF gene mutation was found in 6 % of the cases, which represents an important data for the prognosis and treatment of the patient. In addition, being one of the first studies that include the molecular factor, it opens the way to a line of research that allows patients with melanoma to continue in Guatemala. This would allow to determine prognostic and predictive factors, as well as treatments of the cases under study.


Subject(s)
Immunohistochemistry/methods , Melanoma/diagnosis , Mutation/genetics , Skin Neoplasms , Hospitals, Chronic Disease , Melanoma/pathology
17.
Article in Spanish | LILACS, BNUY, UY-BNMED | ID: biblio-1088702

ABSTRACT

El melanoma anal (MA) es un tumor infrecuente, caracterizado por presentar un comportamiento agresivo y mal pronóstico(1). La sintomatología inespecífica con la cual se presenta y su similitud con etiologías benignas anorrectales, dificulta el diagnóstico y puede conducir a un retraso en el mismo(2)(3). Por lo tanto, es necesaria una exploración física minuciosa y un elevado índice de sospecha. Se discute el caso de una paciente que consultó por tumoración anal dolorosa, no pigmentada y rectorragia; a la que se le realiza diagnóstico de melanoma anal.


Anal melanoma (MA) is an infrequent tumor, characterized by aggressive behavior and poor prognosis(1). The nonspecific symptomatology and its similarity with benign anorectal etiologies, makes the diagnosis difficult and leads to a delay in it(2)(3).Therefore, a thorough physical examination and a high index of suspicion are necessary. The case of a patient who consulted for a non-pigmented and painful anal mass with rectal bleeding is discussed; which is diagnosed with anal melanoma.


O melanoma anal (MA) é um tumor infrequente, caracterizado por apresentar um comportamento agressivo e ter um mauprognóstico(1). A sintomatologia inespecífica da sua apresentação e a sua similaridade com etiologias benignas anorretais dificultam o diagnóstico e pode levar a um atraso do mesmo(2)(3). Por tanto é necessário uma exploração física minuciosa e um indice de suspeita elevado. Discute-se o um caso de uma paciente que consultou por uma tumoração anal, dolorosa, não pigmentada e retorragia, a qual se realizou o diagnostico de melanoma anal.


Subject(s)
Humans , Female , Aged, 80 and over , Anus Neoplasms/diagnosis , Anus Neoplasms/radiotherapy , Anus Neoplasms/diagnostic imaging , Melanoma/diagnosis , Melanoma/radiotherapy , Melanoma/diagnostic imaging , Pain/etiology , Pruritus Ani/etiology , Colonoscopy , Anemia, Iron-Deficiency/etiology , Gastrointestinal Hemorrhage/etiology
18.
Rev. bras. oftalmol ; 78(6): 406-408, nov.-dez. 2019. graf
Article in English | LILACS | ID: biblio-1057922

ABSTRACT

Abstract Choroidal melanomas are the most common primary intraocular malignant tumor in adults. They tend to be more malignant; because of their location hidden behind the iris they can not be detected until they become larger. Therapeutic strategy is related by size, extension, number and location of tumor and growth patterns. High frequency ultrasound biomicroscopy (UBM) gives high resolution, cross-sectional images of the anterior segment lesions. Postequatorial lesions and intracranial extension of the melanomas are scanned by magnetic resonance imaging (MRI). We report a case of bilobed tumor with confusing appereance in preoperative imaging studies and macroscopy following enucleation. MRI is the perfect imaging method to reveal extension and size of the tumor in the posterior chamber. Combined use of UBM and MRI provides appropriate staging of ocular melanomas.


Resumo Melanomas coroidais são os tumores malignos intra-oculares primários mais comuns em adultos. Eles tendem a ser mais malignos; devido à sua localização ser escondida por detrás da íris eles não podem ser detectados até se tornarem maiores. A estratégia terapêutica está relacionada com tamanho, extensão, número e localização dos padrões tumorais e de crescimento. O biomicroscopio ultra-sónico de alta frequência (BMU) fornece imagens transversais de alta resolução das lesões do segmento anterior. Lesões pós-equatoriais e de extensão intracraniana dos melanomas são digitalizadas em ressonância magnética (RM). Relatamos um caso de tumor com dois lóbulos, com aparência confusa em exames de imagem pré-operatórios e macroscopia após enucleação. A RM é o método de imagem perfeito para revelar a extensão e o tamanho do tumor na câmara posterior. O uso combinado de BMU e MRI fornece o faseamento apropriado dos melanomas oculares.


Subject(s)
Humans , Male , Aged, 80 and over , Ciliary Body/pathology , Neoplasm Staging , Melanoma/diagnosis
19.
Rev. méd. Chile ; 147(7): 928-931, jul. 2019. graf
Article in Spanish | LILACS | ID: biblio-1058623

ABSTRACT

Lhermitte phenomenon is a neurological symptom described as a sensation of electric shock that radiates from the back towards the extremities, which appears when a patient flexes the neck. A transient myelopathy as a late complication of radiotherapy is associated with this symptom. It appears two to four months after treatment and disappears spontaneously. We report a 45 years old female with a neck malignant melanoma treated with surgery and adjuvant radiotherapy. She experienced the Lhermitte phenomenon that was triggered by heat. This phenomenon must be differentiated from the Uhthoff phenomenon.


Subject(s)
Humans , Male , Middle Aged , Pain/etiology , Skin Neoplasms/diagnosis , Radiotherapy, Adjuvant/adverse effects , Head and Neck Neoplasms/diagnosis , Hot Temperature/adverse effects , Melanoma/diagnosis , Skin Neoplasms/surgery , Skin Neoplasms/radiotherapy , Diagnosis, Differential , Head and Neck Neoplasms/surgery , Head and Neck Neoplasms/radiotherapy , Melanoma/surgery , Melanoma/radiotherapy
20.
Int. j. odontostomatol. (Print) ; 13(2): 230-234, jun. 2019. graf
Article in English | LILACS | ID: biblio-1002310

ABSTRACT

ABSTRACT: Oral melanoma (OM) is an extremely rare and aggressive malignancy. A 67-year-old patient presented with complains of a slightly symptomatic spot in the mouth since the past 2 years. Extraoral examination revealed left cervical lymphadenopathy, and intraoral examination a blue-black multinodular sessile mass, with irregular margins, involving the attached gingiva of teeth 27 and 28, extending to vestibular sulcus and hard palate, measuring approximately 3.5 cm. The lesion presented focal areas of ulceration. Panoramic radiograph did not show bone involvement. The main diagnostic hypothesis was oral melanoma. Microscopic findings of the incisional biopsy revealed a proliferation of densely pigmented pleomorphic cells, invading the subepithelial connective tissue in sheets or nests showing an organoid pattern. Immunopositivity for S-100, Melan-A and HMB-45 confirmed the diagnosis of melanoma. The patient was referred to an oncology hospital in which multiple metastases were detected, and the patient was subjected to palliative care. Herein we report an OM in advanced clinical stage, and discuss the clinical, morphological and immunohistochemical diagnostic criteria with emphasis on the importance of early diagnosis.


RESUMEN: El melanoma oral (MO) es una malignidad extremadamente rara y agresiva. Un paciente de 67 años acudió a consulta con la queja de una mancha intraoral ligeramente sintomática, presente desde hace dos años. Al examen clínico extraoral, se encontró adenopatía cervical del lado izquierdo, y al examen intraoral, se observó una masa sésil multinodular de color negro azulado, focalmente ulcerada, con bordes irregulares, afectando la encía de los dientes 27 y 28, extendiéndose hasta el surco vestibular y el paladar duro, midiendo aproximadamente 3,5 cm. La radiografía panorámica no mostró involucramiento óseo. La principal hipótesis diagnóstica fue MO. Los hallazgos microscópicos de la biopsia incisional revelaron una proliferación de células pleomórficas densamente pigmentadas, invadiendo difusamente el tejido conectivo en forma de sábanas o nidos con patrón organoide. La positividad inmunohistoquímica para S-100, Melan-A y HMB-45 confirmó el diagnóstico de melanoma. El paciente fue referido a un hospital oncológico, en el cual se le detectaron múltiples metástasis y fue sometido a cuidados paliativos. Este es el reporte de un caso de MO diagnosticado en estado avanzado, en el que se discuten los criterios clínicos, morfológicos e inmunohistoquímicos para su diagnóstico, haciendo énfasis en la importancia del diagnóstico temprano.


Subject(s)
Humans , Aged , Gingival Neoplasms/diagnosis , Melanoma/diagnosis , Prognosis , Gingival Neoplasms/etiology , Gingival Neoplasms/diagnostic imaging , Delayed Diagnosis , Melanoma/diagnostic imaging , Microscopy
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