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Intra-Abdominal Malignant Melanoma: Challenging Aspects of Epidemiology, Clinical and Paraclinical Diagnosis and Optimal Treatment—A Literature Review. Diagnostics (Basel) 2022; 12:diagnostics12092054. [PMID: 36140455 PMCID: PMC9498106 DOI: 10.3390/diagnostics12092054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Revised: 07/30/2022] [Accepted: 08/23/2022] [Indexed: 11/17/2022] Open
Abstract
According to European consensus-based interdisciplinary guidelines for melanoma, cutaneous melanoma (CM) is the most deadly form of dermatological malignancy, accounting for 90% of the deaths of skin cancer patients. In addition to cutaneous melanoma, mucosal melanoma occurs in four major anatomical sites, including the upper respiratory tract, the conjunctiva, the anorectal region, and the urogenital area. As this cancer type metastasizes, a classification used in the current medical literature is the distinction between secondary lesions and primary malignant melanoma of the abdominal cavity. Given that malignant melanoma is the most common cancer that spreads to the gastrointestinal tract, different imaging modalities compete to diagnose the phenomenon correctly and to measure its extension. Treatment is primarily surgery-based, supported by immunotherapy, and prolongs survival, even when performed at stage IV illness. In the end, special forms of malignant melanoma are discussed, such as melanoma of the genito-urinary tract and amelanotic/achromic melanoma. The importance of this present literature review relies on yielding and grouping consistent and relevant, updated information on the many aspects and challenges that a clinician might encounter during the diagnosis and treatment of a patient with intra-abdominal melanoma.
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Yano M, Nasu K, Yasuda M, Katoh T, Kagabu M, Kobara H, Matsuura M, Tokuyama O, Yamawaki T, Wakahashi S, Noguchi T, Mizuno K, Shitsukawa K, Onohara Y, Nakabori T, Miyasaka A, Nakao T, Matsunaga T, Kunimi Y, Sakurai M, Uchiyama A, Itoh R, Ohike N, Hirakawa T, Watanabe T, Nishino K, Motohashi T, Ito K. Clinicopathological features and programmed death-ligand 1 immunohistochemical expression in a multicenter cohort of uterine and ovarian melanomas: a retrospective study in Japan (KCOG-G1701s). Melanoma Res 2022; 32:150-158. [PMID: 35377861 DOI: 10.1097/cmr.0000000000000811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The objective of this study was to propose prognostic factors and optimal treatment strategies by analyzing the clinicopathological features and programmed death-ligand 1 (PD-L1) expression. We analyzed 31 patients diagnosed with uterine or ovarian melanoma between 1997 and 2017 in the Kansai Clinical Oncology Group/Intergroup. Twenty-four and seven patients with cervical and ovarian melanomas were included, respectively. Immune checkpoint inhibitors were used in seven patients, and the objective response rate was 40%. Notably, two patients with objective responses had a high PD-L1 expression. Ten and four patients with cervical and ovarian melanomas, respectively, had high PD-L1 immunohistochemical expressions. Multivariate analysis revealed that tumor stage was an independent prognostic factor for progression-free survival in patients with cervical melanomas. In patients with ovarian melanomas, the 1-year cumulative progression-free and overall survival rates were 0 and 29%, respectively. Kaplan-Meier analyses revealed that age <60 years was associated with poorer progression-free and overall survivals in patients with ovarian melanomas. In patients with cervical melanomas, the 1-, 3-, and 5-year cumulative overall survival rates were 53, 32, and 16%, respectively. Histological atypia was associated with a poorer progression-free survival, but there was no difference in survival between patients who underwent radical hysterectomy and those who did not. The present study is a large cohort study of uterine and ovarian melanomas, which are aggressive tumors with a significantly poor prognosis, even after standard surgery and adjuvant therapy. The use of immune checkpoint inhibitors is a promising and effective treatment option.
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Affiliation(s)
- Mitsutake Yano
- Department of Obstetrics and Gynecology, Faculty of Medicine, Oita University, Oita
- Department of Pathology, Saitama Medical University International Medical Center, Saitama
| | - Kaei Nasu
- Department of Obstetrics and Gynecology, Faculty of Medicine, Oita University, Oita
- Division of Obstetrics and Gynecology, Support System for Community Medicine, Faculty of Medicine, Oita University, Oita
| | - Masanori Yasuda
- Department of Pathology, Saitama Medical University International Medical Center, Saitama
| | - Tomomi Katoh
- Department of Pathology, Saitama Medical University International Medical Center, Saitama
| | - Masahiro Kagabu
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Morioka
| | - Hisanori Kobara
- Department of Obstetrics and Gynecology, Shinshu University School of Medicine, Matsumoto
| | - Motoki Matsuura
- Department of Obstetrics and Gynecology, Sapporo Medical University, School of Medicine, Sapporo
| | - Osamu Tokuyama
- Department of Obstetrics and Gynecology, Osaka City General Hospital, Osaka
| | - Takaharu Yamawaki
- Department of Obstetrics and Gynecology, Ise Red Cross Hospital, Ise
| | - Senn Wakahashi
- Department of Obstetrics and Gynecology, Kobe University, Kobe
- Department of Gynecologic Oncology, Hyogo Cancer Center, Akashi
| | - Tomoko Noguchi
- Department of Obstetrics and Gynecology, Wakayama Medical University, Wakayama
| | - Kaoruko Mizuno
- Department of Obstetrics and Gynecology, Shizuoka City Shizuoka Hospital, Shizuoka
| | - Keiji Shitsukawa
- Department of Obstetrics and Gynecology, Tokushima Prefecture Naruto Hospital, Naruto
| | - Yoshimasa Onohara
- Department of Obstetrics and Gynecology, Tottori Prefectural Kousei Hospital, Kurayoshi
| | - Takashi Nakabori
- Department of Obstetrics and Gynecology, Kurashiki Central Hospital, Kurashiki
| | - Aki Miyasaka
- Department of Obstetrics and Gynaecology, Faculty of Medicine, The University of Tokyo, Tokyo
| | - Takehiro Nakao
- Department of Gynecology, Nihon University School of Medicine, Tokyo
| | - Tatsuya Matsunaga
- Department of Obstetrics and Gynecology, Yokohama City University, Yokohama
| | - Yusuke Kunimi
- Department of Obstetrics and Gynecology, Kochi Health Sciences Center, Kochi
| | - Manabu Sakurai
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tsukuba, Tsukuba
| | - Aya Uchiyama
- Department of Gynecology, Kanagawa Cancer Center, Yokohama
| | - Ryoji Itoh
- Department of Obstetrics and Gynecology, Kusatsu General Hospital, Kusatsu
| | - Nobuyuki Ohike
- Department of Pathology and Laboratory Medicine, Showa University Fujigaoka Hospital, Yokohama
| | - Takashi Hirakawa
- Department of Obstetrics and Gynecology, Gunma University, Maebashi
| | - Tadashi Watanabe
- Department of Obstetrics and Gynecology, Tohoku Medical and Pharmaceutical University Wakabayashi Hospital, Sendai
| | - Koji Nishino
- Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, Niigata
| | - Takashi Motohashi
- Department of Obstetrics and Gynecology, Tokyo Women's Medical University, Tokyo
| | - Kimihiko Ito
- Department of Obstetrics and Gynecology, Kansai Rosai Hospital, Amagasaki, Japan
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Abstract
Here we describe a rare case of a 48-year-old woman with a previous history of malignant melanoma (pT2a pathological stage, IB clinical stage) occurring about five years previously. She complained of abdominal pain and pelvic discomfort, diagnosed as a consequence of a bilateral ovarian solid masses completely occupying the recto-uterine space. She underwent laparotomy surgery with total hysterectomy and bilateral salpingo-oophorectomy. Gross examination of the excised material revealed an unusual grey-black bilateral ovarian tumor; a histopathological diagnosis of ovarian bilateral metastatic melanoma was made. Imaging study (CT/MRI) did not reveal metastasis in other zones of the body. Melanoma metastasis usually affects the skin, liver, brain and lungs, and rarely gynecological localizations. On the other hand, most bilateral ovarian tumors are comprised of serous carcinoma, mature teratoma and gastrointestinal carcinoma metastasis. Exceptionally, primary ovarian melanoma may arise in mature ovarian cystic teratomas.
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Wang J, Hu X, Xiang D. Nanoparticle drug delivery systems: an excellent carrier for tumor peptide vaccines. Drug Deliv 2018; 25:1319-1327. [PMID: 29869539 PMCID: PMC6058474 DOI: 10.1080/10717544.2018.1477857] [Citation(s) in RCA: 77] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 05/12/2018] [Accepted: 05/14/2018] [Indexed: 12/22/2022] Open
Abstract
In the past 40 years, the nanoparticle drug delivery system for tumor peptide vaccines has been widely studied which also reached a splendid result. Nanomaterial can enhance the targeting of vaccines, help vaccines enter the cells and trigger immune response by themselves. They also help in increasing cellular uptake, improving permeability and efficacy. Currently, several categories of nanopreparation, such as liposome, polymeric micelle, polymeric nanoparticle, gold nanoparticle and so on, are proved that they are appropriate for peptide vaccines. This review we discussed the possible mechanisms of nanomaterial's action on the regulation of immunological functions and several major applications of this advanced drug delivery system for tumor peptide vaccine.
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Affiliation(s)
- Jiemin Wang
- a Department of Pharmacy , Second Xiangya Hospital Central South University , Changsha , Hunan Province , China
- b Institute of Clinical Pharmacy Central South University , Changsha , Hunan Province , China
- c Hunan Provincial Engineering Research Center of Translational Medicine and Innovative Drug , Changsha , Hunan Province , China
| | - Xiongbin Hu
- a Department of Pharmacy , Second Xiangya Hospital Central South University , Changsha , Hunan Province , China
- b Institute of Clinical Pharmacy Central South University , Changsha , Hunan Province , China
- c Hunan Provincial Engineering Research Center of Translational Medicine and Innovative Drug , Changsha , Hunan Province , China
| | - Daxiong Xiang
- a Department of Pharmacy , Second Xiangya Hospital Central South University , Changsha , Hunan Province , China
- b Institute of Clinical Pharmacy Central South University , Changsha , Hunan Province , China
- c Hunan Provincial Engineering Research Center of Translational Medicine and Innovative Drug , Changsha , Hunan Province , China
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Yano M, Asami Y, Nishikawa T, Yoshida S, Kamada K, Katoh T, Teramoto Y, Nakamura Y, Yasuda M. Immune checkpoint inhibitors of CTLA4 and PD-1 for malignant melanoma arising in ovarian cystic teratoma: A case report. Medicine (Baltimore) 2018; 97:e12937. [PMID: 30412106 PMCID: PMC6221685 DOI: 10.1097/md.0000000000012937] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
RATIONALE Malignant melanoma (MM) arising in ovarian cystic teratoma (OCT) is a rare disease with poor prognosis. Recently, immune checkpoint inhibitors of cytotoxic T-lymphocyte-associated antigen 4 (CTLA4) and programmed death 1 (PD-1) have shown promising results in MM. Herein we report a case of MM arising in OCT. PATIENT CONCERNS A 63-year-old Japanese primigravida had lower abdominal pain. Magnetic resonance imaging revealed the presence of an 85-mm mass at the right ovary. DIAGNOSES The patient underwent right salpingo-oophorectomy for right ovarian tumor, and histopathological examinations revealed MM arising in OCT. On immunohistochemical analysis, the tumor cells were positive for HMB-45, Melan A, and S-100 protein, and negative for programmed death-ligand 1 (PD-L1). BRAF gene mutations were not detected by the Real-Time PCR. Two months after surgery, liver metastasis was detected. INTERVENTIONS The patient underwent immune checkpoint inhibitors of CTLA4 (ipilimumab) and PD-1 (pembrolizumab and nivolumab). She had interstitial pneumonia associated with ipilimumab, but she safely underwent the immune checkpoint inhibitors therapy along with oral prednisolone. Pembrolizumab, ipilimumab, and nivolumab therapies had poor effect on the tumor. OUTCOMES Now, the present case has had tumor-bearing survival for 14 months since the initial diagnosis and 12 months since the detection of liver metastasis. LESSONS This is the first case of MM arising in OCT treated by immune checkpoint inhibitors, with information of PD-L1 immunohistochemical expression and adverse events. The present case is the longest survivor following the detection of recurrence among all the previous reports. The long survival and slow-growing tumor in the present case may be associated with no PD-L1 expressions.
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Affiliation(s)
- Mitsutake Yano
- Department of Pathology, Saitama Medical University International Medical Center, Saitama
- Department of Obstetrics and Gynecology, Oita University Faculty of Medicine, Oita
| | - Yuri Asami
- Department of Skin Oncology/Dermatology, Saitama Medical University International Medical Center, Hidaka-City, Saitama
| | - Tadaaki Nishikawa
- Department of Gynecologic Oncology, Saitama Medical University International Medical Center, Hidaka-City, Saitama, Japan
| | - Saori Yoshida
- Department of Pathology, Saitama Medical University International Medical Center, Saitama
| | - Kouichi Kamada
- Department of Pathology, Saitama Medical University International Medical Center, Saitama
| | - Tomomi Katoh
- Department of Pathology, Saitama Medical University International Medical Center, Saitama
| | - Yukiko Teramoto
- Department of Skin Oncology/Dermatology, Saitama Medical University International Medical Center, Hidaka-City, Saitama
| | - Yasuhiro Nakamura
- Department of Skin Oncology/Dermatology, Saitama Medical University International Medical Center, Hidaka-City, Saitama
| | - Masanori Yasuda
- Department of Pathology, Saitama Medical University International Medical Center, Saitama
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