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Xu Y, Duan Z, Hu W, Zhu K, Cui P, Du Z, Abe M, Zong L. A secondary jejunal malignant melanoma from nasal mucosal melanoma: Case report. SAGE Open Med Case Rep 2021; 9:2050313X211053708. [PMID: 34671476 PMCID: PMC8521416 DOI: 10.1177/2050313x211053708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 09/29/2021] [Indexed: 11/24/2022] Open
Abstract
Melanomas most commonly localized in the skin can arise anywhere in the body, and approximately 5% of all melanomas appear in other sites of mucosal surfaces out of skin. Primary melanoma from nasal mucosa is quite rare. We present this case: a 46-year-old man had complained a pain in the left upper abdomen for 2 months when he was admitted to the Northern Jiangsu People’s Hospital. The pain was paroxysmal and enhanced when eating. There was no nausea, vomiting, or anorexia. There had been no change in weight in previous months. This patient had a past history of surgery for nasal mucosal malignant melanoma 2 years ago. Abdominal enhanced computed tomography (CT) indicated that a mass originated from small bowel and occupied the left upper abdomen. The patient underwent a laparotomy during which a black lesion measuring about 5 cm × 5 cm × 4 cm was found at the jejunum and resected totally together with partial jejunum. The patient was eventually diagnosed as secondary jejunal malignant melanoma from nasal mucosal melanoma. For patients with a history of melanoma, gastrointestinal metastasis should be considered when patients develop gastrointestinal symptoms. In addition, we recommend positive anti-tumor therapy after surgery.
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Affiliation(s)
- Yingying Xu
- Department of General Surgery, Yizheng People's Hospital, Clinical Medical College, Yangzhou University, Yangzhou, China
| | - Zongkui Duan
- Department of Gastrointestinal Surgery, Northern Jiangsu People's Hospital, Clinical Medical College, Yangzhou University, Yangzhou, China
| | - Wenqing Hu
- Department of Gastrointestinal Surgery, Changzhi People's Hospital, The Affiliated Hospital of Changzhi Medical College, Changzhi, China
| | - Kaixuan Zhu
- Department of General Surgery, Yizheng People's Hospital, Clinical Medical College, Yangzhou University, Yangzhou, China
| | - Peng Cui
- Department of Gastrointestinal Surgery, Changzhi People's Hospital, The Affiliated Hospital of Changzhi Medical College, Changzhi, China
| | - Zhuoran Du
- Department of Gastrointestinal Surgery, Changzhi People's Hospital, The Affiliated Hospital of Changzhi Medical College, Changzhi, China
| | - Masanomu Abe
- Division for Health Service Promotion, University of Tokyo Hospital, Tokyo, Japan
| | - Liang Zong
- Department of Gastrointestinal Surgery, Changzhi People's Hospital, The Affiliated Hospital of Changzhi Medical College, Changzhi, China
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Osofsky R, Kamya C, Hanif H, Phuoc V. A rare cause of lower gastrointestinal bleeding treated with robotic colorectal surgery. Surg Case Rep 2021; 7:125. [PMID: 34014406 PMCID: PMC8137796 DOI: 10.1186/s40792-021-01207-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 05/12/2021] [Indexed: 11/23/2022] Open
Abstract
Background Metastatic melanoma to the colon is rarely diagnosed with an incidence of only 0.3% and more than 95% of cases identified post-mortem. Survival for patients with metastatic melanoma to the colon is poor, with 5-year survival rates of 26.5%. Nonetheless, surgical resection of the colonic metastatic melanoma lesions is recommended as it is associated with improved survival. Additionally, surgical resection is also indicated for palliative reasons, as symptom resolution is achieved in 90% of such patients. Use of the surgical robot has increased dramatically in the past decades, especially in the field of colorectal surgery. Furthermore, recent studies have demonstrated comparable outcomes between patients undergoing either laparoscopic or robotic-assisted colorectal surgery for cancer. Here, we describe the first case, to the authors knowledge, of a robot-assisted sigmoid colectomy for metastatic melanoma. Case presentation A 72-year-old male with a history of metastatic melanoma diagnosed in 2015 with a favorable response to immunotherapy presented to the emergency department with symptomatic lower gastrointestinal bleeding (LGIB). Endoscopy demonstrated a friable melanotic lesion of the sigmoid colon with biopsy demonstrating histopathologic evidence of metastatic melanoma. After further evaluation, the patient consented for an elective robot-assisted segmental colectomy for palliative intent. Diagnostic laparoscopy identified no evidence of further intra-abdominal metastatic disease. After identifying the metastatic lesion in the sigmoid colon, the mesentery of involved segment of sigmoid colon adjacent to the lesion was divided using the bipolar electrosurgical vessel sealer device. The colon was divided both proximal and distal to the lesion using a robotic stapler and a tension-free colo-colonic anastomosis was created intracorporeally. Postoperatively, the patient had an unremarkable course and was discharged home on post-operative day 3. On follow-up, the patient was doing well with resolution of preoperative LGIB. Conclusion This case highlights a rare presentation of metastatic melanoma to the colon in a patient presenting with LGIB. Furthermore, this case demonstrates the feasibility of the minimally invasive robotic-assisted approach for an uncommon pathology.
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Affiliation(s)
- Robin Osofsky
- Department of Surgery, UNM Hospital - 2ACC, University of New Mexico Hospital School of Medicine, Albuquerque, NM, 87131, USA.
| | - Cyril Kamya
- Department of Surgery, UNM Hospital - 2ACC, University of New Mexico Hospital School of Medicine, Albuquerque, NM, 87131, USA
| | - Hamza Hanif
- Shifa College of Medicine, Sector H-8/4, Islamabad, 44000, Federal Capital, Pakistan
| | - Victor Phuoc
- Department of Surgery, UNM Hospital - 2ACC, University of New Mexico Hospital School of Medicine, Albuquerque, NM, 87131, USA
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Takahashi T, Sugita S, Kagaya H, Morita T. Surgically treated gastric melanoma of unknown primary: A case report from a 10-year survivor. Pathol Int 2020; 70:786-792. [PMID: 32803839 PMCID: PMC7689816 DOI: 10.1111/pin.12991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 07/03/2020] [Accepted: 07/07/2020] [Indexed: 11/28/2022]
Abstract
We describe an extremely rare case of simultaneous double melanoma of the stomach with no other obvious primary source. The patient has survived for more than 12 years post-complete gastrectomy. The patient was a woman in her seventies who was referred for anemia by another clinic. Esophagogastroscopy revealed an ulcerated gastric tumor that was diagnosed as a gastrointestinal stromal tumor (GIST) by endoscopic biopsy. She was admitted to our hospital for further examination and treatment. Gastroscopy at our institution revealed two submucosal tumors in the gastric wall. Since no metastatic lesions were detected after systemic exploration, multiple GIST of the stomach was diagnosed, and a total gastrectomy was performed. Malignant melanoma was diagnosed in both lesions by a histopathological study of the resected stomach. The patient's postoperative progress was good, and thorough examination of the skin did not result in the discovery of any systemic neoplastic lesions which could be regarded as the source for the primary tumor. No anticancer treatments were used. The patient has survived, with no recurrence for over ten years postsurgery. Strong evidence is presented in this case for the diagnosis and treatment of gastric malignant melanoma.
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Affiliation(s)
- Toshiyuki Takahashi
- Department of Pathology, Hokkaido Gastroenterology Hospital, Hokkaido, Japan
| | - Shintaro Sugita
- Department of Surgical Pathology, Sapporo Medical University, School of Medicine, Hokkaido, Japan
| | - Hidetoshi Kagaya
- Department of Internal Medicine, Hokkaido Gastroenterology Hospital, Hokkaido, Japan
| | - Takayuki Morita
- Department of Surgery, Hokkaido Gastroenterology Hospital, Hokkaido, Japan
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Long-term survival after surgical treatment followed by adjuvant systemic therapy for primary duodenal melanoma. Clin J Gastroenterol 2020; 13:532-537. [PMID: 32198707 DOI: 10.1007/s12328-020-01112-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 03/08/2020] [Indexed: 10/24/2022]
Abstract
Primary mucosal malignant melanomas of the gastrointestinal tract are rare tumors associated to poor prognosis. Primary duodenal involvement by pigmented lesions is even more uncommon, and only a few reports exist in the literature. We report the case of a patient with large primary duodenal melanoma that presented with upper intestinal obstruction and bleeding that was submitted to urgent pancreaticoduodenectomy followed by adjuvant systemic therapy with an oral alkylating agent (temozolomide) plus intravenous cisplatin. The patient presents no signs of recurrence 3 years after the surgery. We consider that radical surgical resection followed by systemic therapy is a safe and effective treatment strategy option for primary mucosal gastrointestinal melanomas.
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Wakamatsu K, Fukushima S, Minagawa A, Omodaka T, Hida T, Hatta N, Takata M, Uhara H, Okuyama R, Ihn H. Significance of 5- S-Cysteinyldopa as a Marker for Melanoma. Int J Mol Sci 2020; 21:E432. [PMID: 31936623 PMCID: PMC7013534 DOI: 10.3390/ijms21020432] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 01/07/2020] [Accepted: 01/07/2020] [Indexed: 12/18/2022] Open
Abstract
Melanoma is one of the most lethal and malignant cancers and its incidence is increasing worldwide, and Japan is not an exception. Although there are numerous therapeutic options for melanoma, the prognosis is still poor once it has metastasized. The main concern after removal of a primary melanoma is whether it has metastasized, and early detection of metastatic melanoma would be effective in improving the prognosis of patients. Thus, it is very important to identify reliable methods to detect metastases as early as possible. Although many prognostic biomarkers (mainly for metastases) of melanoma have been reported, there are very few effective for an early diagnosis. Serum and urinary biomarkers for melanoma diagnosis have especially received great interest because of the relative ease of sample collection and handling. Several serum and urinary biomarkers appear to have significant potential both as prognostic indicators and as targets for future therapeutic methods, but still there are no efficient serum and urinary biomarkers for early detection, accurate diagnosis and prognosis, efficient monitoring of the disease and reliable prediction of survival and recurrence. Levels of 5-S-cysteinyldopa (5SCD) in the serum or urine as biomarkers of melanoma have been found to be significantly elevated earlier and to reflect melanoma progression better than physical examinations, laboratory tests and imaging techniques, such as scintigraphy and echography. With recent developments in the treatment of melanoma, studies reporting combinations of 5SCD levels and new applications for the treatment of melanoma are gradually increasing. This review summarizes the usefulness of 5SCD, the most widely used and well-known melanoma marker in the serum and urine, compares 5SCD and other useful markers, and finally its application to other fields.
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Affiliation(s)
- Kazumasa Wakamatsu
- Department of Chemistry, Fujita Health University School of Medical Sciences, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi 470-1192, Japan
| | - Satoshi Fukushima
- Department of Dermatology and Plastic Surgery, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan; (S.F.); (H.I.)
| | - Akane Minagawa
- Department of Dermatology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan; (A.M.); (T.O.); (R.O.)
| | - Toshikazu Omodaka
- Department of Dermatology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan; (A.M.); (T.O.); (R.O.)
| | - Tokimasa Hida
- Department of Dermatology, Sapporo Medical University School of Medicine, South 1, West 16, Chuo-ku, Sapporo 060-8543, Japan; (T.H.); (H.U.)
| | - Naohito Hatta
- Department of Dermatology, Toyama Prefectural Central Hospital, 2-2-78 Nishinagae, Toyama, Toyama 930-8550, Japan;
| | - Minoru Takata
- Department of Dermatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikada-cho, Kita-Ku, Okayama 700-8558, Japan;
| | - Hisashi Uhara
- Department of Dermatology, Sapporo Medical University School of Medicine, South 1, West 16, Chuo-ku, Sapporo 060-8543, Japan; (T.H.); (H.U.)
| | - Ryuhei Okuyama
- Department of Dermatology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan; (A.M.); (T.O.); (R.O.)
| | - Hironobu Ihn
- Department of Dermatology and Plastic Surgery, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan; (S.F.); (H.I.)
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A rare case of metastatic malignant melanoma to the colon from an unknown primary. Case Rep Gastrointest Med 2014; 2014:312902. [PMID: 25093125 PMCID: PMC4100276 DOI: 10.1155/2014/312902] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2014] [Accepted: 06/11/2014] [Indexed: 02/07/2023] Open
Abstract
Metastatic melanoma from an unknown primary (MUP) is rare; its occurrence in the gastrointestinal tract is of exceedingly low prevalence. We report a case of a 73-year-old man with metastatic malignant melanoma to the colon from an unknown primary. The rarity of MUP and importance of screening for gastrointestinal metastasis in patients with malignant melanoma are discussed along with the role of surgical resection in improving prognosis and overall survival.
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Malignant melanoma of the gastro-intestinal tract: a case series. Int J Surg 2014; 12:523-7. [PMID: 24576592 DOI: 10.1016/j.ijsu.2014.02.011] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2013] [Revised: 01/09/2014] [Accepted: 02/21/2014] [Indexed: 01/11/2023]
Abstract
BACKGROUND Resection of gastrointestinal (GI) metastases of malignant melanoma (MM) offers a significant survival benefit. No adjuvant therapy has been shown to be effective in the treatment of these metastases. METHODS All resections of MM affecting the GI tract at a UK University teaching hospital between October 1999 and January 2013 were identified from a pathology database. Demographic, investigative, operative and outcome data were retrieved from hospital records. Survival analysis was performed. RESULTS Thirty patients were identified (median age 62.7 years). 3 patients underwent a second operation at a later date to resect further metastases. 6 patients (20.0%) presented with no identifiable cutaneous lesion. The average time to GI metastases was 52.0 months (range 4.9-139.8 months) for those with an identified cutaneous primary (n = 24). Two patients with initial cutaneous lesions with Breslow's thickness <1 mm developed GI metastases. Common presenting symptoms included abdominal pain (n = 8, 27.6%), GI bleeding (n = 5, 17.2%) and symptoms of GI tract obstruction (n = 4, 13.8%). CT scan was the most commonly performed investigation (96.6%). Over half of resections (54.5%, n = 18) included small bowel resection. Mortality at 2 and 5 years was 66.4% and 73.1%. Of the 3 patients who underwent a second resection of GI metastases, one is still alive after 26 months of follow up; 2 patients died after 32.8 and 18.6 months. CONCLUSIONS Clinicians should have a low threshold for investigating GI symptoms in patients with a history of malignant melanoma even in the case of early-stage primary disease. Re-resection should be considered in patients presenting with further GI metastases.
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Torre ML, Frezza B, Fransvea P, Ziparo V, Balducci G, Costa G. Gastrointestinal Metastases of Cutaneous Melanoma. Am Surg 2014. [DOI: 10.1177/000313481408000205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Marco La Torre
- Department of General Surgery Surgical Department of Clinical Sciences Biomedical Technologies and Translational Medicine Faculty of Medicine and Psychology University of Rome “La Sapienza” St. Andrea Hospital Rome, Italy
| | - Barbara Frezza
- Department of General Surgery Surgical Department of Clinical Sciences Biomedical Technologies and Translational Medicine Faculty of Medicine and Psychology University of Rome “La Sapienza” St. Andrea Hospital Rome, Italy
| | - Pietro Fransvea
- Department of General Surgery Surgical Department of Clinical Sciences Biomedical Technologies and Translational Medicine Faculty of Medicine and Psychology University of Rome “La Sapienza” St. Andrea Hospital Rome, Italy
| | - Vincenzo Ziparo
- Department of General Surgery Surgical Department of Clinical Sciences Biomedical Technologies and Translational Medicine Faculty of Medicine and Psychology University of Rome “La Sapienza” St. Andrea Hospital Rome, Italy
| | - Genoveffa Balducci
- Department of General Surgery Surgical Department of Clinical Sciences Biomedical Technologies and Translational Medicine Faculty of Medicine and Psychology University of Rome “La Sapienza” St. Andrea Hospital Rome, Italy
| | - Gianluca Costa
- Department of General Surgery Surgical Department of Clinical Sciences Biomedical Technologies and Translational Medicine Faculty of Medicine and Psychology University of Rome “La Sapienza” St. Andrea Hospital Rome, Italy
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Wang X, Hu M, Liu M, Hu JZ. Metastatic Melanoma Induced Metabolic Changes in C57BL/6J Mouse Stomach Measured by 1H NMR Spectroscopy. METABOLOMICS : OPEN ACCESS 2014; 4:1000135. [PMID: 26246958 PMCID: PMC4523238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Melanoma is a malignant tumor of melanocytes with high capability of invasion and rapid metastasis to other organs. Malignant melanoma is the most common metastatic malignancy found in Gastrointestinal Tract (GI). In this work, the 1H NMR-based metabolomics approach is used to investigate the metabolite profile differences of stomach tissue extracts of metastatic B16-F10 melanoma and control groups in C57BL/6J mouse and to search for specific metabolite biomarker candidates. Principal Component Analysis (PCA), an unsupervised multivariate data analysis method, is used to detect possible outliers, while Orthogonal Projection to Latent Structure (OPLS), a supervised multivariate data analysis method, is employed to evaluate important metabolites responsible for discriminating the control and the melanoma groups. Both PCA and OPLS results reveal that the melanoma group can be well separated from its control group. Among the 50 identified metabolites, it is found that the concentrations of 19 metabolites are significantly changed with the levels of O-phosphocholine and hypoxanthine down-regulated while the levels of isoleucine, leucine, valine, isobutyrate, threonine, cadaverine, alanine, glutamate, glutamine, methionine, citrate, asparagine, tryptophan, glycine, serine, uracil, and formate up-regulated in the melanoma group. These significantly changed metabolites are associated with multiple biological pathways and may be potential biomarkers for metastatic melanoma in stomach.
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Affiliation(s)
- X Wang
- Pacific Northwest National Laboratory, Richland, WA 99352, USA
- State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics, Wuhan Institute of Physics and Mathematics, the Chinese Academy of Sciences, Wuhan, 430071, PR China
| | - M Hu
- Pacific Northwest National Laboratory, Richland, WA 99352, USA
| | - M Liu
- State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics, Wuhan Institute of Physics and Mathematics, the Chinese Academy of Sciences, Wuhan, 430071, PR China
| | - JZ Hu
- Pacific Northwest National Laboratory, Richland, WA 99352, USA
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Atiq O, Khan AS, Abrams GA. Metastatic amelanotic melanoma of the jejunum diagnosed on capsule endoscopy. Gastroenterol Hepatol (N Y) 2012; 8:691-693. [PMID: 24683379 PMCID: PMC3969014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Affiliation(s)
- Omair Atiq
- Department of Internal Medicine, UAB Health Center, Montgomery, Alabama
| | - Ali S. Khan
- Department of Gastroenterology, UAB, Birmingham, Alabama
| | - Gary A Abrams
- Department of Internal Medicine, UAB Health Center, Montgomery, Alabama
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Metastatic malignant melanoma presenting as an appendiceal mucocele. JOURNAL OF ONCOLOGY 2011; 2011:546570. [PMID: 21547210 PMCID: PMC3087427 DOI: 10.1155/2011/546570] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/25/2010] [Revised: 12/18/2010] [Accepted: 01/27/2011] [Indexed: 02/03/2023]
Abstract
Melanoma metastatic to the appendix is extremely rare. Here we describe a case of a 31-year-old female from Bolivia with a remote history of metastatic malignant melanoma first diagnosed as a cutaneous malignant melanoma ten years prior to this presentation. The patient was being followed for a mucocele which on resection was found to be metastatic melanoma. “Mucocele” is a generic diagnosis that warrants further characterization and treatment.
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12
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Current World Literature. Curr Opin Support Palliat Care 2010; 4:293-304. [DOI: 10.1097/spc.0b013e328340e983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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