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An. bras. dermatol ; 96(6): 717-720, Nov.-Dec. 2021. graf
Article in English | LILACS | ID: biblio-1355637


Abstract Large defects in plantar surface secondary to acral melanoma excision can be difficult to repair with local flaps, and skin grafts in weight-bearing surfaces often suffer necrosis causing prolonged disability. Acellular dermal matrices represent an easy alternative to cover deep wounds or those with bone or tendon exposure. Despite their high cost and the requirement of two surgical procedures, this alternative may offer excellent functional and aesthetic results in acral defects.

Humans , Skin Neoplasms/surgery , Reconstructive Surgical Procedures , Acellular Dermis , Melanoma/surgery , Surgical Flaps , Skin Transplantation
An. bras. dermatol ; 96(6): 693-699, Nov.-Dec. 2021. tab, graf
Article in English | LILACS | ID: biblio-1355635


Abstract Background: There are conflicting data regarding the prognostic value of the lymphatic basin drainage pattern in melanoma patients and the evidence is scant in the setting of negative sentinel lymph node biopsy. Objective: To investigate whether the pattern of lymphatic basin drainage influences the risk of nodal disease in patients with melanoma of the trunk and negative sentinel lymph node biopsy. Methods: A case series of patients with trunk melanoma and negative sentinel lymph node biopsy was retrospectively evaluated. Clinicopathological features, the pattern of lymphatic drainage and nodal, metastatic, and overall recurrence-free survival were reviewed. Results: Of the 135 patients included, multiple lymphatic basin drainage was identified in 61 (45.2%). Ten of the 74 (13.5%) patients with single drainage developed nodal recurrence, compared with 2 of the 61 (3.6%) patients with multiple drainages (p = 0.04). Nodal recurrence-free survival was significantly longer in the group with multiple drainages than in the group with single drainage (175.6 vs. 138.7 months; p = 0.04). In multivariate analysis, single drainage was associated with a higher risk of nodal recurrence (HR = 4.54; p = 0.05). No significant differences in metastatic and overall recurrence-free survival were found between groups. Study limitations: Retrospective analysis, single-center study, small sample, detailed histopathologic information not always present. Conclusions: In patients with trunk melanoma and negative sentinel lymph node biopsy, multiple lymphatic basin drainage may be an independent risk factor for nodal disease recurrence. This factor may help to identify patients with negative sentinel lymph node biopsy with a higher risk of nodal recurrence.

Skin Neoplasms/surgery , Melanoma/surgery , Retrospective Studies , Sentinel Lymph Node Biopsy , Lymph Node Excision , Lymph Nodes , Neoplasm Recurrence, Local
An. bras. dermatol ; 96(4): 451-453, July-Aug. 2021. graf
Article in English | LILACS | ID: biblio-1285104


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.

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
An. bras. dermatol ; 96(3): 263-277, May-June 2021. tab, graf
Article in English | LILACS | ID: biblio-1285080


Abstract Mohs micrographic surgery is a specialized form of skin cancer surgery that has the highest cure rates for several cutaneous malignancies. Certain skin cancers can have small extensions or "roots" that may be missed if an excised tumor is serially cross-sectioned in a "bread-loaf" fashion, commonly performed on excision specimens. The method of Mohs micrographic surgery is unique in that the dermatologist (Mohs surgeon) acts as both surgeon and pathologist, from the preoperative considerations until the reconstruction. Since Dr. Mohs's initial work in the 1930s, the practice of Mohs micrographic surgery has become increasingly widespread among the dermatologic surgery community worldwide and is considered the treatment of choice for many common and uncommon cutaneous neoplasms. Mohs micrographic surgery spares the maximal amount of normal tissue and is a safe procedure with very few complications, most of them managed by Mohs surgeons in their offices. Mohs micrographic surgery is the standard of care for high risks basal cell carcinomas and cutaneous squamous cell carcinoma and is commonly and increasingly used for melanoma and other rare tumors with superior cure rates. This review better familiarizes the dermatologists with the technique, explains the difference between Mohs micrographic surgery and wide local excision, and discusses its main indications.

Humans , Skin Neoplasms/surgery , Carcinoma, Basal Cell/surgery , Carcinoma, Squamous Cell/surgery , Melanoma/surgery , Mohs Surgery
Rev. medica electron ; 43(2)mar.-abr. 2021. graf
Article in Spanish | LILACS, CUMED | ID: biblio-1251945


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)

Humans , Male , Adult , Catastrophic Illness/classification , Melanoma/diagnosis , Orthopedics/methods , Signs and Symptoms , Therapeutics , Biopsy , Amputation/methods , Melanoma/surgery
An. bras. dermatol ; 96(1): 64-67, Jan.-Feb. 2021. graf
Article in English | LILACS | ID: biblio-1152784


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.

Humans , Male , Female , Aged , Aged, 80 and over , Skin Neoplasms/surgery , Skin Neoplasms/diagnosis , Melanoma/surgery , Melanoma/diagnosis , Ear, External , Melanocytes , Middle Aged
Rev. bras. cir. cardiovasc ; 36(1): 112-115, Jan.-Feb. 2021. tab, graf
Article in English | LILACS | ID: biblio-1155784


Abstract A 71 year-old male with a history of multiple excisions of an initial Clark's level V melanoma of the breast followed by combined radiation and interferon treatment, as well as a recurrence, 3 years later, of a BRAF-positive tumor of the shoulder, with subsequent therapy with dabrafenib and trametinib, presented again with progressive intracardiac masses causing significant right ventricular outflow obstruction. Additionally, the patient complained of dyspnea and fatigue on exertion, thus he was scheduled for surgical resection.

Humans , Male , Aged , Skin Neoplasms/surgery , Heart Neoplasms/surgery , Heart Neoplasms/diagnostic imaging , Melanoma/surgery , Melanoma/drug therapy , Mutation , Neoplasm Recurrence, Local
Medisan ; 24(1)ene.-feb. 2020. ilus
Article in Spanish | LILACS, CUMED | ID: biblio-1091169


Se describe el caso clínico de un paciente de 42 años de edad, de piel negra, que asistió a la consulta de Cirugía de Tumores Periféricos en el Hospital Oncológico Docente Provincial Conrado Benítez García de Santiago de Cuba, por presentar una lesión oscura hiperpigmentada en el lado izquierdo del escroto, próxima a la región del rafe, de aproximadamente 4 mm y bordes irregulares, que no elevaba la piel ni dolía. Se realizó exéresis de la lesión y el estudio histopatológico reveló la existencia de un melanoma, sin ulceración ni satelitosis, con crecimiento radial, por lo que se profundizó en el área operada en busca de márgenes sin afectación y se resecaron los ganglios linfáticos inguinales bilaterales de manera profiláctica. Luego se indicó quimioterapia e inyecciones de interferón. El paciente mantenía una evolución favorable hasta el año y medio después de operado.

The case report of a 42 years, black skin patient is described, he attended the Peripheral Tumors Surgery Service in Conrado Benítez García Teaching Provincial Cancer Hospital in Santiago de Cuba, due to a hyperpigmented dark lesion in the left side of the scrotum, next to the raphe region, of approximately 4 mm and irregular borders that didn't elevate the skin or hurted. An excision of the lesion was carried out and the histological and pathological study revealed the existence of a melanoma, without ulceration or satelitosis, with radial growth, reason why there was a deep examination of the operated area in search of margins without affectation and the bilateral groin lymph nodes were dried up in a prophylactic way. Then chemotherapy and interferon injections were indicated. The patient maintained a favorable clinical course until a year and a half after the surgery.

Scrotum , Melanoma/surgery , Melanoma/drug therapy
Rev. argent. cir ; 112(2): 157-164, 2020. tab
Article in English, Spanish | LILACS | ID: biblio-1125796


Antecedentes: los melanomas en cabeza y cuello (MCC) han sido asociados con factores pronósticos diferentes de aquellos en otras localizaciones. Objetivo: comparar características demográficas, clínicas y resultados del tratamiento quirúrgico de pacientes con MCC y pacientes con melanomas en tronco y extremidades (MTE). Material y métodos: se llevó a cabo una revisión retrospectiva de las historias clínicas de pacientes operados por melanoma entre enero de 2012 y diciembre de 2017. Quince pacientes (22,3%) tuvieron MCC y 52 (77,7%) MTE. Resultados: ambos grupos tuvieron edad similar (63,8 ± 21,1 versus 58,5 ± 16), pero los MCC mostraron una tendencia con predominio masculino (80% versus 61,3%). Los MCC tuvieron menor espesor tumoral que los MTE (2,07 versus 5,5 mm) y mayor porcentaje de melanoma in situ, 5 (33,3%) versus 8 (15,3%), pero requirieron vaciamientos ganglionares más a menudo (33% versus 25%) así como reconstrucción del defecto primario con colgajos locales y miocutáneos. Durante el seguimiento, en el grupo de MCC, dos pacientes desarrollaron recidivas locales que fueron extirpadas, y otros tres desarrollaron metástasis a distancia en pulmón, intestino delgado y abdomen y fallecieron por la enfermedad; en el grupo de MTE un paciente tuvo recidiva local y cinco fallecieron de metástasis sistémicas. El tamaño de la muestra no permitió aplicar pruebas de significación entre las diferencias encontradas. Conclusión: los MCC se presentan en un amplio rango de edad y estadios, y tuvieron algunas diferencias clínicas con el MTE. Los defectos producidos por la extirpación de la lesión primaria requieren procedimientos reconstructivos más complejos la mayoría de las veces y se aconseja un abordaje multidisciplinario.

Background: Head and neck melanomas (HNMs) have been associated with prognostic factors different from those on other locations. Objective: The goal of the present study was to compare the demographic and clinical characteristics and the outcomes of surgical treatment between patients with HNM and those with trunk and extremity melanoma (TEM). Material and methods: The clinical records of patients undergoing surgery for melanoma between October 2014 and April 2018 were retrospectively reviewed. Fifteen patients (22.3%) had HNM and 52 (77.7) presented TEM. Results: There were no differences in age between both groups (63.8 ± 21.1 versus 58.5 ± 16), but there was a trend toward higher percentage of men in the HNM group (80% versus 61.3%). Patients with HNM had lower tumor thickness than those with TEM (2.07 versus 5.5 mm), higher incidence of melanoma in situ [5 (33.3%) versus 8 (15.3%)]; lymph node resection was more common (33% versus 25%) as well as reconstruction of the primary defect with local and musculocutaneous flaps. During follow-up, two patients in the HNM group developed local recurrences that were excised and three presented distant metastases in the lung, small bowel and abdomen and finally died due to the disease. In the TEM group, one patient had local recurrence and five died due to systemic metastases. The sample size was not sufficient to assess statistically significant differences. Conclusion: Head and neck melanomas occur in a wide age range and stages and has some clinical differences with TEM. The defects produced after the excision of the primary lesion often require more complex procedures and should be managed with a multidisciplinary approach.

Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Head and Neck Neoplasms/epidemiology , Melanoma/epidemiology , Cross-Sectional Studies , Retrospective Studies , Sentinel Lymph Node Biopsy , Extremities/pathology , Torso/pathology , Margins of Excision , Melanoma/surgery
Rev. cuba. oftalmol ; 32(4): e753, oct.-dic. 2019. graf
Article in Spanish | LILACS, CUMED | ID: biblio-1099106


RESUMEN El objetivo de este reporte de caso fue identificar las características de un nevo abultado conjuntival en una paciente femenina de 72 años de edad. Se muestran las pruebas complementarias realizadas para llegar al diagnóstico de melanoma conjuntival, que consiste en un tumor poco frecuente, el cual constituye el 2 por ciento de todos los tumores del ojo. Las células involucradas son los melanocitos del epitelio conjuntival. Un factor de riesgo para esta entidad puede ser la exposición a la luz ultravioleta; sin embargo, esto no está bien determinado. La mayoría de los casos se originan de una melanosis adquirida primaria (50-70 por ciento). La presentación más común es una lesión pigmentada, unilateral, elevada, gruesa, con vasos sanguíneos y áreas de melanosis a su alrededor. Su diagnóstico se realiza con la sospecha clínica que se confirma con el estudio histopatológico. El tratamiento en la actualidad es la excisión local, seguida de crioterapia, radioterapia o quimioterapia. La enfermedad matastásica ocurre en el 11 - 42 por ciento y en el 20 - 52 por ciento de los pacientes en un seguimiento de 5 y 10 años, respectivamente(AU)

ABSTRACT The objective of this case report is to describe the characteristics of a conjunctival bulging nevus in a 72-year-old female patient and the complementary tests that were performed to reach the diagnosis of conjunctival melanoma. Conjunctival melanoma is a rare tumor, which account for 2 percent of all eye tumors. The cells involved are the melanocytes of the conjunctival epithelium. A risk factor for this entity may be exposure to ultraviolet light. However, it has not been precisely described. Most cases originate from a primary acquired melanosis (50-70 percent). The most common presentation is a pigmented, unilateral, elevated, thick, lesion with blood vessels and areas of melanosis around it. Its diagnosis is made with the clinical suspicion confirmed with the histopathological study. Current treatment is local excision, followed by cryotherapy, radiotherapy, or chemotherapy. Metastatic disease occurs in 11-42 percent and 20-52 percent of patients in a 5-year and 10-year follow-up, respectively(AU)

Humans , Female , Aged , Ophthalmoscopy/methods , Eye Neoplasms/epidemiology , Melanoma/surgery , Nevus, Pigmented/diagnostic imaging
Rev. méd. Chile ; 147(7): 928-931, jul. 2019. graf
Article in Spanish | LILACS | ID: biblio-1058623


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.

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
Rev. bras. cir. plást ; 34(1): 151-155, jan.-mar. 2019. ilus
Article in English, Portuguese | LILACS | ID: biblio-994623


O lentigo maligno (LM) é uma forma de melanoma in situ que mais comumente se apresenta como uma mácula de crescimento lentamente progressivo, pigmentada, na face de idosos com pele danificada pelo sol. Esse melanoma in situ tem um risco (30% a 50%) de progressão para lentigo maligno melanoma. A excisão cirúrgica completa da lesão requer margens de pelo menos 10mm, mesmo para lesões in situ. Porém, quando o crescimento de LM ocorre em áreas de implicações estéticas ou funcionais (face, pescoço, solas), a excisão é frequentemente reduzida para preservar estruturas anatômicas importantes e por razões cosméticas. Além disso, as margens periféricas podem ser clinicamente mal definidas e nem sempre pigmentadas, com extensão subestimada e risco de ressecção insuficiente. A "técnica de espaguete", descrita por Gaudy Marqueste, é uma cirurgia estratégica baseada na amostragem de uma faixa de tecido "spaghettilike" para determinar as margens da lesão antes da remoção do tumor. Após a confirmação anatomopatológica de margens livres de neoplasia, a lesão principal central é ressecada, permitindo a reconstrução do defeito no mesmo procedimento, sendo uma alternativa à cirurgia micrográfica de Mohs.(AU)

Lentigo maligna (LM) is a melanoma in situ that commonly presents as a macula with progressive and irregularly pigmented growth, especially in the face of elderly people with sun-damaged skin. This melanoma in situ has a risk (30-50%) of progression to lentigo maligna melanoma. Complete surgical excision of the lesion requires margins of at least 10 mm, even for lesions in situ. However, when the growth of LM occurs in areas of aesthetic or functional implications (face, neck, and soles), the excision is often reduced to preserve important anatomic structures and for cosmetic purposes. Moreover, the peripheral margins may be clinically ill-defined and not always pigmented, and thus, such cases are associated with underestimated extension and risk of insufficient resection. The "spaghetti" technique, described by Gaudy Marqueste, is a strategic surgical approach based on sampling of a range of "spaghetti-like" strips to determine the margins of the lesion prior to removal of the tumor. After the pathological confirmation of neoplasia-free margins, the main central lesion is resected, allowing reconstruction of the defect in the same procedure, as an alternative to Mohs micrographic surgery. (AU)

Humans , Male , Middle Aged , Skin Neoplasms , Hutchinson's Melanotic Freckle/physiopathology , Reconstructive Surgical Procedures/methods , Nasal Surgical Procedures/methods , Melanocytes/pathology , Melanoma/complications , Melanoma/diagnosis , Reconstructive Surgical Procedures/methods , Melanoma/surgery
Prensa méd. argent ; 104(9): 461-462, nov 2018.
Article in Spanish | LILACS, BINACIS | ID: biblio-1047091


A sentinel node biopsy is a procedure in which the sentinel lymph node is identified, removed and examined to determine whether cancer cells are present. It´s used most commonly in evaluating breast cancer and melanoma. The sentinel nodes are the first few lymph nodes into which a tumor drains. The sentinel nodes are removed and analyzed in a laboratory. Melanoma is a tumor of melanocyte origin. There is a considerable evidence that early recognition and surgical removal of melanoma makes this a highly curable cancer. Because early detection of melanoma results in a high frequency of cure it is important to recognize the lesion in the earliest stages. Malignant melanoma is a type of cancer that develops from the pigment-containing cells known as melanocytes, and is the most aggressive and life-threatening skin cancer. Sentinel node biopsy is a surgical procedure to determine whether cancer has spread beyond a primary tumor into the lymphatic system. Removal and examination of the sentinel lymph node to which cancer cells are likely to spread from the primary tumor, are supposed to be an useful tool to prevent early this spread. In this paper the authors present their experience with the management of this procedure.

Humans , Male , Female , Middle Aged , Radionuclide Imaging , Retrospective Studies , Sentinel Lymph Node Biopsy , Melanoma/surgery , Neoplasm Metastasis/diagnosis
Arq. bras. oftalmol ; 81(6): 517-519, Nov.-Dec. 2018. graf
Article in English | LILACS | ID: biblio-973860


ABSTRACT Uveal melanoma is the most common adult primary intraocular cancer. Although liver metastasis is common to the natural history of the disease, metastasis to the fellow eye is extremely rare. Here we report the case of a 59-year-old man with choroidal melanoma in his right eye who underwent enucleation at a different center. The patient was referred to our service 21 months postoperatively, complaining of decreased vision. He was found to have a new pigmented choroidal tumor in his left eye associated with liver disease. Ocular ultrasonography and liver biopsy with histopathological and immunohistochemical analysis were performed and confirmed the diagnosis. Few similar cases have been described in the literature. The differential diagnosis included primary bilateral choroidal melanoma and metastatic choroidal tumor from a primary skin melanoma.

RESUMO O melanoma uveal é o câncer intraocular primário mais frequente em adultos. Embora a metástase hepática seja comum à história natural da doença, a metástase para o outro olho é extremamente rara. Aqui relatamos o caso de um homem de 59 anos com melanoma de coroide em seu olho direito que foi submetido à enucleação em um centro diferente. O paciente foi encaminhado ao nosso serviço 21 meses após a cirurgia, com queixa de diminuição da visão. Foi encontrado um novo tumor de coróide pigmentado em seu olho esquerdo associado com doença hepática. Ultrassonografia ocular e biópsia hepática com exame histopatológico e imuno-histoquímico foram realizadas e confirmaram o diagnóstico. Poucos casos semelhantes foram descritos na literatura. O diagnóstico diferencial incluiu melanoma de coróide bilateral orimário e tumor coroidal metastático de um melanoma primário da pele.

Humans , Middle Aged , Uveal Neoplasms/secondary , Choroid Neoplasms/pathology , Melanoma/pathology , Uveal Neoplasms/diagnostic imaging , Choroid Neoplasms/surgery , Ultrasonography , Fatal Outcome , Rare Diseases/diagnosis , Diagnosis, Differential , Liver/pathology , Melanoma/surgery , Melanoma/secondary , Melanoma/diagnostic imaging
Säo Paulo med. j ; 136(4): 372-375, July-Aug. 2018. tab, graf
Article in English | LILACS | ID: biblio-962742


ABSTRACT CONTEXT: Malignant melanoma is the third most common cause of cerebral metastases after breast and lung cancer. Despite advances in therapeutic options, the prognosis for patients with cerebral metastases from melanoma remains poor, with a median survival time of six months after diagnosis. CASE REPORT: A 65-year-old woman was diagnosed with a malignant melanoma on the third toe of her left foot.The tumorous spot was excised surgically. However, the melanoma reappeared after one year and skin biopsy confirmed recurrence of malignant melanoma. Investigations showed metastasis to the left pelvic region, left lobe of the liver and right lobe of the lung.The patient then received chemotherapy. Subsequently, the patient was brought to the emergency department with an altered level of consciousness (Glasgow coma scale: 9) and hemiplegia on the right side of her body. Computed tomography scans of the brain revealed hemorrhagic lesions in the parieto-occipital lobes of the brain. Urgent surgical evacuation was done to remove the lesion, following which the patient showed improvement in her score on the Glasgow coma scale and a concomitant decrease in weakness. She was discharged from hospital with full consciousness.The patient died of acute renal failure 14 months after the brain surgery and approximately 4 years after the initial presentation of the case. CONCLUSION: This case outcome is rare and shows the effectiveness of surgery to treat cerebral metastasis from malignant melanoma in a situation with multisystem metastasis already present.

Humans , Female , Aged , Skin Neoplasms/pathology , Brain Neoplasms/surgery , Toes/pathology , Foot Diseases/pathology , Melanoma/surgery , Prognosis , Skin Neoplasms/mortality , Time Factors , Brain Neoplasms/mortality , Brain Neoplasms/secondary , Tomography, X-Ray Computed , Survival Analysis , Fatal Outcome , Melanoma/mortality , Melanoma/pathology
An. bras. dermatol ; 93(4): 553-558, July-Aug. 2018.
Article in English | LILACS | ID: biblio-949919


Abstract: Cutaneous melanoma is the solid neoplasia with the highest growing incidence among all tumors. It spreads predictably to the lymphatic vessels and sentinel lymph node, and when the latter is affected the prognosis worsens dramatically. Sentinel lymph node biopsy is considered when thickness of the primary tumor exceeds 1mm and/or when there are adverse features in thinner melanomas. When there is nodal metastasis, current evidence in the literature recommends complete lymphadenectomy, although this procedure has its intrinsic risks (i.e., lymphedema and cellulitis), and there are no published clinical trials proving additional overall survival benefits. The current in-depth literature review thus aims to identify patients that will benefit most from the procedure, including those with the highest likelihood of presenting additional affected lymph nodes in the same nodal basin. The authors also discuss techniques for identification of the sentinel lymph node, false-negative rates, and predictive models for lymph node involvement. In conclusion, complete elective lymphadenectomy should always be discussed on a case-by-case basis when metastases are detected in the sentinel lymph node.

Humans , Skin Neoplasms/surgery , Skin Neoplasms/pathology , Sentinel Lymph Node Biopsy , Melanoma/surgery , Melanoma/pathology , Lymph Node Excision
An. bras. dermatol ; 93(3): 332-336, May-June 2018. tab, graf
Article in English | LILACS | ID: biblio-949883


Abstract: BACKGROUND: Melanoma is one of the conditions with greater increase in incidence worldwide in recent decades. It is a skin cancer with potential high lethality and predominates in Caucasian adults. Treatment of primary cutaneous melanoma is essentially surgical and search for sentinel lymph node can modify the aggressiveness of the treatment. OBJECTIVE: To analyze the epidemiological profile of patients diagnosed with primary cutaneous melanoma, histopathological features and compare with literature data. METHODS: This is a retrospective, observational, single-center, case series study of patients with primary cutaneous melanoma, who underwent surgery between January 2008 and December 2013. The parameters include: Age, sex, clinical stage, date of surgery, tumor location, histological subtype, condition of surgical margins, Breslow thickness, mitotic index, presence of ulceration and metastasis on admission. RESULTS: We included 321 melanoma patients who were treated at Hospital Erasto Gaertner. The population consisted of 58.9% females and 41.1% males with an average age of 52.8 ± 16.3 years. As for the clinical stage, 51.1% were in the initial stage, 24.3% in the clinical stage II (A, B and C), 21.2% in clinical stage III and 3.4% with distant metastases. The most frequent location of the primary melanoma was the trunk, and the histological subtype was superficial spreading pattern. Intermediate and thick melanomas were the most frequent. STUDY LIMITATIONS: This is a retrospective study and some information and data could be incomplete or absent. CONCLUSION: The diagnosis and treatment of melanoma in early stages provides less morbidity and improved survival of patients. Understanding the biological behavior of tumor and knowing the local epidemiology guide health strategies.

Humans , Male , Female , Child , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Skin Neoplasms/genetics , Melanoma/epidemiology , Skin Neoplasms/surgery , Skin Neoplasms/diagnosis , Skin Neoplasms/pathology , Skin Neoplasms/epidemiology , Brazil/epidemiology , Retrospective Studies , Hospitals , Melanoma/surgery , Melanoma/diagnosis , Melanoma/pathology , Neoplasm Metastasis
Rev. chil. cir ; 70(1): 66-69, 2018. ilus
Article in Spanish | LILACS | ID: biblio-899658


Resumen Introducción El melanoma maligno primario de esófago es un tumor raro y muy agresivo. De manejo controversial, el tratamiento quirúrgico es el que predomina en enfermedad localizada. Caso clínico Presentamos el caso de una mujer joven con melanoma maligno primario de esófago de presentación atípica y su manejo quirúrgico utilizando la técnica de Akiyama.

Introduction The Primary Malignant Melanoma of Esophagus is an uncommon and very agressive tumor. With controversial management, it predominates the surgical treatment in localized disease. Clinical case We present the case of a young women with Primary Malignant Melanoma of Esophagus with atypical presentation and its surgical management using the Akiyama technique.

Humans , Female , Middle Aged , Esophageal Neoplasms/surgery , Esophagectomy , Melanoma/surgery , Esophageal Neoplasms/diagnosis , Endoscopy, Digestive System , Positron Emission Tomography Computed Tomography , Lymph Node Excision , Melanoma/diagnosis