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1.
We report an 84-year-old Japanese woman who presented with a pedunculated malignant melanoma of the vaginal mucosa. Mucosal melanoma is believed to be more common in Japan than other countries, but such tumors of the vulvovaginal region are quite unusual. In our patient, three tumors were connected by a narrow pedicle. Three black tumors measuring 5-10 mm in diameter with a common pedicle were seen on the vaginal mucosa at five o'clock from the cervix. The tumors were hanging from the narrow pedicle. On histologic examination, they were diagnosed as malignant melanoma. Resection was done with a distal margin of 3 cm from the tumors and a margin of 1 cm from the cervix. The patient has had no evidence of local recurrence or distant metastasis. In our patient, the three main tumors had a common pedicle, which seems to be a unique finding. Since pedunculated malignant melanomas are rare, making a clinical diagnosis is difficult. Although pedunculated melanomas are recognized as having a high malignant potential because these lesions are generally thick, a relatively good outcome is sometimes reported. In our patient, there was no tumor infiltration into the dermis of the pedicle, and this may be one reason for the good outcome at present. There has been no previous report of a mucosal melanoma consisting of three tumors like those in the present patient.  相似文献   

2.
Three primary lesions of malignant melanoma developed in a 44-year-old Japanese woman with Werner syndrome. One lesion was on the right large pudental lip and the others in distinct locations on her left sole. After the wide local excision of these tumors, the wound of the large pudental lip was sutured, and the defects on the sole were covered with skin grafts. After one course of chemotherapy consisting of dacarbazine, nimustine, vincristine sulfate and local injection of Interferon beta were performed, severe myelosupression occurred and continued for two months. Defective production of WRN protein was confirmed by Western blotting, although the three representative mutations in Japanese patients, mutations 1, 4 and 6, which include over 90% of the Japanese patients, were not detected. We also reviewed 26 cases of malignant melanoma associated with Werner syndrome (WS), including ours.  相似文献   

3.
姜福琼 《皮肤病与性病》2012,34(1):25-28,31
皮肤恶性黑素瘤(cutaneous malignant melanoma,CMM)是黑色素细胞的恶性肿瘤,本文对CMM的发病情况、临床分期及目前的治疗方法进行了综述。  相似文献   

4.
5.
Malignant melanoma during pregnancy is a difficult problem as a variety of risks to both the mother and fetus must be weighed. We describe a rapidly progressive malignant melanoma diagnosed during pregnancy. There are no standarized guidelines for treatment; each case requires an individualized approach. We review the literature and present an algorithm to aid in approaching such patients.  相似文献   

6.
皮肤黑色素瘤诊治的误区   总被引:2,自引:0,他引:2  
目的揭示皮肤黑色素瘤诊断和治疗的误区,探讨合理诊断和治疗黑色素瘤的方法。方法结合有关文献,并对15例足部皮肤黑色素瘤的病程和治疗进行分析。结果大多数患者没有及时就医以及医疗单位病检取材不合理。结论正确取材活检,明确切除范围,及时手术以及一期修复组织缺损是有效防止癌肿扩散,提高生存率的关键。  相似文献   

7.
本文综述了原发皮肤恶性黑色素细胞分子遗传学改变,染色体上的非随机改变主要发生在1、6、9、7及10号染色体上。  相似文献   

8.
BACKGROUND: The surgical management of primary cutaneous malignant melanoma usually involves an excision biopsy of the suspected lesion followed by wide local excision. No study has addressed whether a delay between these two surgical procedures influences patient outcome. OBJECTIVES: To determine if the surgical interval (SI) between the diagnostic excision biopsy and wide local excision for primary cutaneous malignant melanoma affects recurrence or survival outcome. METHODS: A cohort of 986 patients who had a diagnostic excision biopsy followed by wide local excision was identified from those registered on a specialist database that records the clinicopathological features, surgical treatment and follow-up information of all patients with malignant melanoma in Scotland. The cohort was divided into five arbitrary groups determined by the length of the SI as follows:< or =14 days, 15-28 days, 29-42 days, 43-91 days and > or = 92 days. Overall survival, disease-free survival and recurrence-free interval between the groups were compared univariately and multivariately. RESULTS: The mean age at excision biopsy was 47.4 years and the median period of follow-up was 5 years (range 27 days to 20.7 years). The median SI was 30 days (range 1-468 days). The SI was: (i)< or =14 days for 130 (13%); (ii) 15-28 days for 320 (33%); (iii) 29-42 days for 262 (27%); (iv) 43-91 days for 251 (25%); and (v) > or = 92 days for 23 (2%) patients. The latter group was older, had thinner melanomas, a higher percentage of lesions on the head and neck, fewer superficial spreading malignant melanomas and ulceration present less often compared with patients treated earlier. Univariately, there was no significant difference in overall survival (P = 0.60) or disease-free survival (P = 0.24) between the groups. Although there was a statistically significant difference in the percentage of recurrence-free patients between the groups (P = 0.011), the better recurrence-free rates occurred in the 29-42 and 43-91 day groups. After adjusting for age, sex, tumour thickness, site, histology, ulceration and mitotic activity using Cox's proportional hazards model, there was no statistically significant difference in overall survival, disease-free survival and recurrence-free percentages between the surgical groups (P = 0.88, P = 0.44 and P = 0.084, respectively). CONCLUSIONS: There was no evidence that survival outcome or recurrence was related to the time interval between the diagnostic excision biopsy and wide local excision of melanoma.  相似文献   

9.
目的:探讨黑素瘤抑制性活性因子(MIA)在黑素瘤及基底细胞癌中的表达及其作用。方法:应用sP免疫组化技术检测38份黑素瘤石蜡标本、35份基底细胞癌石蜡标本以及32份色素痣石蜡标本中MIA的表达水平。结果:MIA在所有色素痣以及基底细胞癌中均呈阴性表达,而在原位黑素瘤、侵袭性黑素瘤、有淋巴结转移的黑素瘤、无淋巴结转移的黑素瘤阳性表达率分别为21.4%、91.6%、94.1%和42.8%。结论:MIA在黑素瘤的发生发展中起重要作用,MIA有可能成为临床诊断、治疗黑素瘤的靶点。  相似文献   

10.
By using 111In-labeled monoclonal antibody (ZME-018) against human malignant melanoma, we examined its usefulness in radioimmunodetection of human melanoma xenografts in nude mice. Two human malignant melanoma cell lines were used in this study, KHm-1/4; and KHm-3/ps. KHm-1/4 cells express melanoma-associated antigen which is reactive with ZME-018, whereas KHm-3/ps cells do not. ZME-018 was conjugated with DTPA (diethylene triamine pentaacetic acid) first; then the conjugate was labeled with 111In. After these procedures, labeled ZME-018 retained its binding activity against KHm-1/4 cells in vitro. Nude mice, bearing melenoma xenografts started from injections into the right hind legs, were i.p. or i.v. injected with ∽300 μCi (60 μg) of labeled ZME-018. Tumor images were taken with gamma camera at 24 hr intervals. Clear tumor images were obtained by 24 hrs after injection. The best imaging was obtained at 72 hrs with no background of internal organs. Specific localization was confirmed by the absence of imaging in the mice which received free 111In only and also by using control mice bearing antigen-negative melanoma cells (KHm-3/PS). An example of tissue distribution of the labeled antibody in terms of tumor to tissue ratio at day 3 is as follows: tumor/intestine; 20/1, tumor/liver; 10/1, tumor/blood; 8/1, tumor/muscle; 8/1, tumor/heart; 3/1, tumor/kidney; 2/1. This study demonstrates the future applicability of 111In-labeled monoclonal anti-melanoma antibody for radioimmunodetection of metastatic lesions in melanoma patients.  相似文献   

11.

Background

Special AT-rich sequence-binding protein-1 (SATB1), a new type of gene regulator, has been reported to be expressed in several human cancers and may have malignant potential. However, no data on SATB1 expression and its relationship to tumor progression in cutaneous malignant melanoma (CMM) has yet been reported.

Objective

We examined the immunohistochemical expression of SATB1 in CMM to determine whether it could serve as a prognostic marker.

Methods

A total of 97 samples of primary CMM and controls were immunostained for SATB1. The following clinicopathologic variables were evaluated: age, gender, subtype, SATB1 expression, Breslow thickness, Clark level, presence of ulceration, lymph node metastasis, distant metastasis, and survival. Statistical analyses were performed to assess for associations. Several parameters were analyzed for survival using the Kaplan-Meier method and Cox proportional-hazards model.

Results

Forty cases (85.1%) of CMM showed positive staining for SATB1 by immunohistochemistry. The intensity of SATB1 staining was significantly higher in CMM than in nevus NV and normal skin (NS) (P < 0.01). High SATB1 expression was significantly correlated with Breslow thickness, Clark level, mortality, presence of ulceration, and lymph node metastasis (P < 0.01). Moreover, Kaplan-Meier analysis revealed that SATB1 overexpression was significantly associated with worse survival (P < 0.01). Further univariate analysis and multivariate regression analysis indicated that SATB1 expression was an independent prognostic marker for CMM (P = 0.03).

Conclusions

The overexpression of SATB1 correlated with metastatic potential of CMM and is a novel independent prognostic marker for predicting outcome.  相似文献   

12.
Summary Background  Cutaneous malignant melanoma is the most serious form of skin cancer and accounts for about three-quarters of all skin cancer deaths. Over the last few decades the incidence and mortality rates of melanoma have been increasing worldwide. The risk of melanoma is higher in individuals with both phenotypic susceptibility and a history of sun exposure. Therefore, recommended sun protection behaviours include wearing long-sleeved clothing, seeking shade, avoiding the sun when it is strongest, and using sunscreen lotion with a sun protection factor of 15 or higher. It has been reported, however, that the use of sunscreens does not protect against melanoma and seems to increase the duration of recreational sun exposure.
Methods  Published epidemiological studies examining sunscreen use and melanoma have been reviewed from an epidemiological point of view, taking into account potential biases. We have classified case–control studies into four categories: (1) inconclusive studies because of major bias in control population and/or the lack of multivariate analysis; (2) no association between sunscreen use and melanoma after controlling for confounders; (3) negative association (i.e. protective effect of sunscreen); and (4) positive association. Various other epidemiological studies were also analysed.
Results  These results are controversial. Two case–control studies show a protective effect of sunscreen use, while three studies showed a significant risk associated with sunscreen use. However, the discordant results, the low relative risks, the lack of dose–effect relationship and the numerous biases, especially the uncertainty that exposure (sunscreen use) preceded melanoma do not suggest a causative association between sunscreen use and melanoma. Several hypotheses could partly explain these contradictory results.  相似文献   

13.
BACKGROUND: The incidence of cutaneous malignant melanoma (CMM) and melanoma in situ (MIS) has been increasing during the last 50 years. Malignant melanoma (MM) is also the most common intraocular malignancy (IMM). Besides ultraviolet radiation, the cause of these tumours is largely unknown. OBJECTIVES: We designed a study to examine the effect of body mass index (BMI) and tobacco use on the risk for MM and MIS. METHODS: Analyses were performed on a nationwide cohort of 339 802 Swedish construction workers. Exposure information was collected prospectively by questionnaires combined with personal interviews. RESULTS: Follow up yielded a total of 7 663 400 person-years during which 1639 workers developed MM/MIS. The risk for MM/MIS was reduced in current or previous smokers compared with those who had never smoked, both when analysing all smoking tobacco products combined and when analysing cigarette and pipe smokers separately. The risk was further diminished with longer duration of smoking and greater quantity of tobacco smoked. The effect was more evident in CMM/MIS than in IMM. Snuff taking conferred a decreased risk for CMM/MIS, and a BMI over normal weight range conferred an increased risk for CMM. CONCLUSIONS: Tobacco smoking was found to be inversely associated with the risk for CMM and MIS. The mechanism of action is unknown but it has been suggested to be due to the immune suppressive effect that tobacco exerts which would be protective against deleterious immune reactions caused by, for example, the sun. Neither is the mechanism behind the higher risk for CMM due to being overweight known. One hypothesis is that it is an effect of a hormonal imbalance. Further studies are required to elucidate these mechanisms.  相似文献   

14.
目的:检测肾上腺髓质素(adrenomedullin,ADM)在人黑素瘤中的表达。方法:采用免疫组织化学SP法检测ADM在15例黑素瘤、30例色素痣组织标本及人成纤维细胞、黑素瘤细胞系A375中的表达。结果:人成纤维细胞中ADM的表达为弱阳性、A375中ADM表达呈强阳性。黑素瘤组织标本中80%检测到ADM,色素痣组织标本中仅有43.3%检测到ADM的表达,差异有统计学意义(P〈0.05)。结论:肾上腺髓质素在人黑素瘤组织中高表达,在人的色素痣和成纤维细胞中低表达,提示ADM与黑素瘤发生、发展可能密切相关。  相似文献   

15.
Two types of human malignant melanoma were treated either with peplomycin alone, hyperthermia alone, or a combination of peplomycin and hyperthermia. The antitumor effect of combination therapy was evaluated by tumor growth curves, maximal suppression rate, and histopathology. A marked antitumor effect of combination therapy with peplomycin (5 mg/kg) and hyperthermia (43°C, 30 min) was obtained for both types of melanoma. Histopathologic findings revealed advanced central necrosis and pyknotic nuclei in the tumor cells. Although peplomycin alone (20 mg/kg, 6 times) had no antitumor effect on C24 melanoma, the peplomycin (5 mg/kg, 6 times) + heat group showed complete inhibition of the tumor growth. These results suggest that hyperthermia enhances the antitumor effect of peplomycin even against peplomycin-resistant tumor cells.  相似文献   

16.
We report a 58-year-old woman presenting with dyspnoea and recurrent pulmonary embolism. Echocardiography revealed pericardial effusion and a tumour located in the atrioventricular groove. Surgical exploration showed tumorous infiltration of the ventricle wall and of parts of the atrium. Curative excision was not possible and the operation was discontinued. Histology revealed an amelanotic malignant melanoma. No other tumour location was detected by scanning procedures. This case represents a very rare manifestation of melanoma exclusively located in the atrioventricular groove of the heart leading to recurrent pulmonary embolism. A review of the literature on cardiac involvement of melanoma is provided.  相似文献   

17.
An increased risk for a second malignancy has been reported in patients with mycosis fungoides. We describe two subjects with mycosis fungoides who developed small malignant melanoma after topical application of nitrogen mustard.  相似文献   

18.
Polypoid malignant melanoma is a peculiar morphological variant of melanoma with a distinct exophytic pattern of growth. This form of melanoma is usually very thick and the prognosis is accordingly poor. We present here a previously undescribed form of Spitz naevus which had a similar polypoid exophytic silhouette and marked cytological atypia. Despite these close morphological similarities, polypoid Spitz naevus evolves in a completely benign manner. Morphologically, polypoid Spitz naevus can be distinguished from polypoid melanoma by the absence of mitoses and by the prominent stromal reaction throughout the lesion.  相似文献   

19.
BACKGROUND: Proteasomes, nonlysosomal proteolytic structures, are implicated in cell growth and differentiation. An abnormal expression has been described in haematopoietic malignancies and in some solid tumours. OBJECTIVES: To study the plasma proteasome levels in patients with malignant melanoma (MM) using an enzyme-linked immunosorbent assay (ELISA) technique, and to compare them with the values obtained in a normal population and in patients with severe psoriasis or chronic idiopathic urticaria (CIU). METHODS: Plasma proteasome level was measured using a sandwich ELISA test in normal donors (n = 14), and in patients with stage I/II (n = 13), stage III (n = 6) and stage IV (n = 10) MM, severe psoriasis (n = 13) and CIU (n = 6). Tissue proteasome expression was also detected by immunohistology using a monoclonal antibody in paraffin-embedded samples of normal tissue, psoriasis skin and MM. RESULTS: In normal donors, mean +/- SEM plasma proteasome concentration was 2138 +/- 221 ng mL(-1). Patients with stages III and IV MM exhibited a significantly higher value (3373 +/- 470 ng mL(-1) and 8931 +/- 1232 ng mL(-1), respectively). Values in patients with stage I/II MM and CIU were not significantly different from those in normal volunteers. Patients with severe psoriasis also exhibited increased values (3398 +/- 374 ng mL(-1)) but to a lesser extent than in patients with stage IV MM. There was a significant correlation of proteasome levels with serum lactate dehydrogenase in the MM group. Tissue expression as demonstrated by immunohistochemistry paralleled these findings. The strongest expression was seen on MM slides and to a lesser extent in psoriasis samples, the weakest expression being observed in normal skin. CONCLUSIONS: Proteasomes are strongly expressed in cutaneous MM; high levels of circulating proteasomes are detected in patients with metastatic MM with a high melanoma burden, and at a lesser extent in psoriatic patients, which suggests proteasomes represent a marker more of nonspecific inflammation than of early cancer.  相似文献   

20.
Human malignant melanoma cultured cells were treated either with ACNU (1-(4-amino-2-methyl-5-pyrimidinyl)methyl-3-(2-chlorethyl)-3-nitro sourea hydrochloride), hyperthermia, or the combination of ACNU and hyperthermia. The combination treatment inhibited the cell growth to a slightly synergistic degree compared to the respective single treatments. The present in vitro experimental results support in part the finding of our previous report that the combination treatment with ACNU and hyperthermia have a significantly synergistic antitumor effect to human melanoma transplanted to nude mice. However, the synergistic effect was much less intense in the present in vitro experiment. The difference may have resulted from the environmental differences between in vitro and in vivo experimental systems.  相似文献   

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