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Burroni AG, Capurro N, Rongioletti F, Cozzani E, Pronzato P, Herzum A, Guadagno A, Molle MF, Oddenino GA, Parodi A. Diffuse Melanosis Cutis as the First Sign of Recurrence of Low-Risk Melanoma: Case Report and Systematic Review. Dermatol Pract Concept 2024; 14:dpc.1401a8. [PMID: 38364426 PMCID: PMC10868795 DOI: 10.5826/dpc.1401a8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2023] [Indexed: 02/18/2024] Open
Abstract
INTRODUCTION Diffuse Melanosis Cutis (DMC) is a rare and late complication of metastatic malignant melanoma (MM) characterized by progressive pigmentation of skin and sometimes mucous membranes. The distinctive feature is the widespread and progressive deposition of melanin precursors in the dermis. OBJECTIVES The purpose of this review is to define the clinical and demographic features of DMC and to promote a deeper insight into the clinical manifestation, histological findings, and pathophysiology behind DMC. METHODS We have conducted a systematic review of the literature on published DMC in compliance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. We also reported a case of DMC secondary to low-risk melanoma. RESULTS Overall, including our case report, we reported 53 articles described 62 DMC patients. Breslow level of primary melanoma was reported having a mean value of 3.3 mm. The mean survival rate from onset of DMC resulted being 4.36 months. CONCLUSIONS Among the most widely accepted etiopathogenetic hypotheses are deposition of melanic precursors in the dermis following tumor lysis, melanocyte proliferation induced by neoplastic growth factors, and the presence of diffuse dermal micro-metastases of MM. However, unanimous consensus on the proposed etiopathogenetic models of DMC is still lacking.
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Affiliation(s)
- Anna Graziella Burroni
- Section of Dermatology, Department of Health and Science (DissaL), Polyclinic Hospital San Martino, IRCCS, Università di Genova, Italy
| | - Niccolò Capurro
- Section of Dermatology, Department of Health and Science (DissaL), Polyclinic Hospital San Martino, IRCCS, Università di Genova, Italy
| | | | - Emanuele Cozzani
- Section of Dermatology, Department of Health and Science (DissaL), Polyclinic Hospital San Martino, IRCCS, Università di Genova, Italy
| | - Paolo Pronzato
- Medical Oncology 2 Unit, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Astrid Herzum
- Section of Dermatology, Department of Health and Science (DissaL), Polyclinic Hospital San Martino, IRCCS, Università di Genova, Italy
| | - Antonio Guadagno
- Division of Pathology, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Mattia Fabio Molle
- Section of Dermatology, Department of Health and Science (DissaL), Polyclinic Hospital San Martino, IRCCS, Università di Genova, Italy
| | - Giorgio Alberto Oddenino
- Section of Dermatology, Department of Health and Science (DissaL), Polyclinic Hospital San Martino, IRCCS, Università di Genova, Italy
| | - Aurora Parodi
- Section of Dermatology, Department of Health and Science (DissaL), Polyclinic Hospital San Martino, IRCCS, Università di Genova, Italy
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Sim SJY, Dear K, Mastoraki E, James M, Haider A, Ellery P, Freeman A, Alnajjar HM, Muneer A, Watchorn R, Kravvas G, Bunker CB. Genital lichen sclerosus and melanoma; a systematic review. SKIN HEALTH AND DISEASE 2023; 3:e198. [PMID: 37013116 PMCID: PMC10066758 DOI: 10.1002/ski2.198] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 11/23/2022] [Accepted: 11/28/2022] [Indexed: 12/14/2022]
Abstract
Background Lichen sclerosus (LSc) is a chronic, inflammatory, destructive skin disease with a predilection for the genitalia (GLSc). An association with vulval (Vu) and penile (Pe) squamous carcinoma (SCC) is now well established but melanoma (MM) has only rarely been reported complicating GLSc. Methods We have performed a systematic literature review of GLSc in patients with genital melanoma (GMM). Only articles that mentioned both GMM and LSc affecting either the penis or vulva were included. Results Twelve studies with a total of 20 patients were included. Our review shows that an association of GLSc with GMM has been more frequently reported in women and female children than men viz, 17 cases compared with three. It is notable that five of the cases (27.8%) concerned female children aged under twelve. Discussion These data suggest a rare association between GLSc and GMM. If proven, there arise intriguing questions about pathogenesis and consequences for counselling of patients and follow-up.
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Affiliation(s)
| | - Katherine Dear
- Department of DermatologyUniversity College London Hospitals NHS Foundation TrustLondonUK
| | - Evanthia Mastoraki
- Department of DermatologyUniversity College London Hospitals NHS Foundation TrustLondonUK
| | - Mariel James
- Department of DermatologyUniversity College London Hospitals NHS Foundation TrustLondonUK
| | - Aiman Haider
- Department of HistopathologyUniversity College London Hospitals NHS Foundation TrustLondonUK
| | - Peter Ellery
- Department of HistopathologyUniversity College London Hospitals NHS Foundation TrustLondonUK
| | - Alex Freeman
- Department of HistopathologyUniversity College London Hospitals NHS Foundation TrustLondonUK
| | - Hussain M. Alnajjar
- Department of UrologyUniversity College London Hospitals NHS Foundation TrustLondonUK
| | - Asif Muneer
- Department of UrologyUniversity College London Hospitals NHS Foundation TrustLondonUK
| | - Richard Watchorn
- Department of DermatologyUniversity College London Hospitals NHS Foundation TrustLondonUK
| | - Georgios Kravvas
- Department of DermatologyUniversity College London Hospitals NHS Foundation TrustLondonUK
| | - Christopher B. Bunker
- Department of DermatologyUniversity College London Hospitals NHS Foundation TrustLondonUK
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Wolters VERA, Lok CAR, Gordijn SJ, Wilthagen EA, Sebire NJ, Khong TY, van der Voorn JP, Amant F. Placental pathology in cancer during pregnancy and after cancer treatment exposure. Placenta 2021; 111:33-46. [PMID: 34153795 DOI: 10.1016/j.placenta.2021.06.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Accepted: 06/03/2021] [Indexed: 01/07/2023]
Abstract
Cancer during pregnancy has been associated with (pathologically) small for gestational age offspring, especially after exposure to chemotherapy in utero. These infants are most likely growth restricted, but sonographic results are often lacking. In view of the paucity of data on underlying pathophysiological mechanisms, the objective was to summarize all studies investigating placental pathology related to cancer(treatment). A systematic search in PubMed/Medline, Embase (OVID) and SCOPUS was conducted to retrieve all studies about placental pathology in cancer during pregnancy or after cancer treatment, published until August 2020. The literature search yielded 5784 unique publications, of which 111 were eligible for inclusion. Among them, three groups of placental pathology were distinguished. First, various histopathologic changes including maternal vascular malperfusion have been reported in pregnancies complicated by cancer and after cancer treatment exposure, which were not specific to type of cancer(treatment). Second, cancer(treatment) has been associated with placental cellular pathology including increased oxidative damage and apoptosis, impaired angiogenesis and genotoxicity. Finally, involvement of the placenta by cancer cells has been described, involving both the intervillous space and rarely villous invasion, with such fetuses are at risk of having metastases. In conclusion, growth restriction is often observed in pregnancies complicated by cancer and its cause can be multifactorial. Placental histopathologic changes, cellular pathology and genotoxicity caused by the cancer(treatment) may each play a role.
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Affiliation(s)
- Vera E R A Wolters
- Department of Gynecologic Oncology and Center for Gynecologic Oncology Amsterdam (CGOA), Netherlands Cancer Institute - Antoni van Leeuwenhoek and University Medical Centers Amsterdam, Plesmanlaan 121, 1066, CX Amsterdam, the Netherlands.
| | - Christine A R Lok
- Department of Gynecologic Oncology and Center for Gynecologic Oncology Amsterdam (CGOA), Netherlands Cancer Institute - Antoni van Leeuwenhoek and University Medical Centers Amsterdam, Plesmanlaan 121, 1066, CX Amsterdam, the Netherlands.
| | - Sanne J Gordijn
- Department of Gynaecology and Obstetrics, University of Groningen, University Medical Center Groningen, CB 20 Hanzeplein 1, 9713, GZ Groningen, the Netherlands.
| | - Erica A Wilthagen
- Scientific Information Service, Netherlands Cancer Institute - Antoni van Leeuwenhoek, Plesmanlaan 121, 1066, CX Amsterdam, the Netherlands.
| | - Neil J Sebire
- Department of Paediatric Pathology, NIHR Great Ormond Street Hospital BRC, London, WC1N 3JH, United Kingdom.
| | - T Yee Khong
- SA Pathology, Women's and Children's Hospital, 72 King William Road, North Adelaide, SA5006, Australia.
| | - J Patrick van der Voorn
- Department of Pathology, University Medical Centers Amsterdam, Location VU University Medical Center, De Boelelaan 1117, 1081 HV, Amsterdam, the Netherlands.
| | - Frédéric Amant
- Department of Gynecologic Oncology and Center for Gynecologic Oncology Amsterdam (CGOA), Netherlands Cancer Institute - Antoni van Leeuwenhoek and University Medical Centers Amsterdam, Plesmanlaan 121, 1066, CX Amsterdam, the Netherlands; Department of Oncology, KU Leuven, Herestraat 49, 3000, Leuven, Belgium.
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Reed N, Balega J, Barwick T, Buckley L, Burton K, Eminowicz G, Forrest J, Ganesan R, Harrand R, Holland C, Howe T, Ind T, Iyer R, Kaushik S, Music R, Sadozye A, Shanbhag S, Siddiqui N, Syed S, Percival N, Whitham NL, Nordin A, Fotopoulou C. British Gynaecological Cancer Society (BGCS) cervical cancer guidelines: Recommendations for practice. Eur J Obstet Gynecol Reprod Biol 2020; 256:433-465. [PMID: 33143928 DOI: 10.1016/j.ejogrb.2020.08.020] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 08/05/2020] [Accepted: 08/21/2020] [Indexed: 01/20/2023]
Abstract
Cervix cancer in many countries is declining and screening programmes and immunisation will reduce the incidence in the next few decades. This guideline attempts to cover management of invasive disease reflecting diagnosis and imaging including new imaging and sentinel lymph node biopsies. Smaller volume disease is usually managed surgically whereas advanced disease is treated with (chemo)- radiation. It also includes discussion of fertility sparing procedures. Practices are changing frequently for all aspects of care usually in attempts to reduce complications and improve quality of life. The management of advanced disease is treated by chemotherapy and the use of newer agents is also discussed. Other sections discuss specialist situations such as cancer in pregnancy, rare cervical tumours, late effects and supportive measures and fertility preserving approaches.
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Affiliation(s)
- Nick Reed
- Beatson Oncology Centre, Glasgow, United Kingdom.
| | | | | | - Lynn Buckley
- Clinical Nurse Specialist, Hull University Teaching Hospitals NHS Trust, United Kingdom
| | | | | | | | | | | | | | | | - Thomas Ind
- Royal Marsden Hospital, London, United Kingdom
| | - Rema Iyer
- East Kent Hospitals University Foundation NHS Trust, United Kingdom
| | | | - Robert Music
- Jo's Cervical Cancer Trustt, London, United Kingdom
| | | | - Smruta Shanbhag
- University Hospitals Coventry and Warwickshire NHS Trust, United Kingdom
| | | | - Sheeba Syed
- Queen Elizabeth University Hospital, Glasgow, United Kingdom
| | | | - Natasha Lauren Whitham
- Lancashire Teaching Hospitals (Royal Preston Hospital, Fulwood, Lancashire), United Kingdom
| | - Andy Nordin
- East Kent Gynaecological Oncology Centre, East Kent Hospitals University Foundation Nhs Trust, Queen Elizabeth The Queen Mother Hospital, Margate, United Kingdom
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Li JN, Nijhawan RI, Srivastava D. Cutaneous Surgery in Patients Who Are Pregnant or Breastfeeding. Dermatol Clin 2019; 37:307-317. [PMID: 31084725 DOI: 10.1016/j.det.2019.03.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Dermatologic surgery in pregnant/postpartum patients requires deliberate consideration. Although surgery can be safely performed during any trimester, the second trimester and immediate postpartum period is optimal. Surgery should not be delayed for melanoma/high-risk skin cancers. Perioperative positioning, analgesic, antiseptic, and antibiotic selection should be deliberate to avoid risk to the patient/fetus/infant. The left lateral tilt position reduces aortocaval compression syndrome. Lidocaine and epinephrine can be used safely. Alcohol and chlorhexidine are considered safe. Antibiotics commonly used in skin surgery are safe in pregnancy and lactation. Acetaminophen is first line for pain management. Nonsteroidal antiinflammatory drugs should be avoided.
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Affiliation(s)
- Jeffrey N Li
- Department of Dermatology, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390, USA
| | - Rajiv I Nijhawan
- Department of Dermatology, University of Texas Southwestern Medical Center, 5939 Harry Hines Boulevard, Professional Office Building 2, Suite 400, Dallas, TX 75390, USA
| | - Divya Srivastava
- Department of Dermatology, University of Texas Southwestern Medical Center, 5939 Harry Hines Boulevard, Professional Office Building 2, Suite 400, Dallas, TX 75390, USA.
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Mendizábal E, De León-Luis J, Gómez-Hidalgo NR, Joigneau L, Pintado P, Rincón P, Ortega V, Lizarraga S. Maternal and perinatal outcomes in pregnancy-associated melanoma. Report of two cases and a systematic literature review. Eur J Obstet Gynecol Reprod Biol 2017; 214:131-139. [DOI: 10.1016/j.ejogrb.2017.04.023] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2016] [Revised: 04/01/2017] [Accepted: 04/09/2017] [Indexed: 10/19/2022]
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Gynecologic Cancers in Pregnancy: Guidelines of a Second International Consensus Meeting. Int J Gynecol Cancer 2014; 24:394-403. [DOI: 10.1097/igc.0000000000000062] [Citation(s) in RCA: 133] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
ObjectivesThis study aimed to provide timely and effective guidance for pregnant women and health care providers to optimize maternal treatment and fetal protection and to promote effective management of the mother, fetus, and neonate when administering potentially teratogenic medications. New insights and more experience were gained since the first consensus meeting 5 years ago.MethodsMembers of the European Society of Gynecological Oncology task force “Cancer in Pregnancy” in concert with other international experts reviewed the existing literature on their respective areas of expertise. The summaries were subsequently merged into a complete article that served as a basis for discussion during the consensus meeting. All participants approved the final article.ResultsIn the experts’ view, cancer can be successfully treated during pregnancy in collaboration with a multidisciplinary team, optimizing maternal treatment while considering fetal safety. To maximize the maternal outcome, cancer treatment should follow a standard treatment protocol as for nonpregnant patients. Iatrogenic prematurity should be avoided. Individualization of treatment and effective psychologic support is imperative to provide throughout the pregnancy period. Diagnostic procedures, including staging examinations and imaging, such as magnetic resonance imaging and sonography, are preferable. Pelvic surgery, either open or laparoscopic, as part of a treatment protocol, may reveal beneficial outcomes and is preferably performed by experts. Most standard regimens of chemotherapy can be administered from 14 weeks gestational age onward. Apart from cervical and vulvar cancer, as well as important vulvar scarring, the mode of delivery is determined by the obstetrician. Term delivery is aimed for. Breast-feeding should be considered based on individual drug safety and neonatologist–breast-feeding expert’s consult.ConclusionsDespite limited evidence-based information, cancer treatment during pregnancy can succeed. State-of-the-art treatment should be provided for this vulnerable population to preserve maternal and fetal prognosis.Supplementary InformationSupplementary data on teratogenic effects, ionizing examinations, sentinel lymph node biopsy, tumor markers during pregnancy, as well as additional references and tables are available at the extended online version of this consensus article, go to http://links.lww.com/IGC/A197.
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8
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Gynecologic malignancy in pregnancy. Obstet Gynecol Sci 2013; 56:289-300. [PMID: 24328018 PMCID: PMC3784125 DOI: 10.5468/ogs.2013.56.5.289] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2013] [Revised: 07/22/2013] [Accepted: 07/22/2013] [Indexed: 12/20/2022] Open
Abstract
Gynecologic malignancy during pregnancy is a stressful problem. For the diagnosis and treatment of malignancy during pregnancy, a multidisciplinary approach is needed. Patients should be advised about the benefits and risk of treatment. When selecting a treatment for malignancy during pregnancy, the physiologic changes that occur with the pregnancy should be considered. Various diagnostic procedures that do not harm the fetus can be used. Laparoscopic surgery or laparotomy may be safely performed. The staging approach and treatment should be standard. Systemic chemotherapy during the first trimester should be delayed if possible. Radiation therapy should preferably start postpartum. Although delivery should be delayed preferably until after 35 weeks of gestation, termination of pregnancy may be considered when immediate treatment is required. Subsequent pregnancies do not increase the risk of malignancy recurrence.
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10
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Sebaratnam DF, Venugopal SS, Frew JW, McMillan JR, Finkelstein ER, Martin LK, Murrell DF. Diffuse melanosis cutis: A systematic review of the literature. J Am Acad Dermatol 2013; 68:482-8. [DOI: 10.1016/j.jaad.2012.08.018] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2012] [Revised: 08/12/2012] [Accepted: 08/14/2012] [Indexed: 11/17/2022]
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Andtbacka RHI, Donaldson MR, Bowles TL, Bowen GM, Grossmann K, Khong H, Grossman D, Anker C, Florell SR, Bowen A, Duffy KL, Leachman SA, Noyes RD. Sentinel Lymph Node Biopsy for Melanoma in Pregnant Women. Ann Surg Oncol 2012; 20:689-96. [DOI: 10.1245/s10434-012-2633-7] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2012] [Indexed: 01/08/2023]
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Amant F, Van Calsteren K, Halaska MJ, Beijnen J, Lagae L, Hanssens M, Heyns L, Lannoo L, Ottevanger NP, Vanden Bogaert W, Ungar L, Vergote I, du Bois A. Gynecologic Cancers in Pregnancy. Int J Gynecol Cancer 2009; 19 Suppl 1:S1-12. [DOI: 10.1111/igc.0b013e3181a1d0ec] [Citation(s) in RCA: 101] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Amant F, Van Calsteren K, Vergote I, Ottevanger N. Gynecologic oncology in pregnancy. Crit Rev Oncol Hematol 2008; 67:187-95. [PMID: 18296060 DOI: 10.1016/j.critrevonc.2008.01.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2007] [Accepted: 01/16/2008] [Indexed: 11/19/2022] Open
Affiliation(s)
- Frédéric Amant
- Gynecologic Oncology, Leuven Cancer Institute (LKI), Department of Obstetrics and Gynecology, UZ Gasthuisberg, Katholieke Universiteit Leuven, Belgium.
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Abstract
Despite its low incidence, vulvar melanoma carries a poor prognosis and shows a high tendency to metastasize because the diagnosis is often delayed. Although it is very well known that ultraviolet radiation is an important aetiological factor for cutaneous melanomas in adults, this cannot be considered true for vulvar melanoma. Chronic inflammatory disease, viral infections, irritant agents are the main factors suspected to induce mucosal melanoma. We report 10 cases of vulvar malignant melanoma observed in our institute from 1990 to 2005 and a review of the literature.
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Abstract
Placental pathology continues to be an underutilized, undertaught, and inadequately handled surgical subspecialty. The requests for placental pathology are soaring, due partly to demands from obstetricians and to the litigious environment in which they practice, and to improved obstetrical care leading to pregnancies in medically challenging situations. Evaluation of the placenta requires a good understanding of the questions and issues concerning both the fetus/infant and the mother. Information from placental pathology can be critical in early neonatal care and in reproductive planning for the family, and it can provide risk assessment for neurologic outcome of the infant. A comfortable interaction among the obstetric staff, mothers, and pathologists often obviates need for legal intervention in unexpected pregnancy outcomes. Some critical pathologic features that involve maternal and fetal management are illustrated herein. A template for gross examination and a few critical histopathologic diagnostic features with clincopathologic correlation are included.
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Affiliation(s)
- Drucilla J Roberts
- Department of Pathology, Massachusetts General Hospital, 55 Fruit St, Boston, MA 02115, USA.
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Gambichler T, Stücker M, Kerner K, Weiner S, Waldherr R, Altmeyer P, Kreuter A. Acute kidney injury in a patient with melanuria, diffuse melanosis, and metastatic malignant melanoma. Am J Clin Dermatol 2008; 9:267-70. [PMID: 18572978 DOI: 10.2165/00128071-200809040-00007] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Diffuse melanosis with melanuria is a rare complication of metastatic malignant melanoma that is associated with a very poor prognosis. Acute kidney injury secondary to melanuria has not been reported previously. We describe a patient with malignant melanoma, diffuse melanosis, and melanuria who developed acute kidney injury that was clinically indicated by an increase in urinary excreted metabolites in the serum. Histopathologic examination of kidney tissue revealed damage to tubules associated with disseminated intra-tubular melanin deposits. Diffuse melanosis with melanuria may lead to morphologic and functional kidney changes and warrants careful monitoring of kidney function in affected malignant melanoma patients.
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Affiliation(s)
- Thilo Gambichler
- Department of Dermatology, Ruhr-University Bochum, Bochum, Germany.
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Hormones, nevi, and melanoma: An approach to the patient. J Am Acad Dermatol 2007; 57:919-31; quiz 932-6. [DOI: 10.1016/j.jaad.2007.08.045] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2007] [Revised: 08/05/2007] [Accepted: 08/31/2007] [Indexed: 12/22/2022]
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Bollos RH, Nakamura MU, Lapchick VBV, Bevilacqua EMAF, Correa M, Daher S, Ishigai MMS, Jasiulionis MG. Metastatic melanoma positively influences pregnancy outcome in a mouse model: could a deadly tumor support embryo life? Clin Exp Metastasis 2007; 25:65-73. [DOI: 10.1007/s10585-007-9102-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2007] [Accepted: 09/21/2007] [Indexed: 12/31/2022]
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Dessolle L, Dalmon C, Roche B, Daraï E. Métastases placentaires de cancers maternels: revue de la littérature. ACTA ACUST UNITED AC 2007; 36:344-53. [PMID: 17289295 DOI: 10.1016/j.jgyn.2006.12.022] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2006] [Revised: 11/30/2006] [Accepted: 12/28/2006] [Indexed: 11/19/2022]
Abstract
The purpose of this paper was to update and analyse all the reported cases of placental metastasis. These tumours are rare and seem to complicate aggressive or disseminated malignant melanomas, leukaemias, breast cancers and lung cancers. Maternal prognosis is poor. The risk factors of cancer in the newborn are unknown. In a pregnant woman with a history of malignancy, a systematic histological examination of the placenta for evidence of metastasis is required. Close observation and follow-up of the infant has to be recommended, especially in case of placental involvement. To estimate the incidence of placental metastases and to improve knowledge of their natural history, the creation of registries of malignancies associated with pregnancy is required.
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Affiliation(s)
- L Dessolle
- Service de gynécologie-obstétrique, centre hospitalier des Pays-de-Morlaix, BP 97237, 29672 Morlaix cedex, France.
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Patrick RJ, Fenske NA, Messina JL. Primary mucosal melanoma. J Am Acad Dermatol 2007; 56:828-34. [PMID: 17349716 DOI: 10.1016/j.jaad.2006.06.017] [Citation(s) in RCA: 177] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2005] [Revised: 05/08/2006] [Accepted: 06/19/2006] [Indexed: 01/07/2023]
Abstract
Primary mucosal melanomas are rare, biologically aggressive neoplasms. The distribution of head and neck, female genital tract, anal/rectal, and urinary tract sites is 55.4%, 18.0%, 23.8%, and 2.8%, respectively. The median age at presentation is the seventh decade, and women are given the diagnosis more frequently than men. Unfortunately, most afflicted individuals harbor micrometastatic disease and experience a course characterized by multiple local recurrences before the clinical development of distant disease. Approximately a third of patients have nodal involvement at presentation, and the overall 5-year survival is only 25%. Despite aggressive surgical resection and a multitude of adjuvant treatments, the prognosis remains grave. Early detection, which is difficult because of the occult anatomic locations in which these tumors occur, allows the best hope for cure.
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Affiliation(s)
- Ronald J Patrick
- Department of Dermatology, University of South Florida College of Medicine, Tampa, FL 33612, USA
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Abstract
Melanoma and other benign or malignant pigmented skin tumors can significantly overlap in their clinical and dermoscopical presentations. Thus, pigmented skin lesions may be misdiagnosed in a large number of cases. An extensive review of the published work provides numerous examples of benign lesions mimicking melanoma. Although a number of melanocytic nevi may have been identified as melanomas, information about their clinical appearance is limited. In this report, we present the clinical appearances of two melanocytic nevi on the vulva and the upper extremity that were difficult to diagnose clinically. Detecting melanoma at an early stage is of the utmost importance. However, more attention should be given to the diagnostic accuracy of benign pigmented skin lesions, which otherwise may be diagnosed and treated as melanoma.
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Affiliation(s)
- Eiichi Makino
- Department of Dermatology, Kawasaki Medical School, Kurashiki, Okayama, Japan.
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