ABSTRACT
In the follow-up of patients with malignant melanoma treated by surgical resection of the cutaneous tumour, it is important to achieve early detection of possible lymph node metastasis. In many cases, clinical examination alone will not be sufficient. In our study, single-photon emission tomography (SPET) with technetium-99m sestamibi (MIBI) was used in the assessment of 30 patients with previously resected malignant melanoma when the clinical examination raised the suspicion of lymph node metastasis. Using MIBI, 16 out of 17 lymph node metastases were detected and confirmed by histology. No false-positive results were obtained during this prospective study. It is concluded that MIBI scintigraphy may be useful in the early detection of lymph node metastases of malignant melanomas. If our preliminary results are confirmed, early detection of lymph node metastasis of previously resected malignant melanoma by 99mTc-MIBI scintigraphy may have a significant impact on the management of these patients.
Subject(s)
Melanoma/diagnostic imaging , Melanoma/secondary , Radiopharmaceuticals , Skin Neoplasms/pathology , Technetium Tc 99m Sestamibi , Tomography, Emission-Computed, Single-Photon , Evaluation Studies as Topic , Female , Follow-Up Studies , Humans , Lymphatic Metastasis , Male , Melanoma/epidemiology , Middle Aged , Predictive Value of Tests , Sensitivity and SpecificityABSTRACT
INTRODUCTION: Secondary myelodysplasia after antimitotic therapy is a rare complication usually observed with alkylating agents. The condition usually progresses to acute leukaemia with very poor short term prognosis. CASE REPORT: We report the cases of 2 women who developed myelodysplasia 2 and 9 months after treatment associating dacarbazine and fotemustine for visceral metastases of a malignant melanoma. DISCUSSION: The frequency of these rare complications is probably underestimated because of the rapid unfavourable outcome of metastatic malignant melanoma. We were unable to determine whether dacarbazine, fotemustine or their combination was incriminated in this complication. Risk could be reduced by carefully determining the cumulative doses of these antimitotics.
Subject(s)
Antineoplastic Agents/adverse effects , Dacarbazine/adverse effects , Melanoma/drug therapy , Myelodysplastic Syndromes/chemically induced , Nitrosourea Compounds/adverse effects , Organophosphorus Compounds/adverse effects , Skin Neoplasms/drug therapy , Aged , Antineoplastic Agents/therapeutic use , Brain Neoplasms/secondary , Dacarbazine/therapeutic use , Drug Therapy, Combination , Fatal Outcome , Female , Humans , Melanoma/secondary , Middle Aged , Nitrosourea Compounds/therapeutic use , Organophosphorus Compounds/therapeutic useABSTRACT
INTRODUCTION: We report the apparently first description of bullous Kaposi's sarcoma in a patient with AIDS. CASE REPORT: Kaposi's sarcoma was observed in a HIV positive homosexual who had developed AIDS. The delay between the development of Kaposi's sarcoma and the appearance of bullae was 6 months. Bullae occurred after oedema and necrosis of the subepidermic derma. DISCUSSION: This unusual clinical presentation of Kaposi's syndrome in an AIDS patient led to rapid tumor extention and would thus suggest a rapidly unfavourable prognosis.
