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1. Lăzureanu C, Baderca F, Burlacu O, Nicodin A: Soft tissue epithelioid angiosarcoma. Rom J Morphol Embryol; 2010;51(4):787-92
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  • [Title] Soft tissue epithelioid angiosarcoma.
  • We present a case of 48-year-old male with a nine months history of right inferior thoracic (T10-T12) paravertebral mass, which became painful after a back trauma; dyspnea and hemoptysis were associated.
  • Fragments of 10 cm large tumor resection specimen (striated muscle, dense connective tissue, adipose tissue, lymph nodes and intercostals nerves) were routinely processed, further immunohistochemical investigations were needed, using Dako antibodies pan-CK clone MNF116, CD34, CD20, vimentin, synaptophysin, melanoma HMB45 clone, with LSAB 2Kits system and further CK AE1÷AE3, CK7, CK20, CEA, S-100 protein, CD31, von Willebrand factor, D2-40÷podoplanin, Ki-67 antigen, with EnVision system and DAB visualization in both systems.
  • The histological and immunohistochemical aspects were indicative for soft tissue epithelioid angiosarcoma, which was misdiagnosed on frozen and HE sections as a carcinoma, because of the cohesiveness and nesting properties of the malignant cells, together with the presence of lymph node metastases.
  • The proliferative activity of the malignant cells, highlighted by Ki-67 antibody, clone MIB 1 was high (30% of malignant cells were positive at HPF).
  • The patient was discharged with adjuvant therapy indication: radiotherapy and chemotherapy.
  • [MeSH-major] Hemangiosarcoma / pathology. Soft Tissue Neoplasms / pathology
  • [MeSH-minor] Diagnostic Errors. Epithelioid Cells / metabolism. Epithelioid Cells / pathology. Humans. Immunohistochemistry. Male. Middle Aged. Thoracic Neoplasms / diagnosis. Thoracic Neoplasms / metabolism. Thoracic Neoplasms / pathology

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  • (PMID = 21103644.001).
  • [ISSN] 1220-0522
  • [Journal-full-title] Romanian journal of morphology and embryology = Revue roumaine de morphologie et embryologie
  • [ISO-abbreviation] Rom J Morphol Embryol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Romania
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2. Chen IY, Yang SF, Chen FM, Chai CY: Abdominopelvic perivascular epithelioid cell tumor with overt malignancy: a case report. Kaohsiung J Med Sci; 2005 Jun;21(6):277-81

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  • [Title] Abdominopelvic perivascular epithelioid cell tumor with overt malignancy: a case report.
  • Perivascular epithelioid cell tumor (PEComa) is a group of rare tumors composed of epithelioid cells with characteristic perivascular distribution and co-expression of the melanogenic marker HMB-45 and muscular markers.
  • Though the cytologic appearance of the tumor cells was relatively bland, the extensive necrosis, presence of lymph node metastases, and surrounding tissue invasion were all indicative of malignancy.
  • Relapse of the tumor with multiple lymphadenopathy shortly after debulking surgery for the primary lesion, and postoperative adjuvant chemotherapy, further denoted its aggressive behavior.
  • [MeSH-major] Abdominal Neoplasms / pathology. Carcinoma / pathology. Epithelioid Cells / pathology. Pelvic Neoplasms / pathology
  • [MeSH-minor] Adolescent. Antigens, Neoplasm. Female. Humans. Lymphatic Metastasis. Melanoma-Specific Antigens. Neoplasm Invasiveness. Neoplasm Proteins / analysis

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  • (PMID = 16035571.001).
  • [ISSN] 1607-551X
  • [Journal-full-title] The Kaohsiung journal of medical sciences
  • [ISO-abbreviation] Kaohsiung J. Med. Sci.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] China (Republic : 1949- )
  • [Chemical-registry-number] 0 / Antigens, Neoplasm; 0 / Melanoma-Specific Antigens; 0 / Neoplasm Proteins
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3. Chao MM, Schwartz JL, Wechsler DS, Thornburg CD, Griffith KA, Williams JA: High-risk surgically resected pediatric melanoma and adjuvant interferon therapy. Pediatr Blood Cancer; 2005 May;44(5):441-8
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  • [Title] High-risk surgically resected pediatric melanoma and adjuvant interferon therapy.
  • BACKGROUND: Pediatric patients with high-risk surgically resected melanoma are at risk for relapse, yet little is known about these young patients and how they tolerate high-dose interferon therapy.
  • PROCEDURE: We reviewed medical records of patients (< or =18 years) with high-risk melanoma referred to the University of Michigan Pediatric Hematology-Oncology service between January 1989 and July 2003.
  • RESULTS: Fourteen patients were identified with high-risk resected melanoma.
  • The median time to establish diagnosis was 9 months.
  • Primary lesions were diagnosed as unequivocal melanoma, atypical epithelioid melanocytic proliferations, or atypical Spitz tumor with indeterminate malignant potential.
  • Two patients with unequivocal melanoma with Breslow depth >4 mm had negative SLN biopsies.
  • Grade 3 or 4 toxicities were uncommon with exception of neutropenia, resulting in modification of therapy in one patient.
  • CONCLUSIONS: Invasive melanoma can occur in very young children.
  • Pediatric patients tolerated adjuvant high-dose interferon well and may be less likely than adults to require therapy modification secondary to toxicities.
  • [MeSH-major] Interferons / therapeutic use. Melanoma / drug therapy. Melanoma / pathology
  • [MeSH-minor] Adolescent. Chemotherapy, Adjuvant. Child. Child, Preschool. Disease-Free Survival. Female. Humans. Male. Neoplasm Invasiveness. Neoplasm Metastasis. Retrospective Studies. Survival Rate

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  • [Copyright] 2004 Wiley-Liss, Inc.
  • [CommentIn] Pediatr Blood Cancer. 2005 May;44(5):431-2 [15514915.001]
  • (PMID = 15468307.001).
  • [ISSN] 1545-5009
  • [Journal-full-title] Pediatric blood & cancer
  • [ISO-abbreviation] Pediatr Blood Cancer
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 9008-11-1 / Interferons
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4. Aida K, Monia K, Ahlem S, Dominique HT, Becima F, Sylvie F, Ridha KM: Agminated Spitz nevi arising on a nevus spilus after chemotherapy. Pediatr Dermatol; 2010 Jul-Aug;27(4):411-3
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  • [Title] Agminated Spitz nevi arising on a nevus spilus after chemotherapy.
  • We report here a further case in a child that is original because it is induced by chemotherapy.
  • A 3-year-old boy presented 3 months after the onset of a chemotherapy for a vesico-prostatic rhabdomyosarcoma, multiple pigmented papulo-nodules located on the face, neck, chest wall, and the higher back.
  • Our patient may have a high risk for melanoma since he has many criteria predisposing to this risk.
  • Some of these criteria are related to NS but we should also take into account the chemotherapy induction and the high number of Spitz nevi.
  • [MeSH-major] Antineoplastic Agents / adverse effects. Nevus, Epithelioid and Spindle Cell / chemically induced. Prostatic Neoplasms / drug therapy. Rhabdomyosarcoma / drug therapy. Skin Neoplasms / chemically induced. Urinary Bladder Neoplasms / drug therapy


5. Nascimento AF, Bertoni F, Fletcher CD: Epithelioid variant of myxofibrosarcoma: expanding the clinicomorphologic spectrum of myxofibrosarcoma in a series of 17 cases. Am J Surg Pathol; 2007 Jan;31(1):99-105
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  • [Title] Epithelioid variant of myxofibrosarcoma: expanding the clinicomorphologic spectrum of myxofibrosarcoma in a series of 17 cases.
  • Myxofibrosarcoma (MFS) is one of the most common soft tissue sarcomas of elderly patients and has a predilection for the limbs.
  • Herein, we report a previously undescribed variant of MFS showing epithelioid morphology.
  • Seventeen cases diagnosed as epithelioid MFS were retrieved from the authors' files from among 570 cases of MFS.
  • Fifteen patients presented with a mass, and in 2 of these there was also pain.
  • In 10 cases, the tumor was located in subcutaneous tissue and in 6 cases it was subfascial.
  • Twelve patients were treated by surgery followed by chemotherapy and/or radiation (8 cases).
  • One patient received chemotherapy after an incisional biopsy and 1 patient was treated by surgery alone.
  • Ten patients (71.4%) developed local recurrences.
  • Seven patients (50%) developed metastases to lungs or retroperitoneum.
  • Neoplastic cells were arranged singly and in small clusters in the myxoid areas or formed sheets in the hypercellular areas, where they showed epithelioid morphology with round nuclei, vesicular chromatin, prominent nucleoli, and moderate amounts of eosinophilic cytoplasm.
  • The epithelioid areas were generally multifocal with admixed areas of conventional MFS.
  • Differential diagnosis included carcinoma, melanoma, myoepithelial carcinoma, pleomorphic liposarcoma, and pleomorphic rhabdomyosarcoma.
  • In conclusion, epithelioid MFS is a rare variant of MFS, accounting for <3% of MFS in consultation material.
  • [MeSH-major] Epithelioid Cells / pathology. Fibrosarcoma / secondary. Sarcoma / secondary. Soft Tissue Neoplasms / pathology
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Biomarkers, Tumor / analysis. Carcinoma / diagnosis. Combined Modality Therapy. Diagnosis, Differential. Extremities. Fatal Outcome. Female. Humans. Immunoenzyme Techniques. Liposarcoma / diagnosis. Male. Melanoma / diagnosis. Middle Aged. Myoepithelioma / diagnosis. Rhabdomyosarcoma / diagnosis

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  • (PMID = 17197925.001).
  • [ISSN] 0147-5185
  • [Journal-full-title] The American journal of surgical pathology
  • [ISO-abbreviation] Am. J. Surg. Pathol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers, Tumor
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6. Silva EG, Deavers MT, Bodurka DC, Malpica A: Uterine epithelioid leiomyosarcomas with clear cells: reactivity with HMB-45 and the concept of PEComa. Am J Surg Pathol; 2004 Feb;28(2):244-9
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  • [Title] Uterine epithelioid leiomyosarcomas with clear cells: reactivity with HMB-45 and the concept of PEComa.
  • In this study, we investigated HMB-45 expression in epithelioid uterine leiomyosarcomas with clear cell areas.
  • From 12 epithelioid leiomyosarcomas, we selected 5 that had:.
  • 1) clear cell areas and 2) spindle cell areas that were at least focally positive for desmin and caldesmon.
  • Two received radiotherapy, and three were also treated with chemotherapy.
  • The epithelioid component varied from 50% to 90% in each case; and the percentage of clear cells was < 1% in one case, 5% in one case, and 10% to 80% in three cases.
  • Four cases were positive for HMB-45 only in the clear cell areas.
  • Unequivocal uterine epithelioid leiomyosarcomas may have clear cells positive for HMB-45.
  • In uterine smooth muscle tumors, some epithelioid cells most likely undergo clear cell changes and become positive for HMB-45.
  • It would be advisable to perform this stain in all epithelioid smooth muscle tumors of the uterus.
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Antigens, Neoplasm. Epithelial Cells / pathology. Female. Humans. Immunohistochemistry / methods. Melanoma-Specific Antigens. Middle Aged. Staining and Labeling

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  • (PMID = 15043315.001).
  • [ISSN] 0147-5185
  • [Journal-full-title] The American journal of surgical pathology
  • [ISO-abbreviation] Am. J. Surg. Pathol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antigens, Neoplasm; 0 / Melanoma-Specific Antigens; 0 / Neoplasm Proteins
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7. Seya T, Tanaka N, Shinji S, Shinji E, Yokoi K, Horiba K, Kanazawa Y, Yamada T, Oaki Y, Tajiri T: Case of rectal malignant melanoma showing immunohistochemical variability in a tumor. J Nippon Med Sch; 2007 Oct;74(5):377-81
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  • [Title] Case of rectal malignant melanoma showing immunohistochemical variability in a tumor.
  • We report on a patient with rectal malignant melanoma.
  • A biopsy of the rectal tumor showed the proliferation of epithelioid cells with pleomorphic features.
  • Abdominopelvic computed tomography (CT) revealed multiple liver and lymph node metastases.
  • Neoadjuvant chemotherapy using cisplatin and irinotecan via the subcutaneous reservoir port was performed and a partial response was obtained.
  • However, the final pathological diagnosis of the surgically resected specimen was malignant amelanotic melanoma of the rectum.
  • As preoperative pathological diagnosis showed rare rectal tumor, we measured the chemosensitivity of the rectal tumor using the collagen gel droplet-embedded culture drug sensitivity test (CD-DST) to determine the most appropriate chemotherapy regimen for the patient.
  • However, there were no anticancer drugs tested by CD-DST for malignant melanoma.
  • [MeSH-major] Biomarkers, Tumor / analysis. Melanoma / diagnosis. Neoplasm Proteins / analysis. Proto-Oncogene Proteins c-kit / analysis. Rectal Neoplasms / diagnosis
  • [MeSH-minor] Adult. Antigens, Neoplasm. Antineoplastic Combined Chemotherapy Protocols / pharmacology. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Digestive System Surgical Procedures. Drug Resistance, Neoplasm. Drug Screening Assays, Antitumor / methods. Fatal Outcome. Humans. Immunohistochemistry. Interferon-beta / administration & dosage. Male. Melanoma-Specific Antigens. Neoadjuvant Therapy. Tumor Cells, Cultured

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  • (PMID = 17965534.001).
  • [ISSN] 1345-4676
  • [Journal-full-title] Journal of Nippon Medical School = Nippon Ika Daigaku zasshi
  • [ISO-abbreviation] J Nippon Med Sch
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Antigens, Neoplasm; 0 / Biomarkers, Tumor; 0 / Melanoma-Specific Antigens; 0 / Neoplasm Proteins; 77238-31-4 / Interferon-beta; EC 2.7.10.1 / Proto-Oncogene Proteins c-kit
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8. Liu M, Ba E, Zhao P, Li X: [A clinicopathological study of fifteen epithelioid angiosarcoma]. Zhonghua Bing Li Xue Za Zhi; 2002 Oct;31(5):407-10
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  • [Title] [A clinicopathological study of fifteen epithelioid angiosarcoma].
  • OBJECTIVE: To study the clinicopathological features of epithelioid angiosarcoma (EA) and to propose its differential diagnosis.
  • The tumors were located in the retroperitoneum (n = 3), extremities (n = 3), femur (n = 4), thyroid (n = 2), supraobit (n = 1), soft tissue of thorax (n = 1), soft tissue of neck (n = 1).
  • Histologically, the epithelioid cells were arranged diffusely or in nests with hemorrhage and focal necrosis.
  • Surgical resection was the treatment of choice, occasionally with adjuvant chemotherapy. Follow-up.
  • Twelve died from 2 weeks to 38 months with a median interval of 19 months after lumpectomy.
  • The differential diagnosis of EA includes metastatic carcinoma, epithelioid hemangioendothelioma, melanoma, epithelioid sarcoma etc.
  • [MeSH-major] Hemangioendothelioma, Epithelioid / diagnosis. Melanoma / diagnosis. Sarcoma / diagnosis
  • [MeSH-minor] Adult. Aged. Diagnosis, Differential. Epithelioid Cells / pathology. Female. Humans. Immunohistochemistry. Male. Middle Aged

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  • (PMID = 12485481.001).
  • [ISSN] 0529-5807
  • [Journal-full-title] Zhonghua bing li xue za zhi = Chinese journal of pathology
  • [ISO-abbreviation] Zhonghua Bing Li Xue Za Zhi
  • [Language] chi
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] China
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9. Toyoshima M, Okamura C, Niikura H, Ito K, Yaegashi N: Epithelioid leiomyosarcoma of the uterine cervix: a case report and review of the literature. Gynecol Oncol; 2005 Jun;97(3):957-60
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  • [Title] Epithelioid leiomyosarcoma of the uterine cervix: a case report and review of the literature.
  • BACKGROUND: Epithelioid leiomyosarcomas arising from the uterine cervix are extremely rare neoplasms, with only three cases reported in the English literature.
  • Histological findings, including immunohistochemical study using desmin, SMA, cytokeratin, S-100, HMB-45, vimentin, melan-A, and CD68, led to a diagnosis of epithelioid leiomyosarcoma of the uterine cervix.
  • The patient underwent adjuvant chemotherapy and has been disease-free for over 20 months.
  • CONCLUSION: Immunohistochemical studies may be needed to differentiate among the alternative diagnoses of malignant melanoma, metastatic carcinoma, and epithelioid sarcoma.

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  • (PMID = 15890394.001).
  • [ISSN] 0090-8258
  • [Journal-full-title] Gynecologic oncology
  • [ISO-abbreviation] Gynecol. Oncol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 10
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10. Hornick JL, Jaffe ES, Fletcher CD: Extranodal histiocytic sarcoma: clinicopathologic analysis of 14 cases of a rare epithelioid malignancy. Am J Surg Pathol; 2004 Sep;28(9):1133-44
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  • [Title] Extranodal histiocytic sarcoma: clinicopathologic analysis of 14 cases of a rare epithelioid malignancy.
  • Histiocytic sarcoma is a rare malignant neoplasm that occurs in lymph nodes, skin, and the gastrointestinal tract.
  • All patients presented with a solitary mass, ranging in size from 1.8 to 12 cm (median 6.8 cm).
  • Seven tumors arose in soft tissue (6 lower limb; 1 upper limb), 5 in the gastrointestinal tract (1 involving both stomach and colon, 1 ileum, 2 rectum, 1 anus), 1 in the nasal cavity, and 1 in the lung.
  • The tumors were generally composed of sheets of large epithelioid cells with abundant eosinophilic cytoplasm, oval to irregular nuclei, vesicular chromatin, and large nucleoli.
  • Six patients were treated with postoperative radiation and 7 with chemotherapy (CHOP or ProMACE-MOPP).
  • Two tumors recurred locally, and 5 patients developed distant spread: 3 to lymph nodes, 1 to lung, and 1 to bone.
  • Histiocytic sarcoma may arise primarily in soft tissue and shows reproducible histologic features, including abundant eosinophilic cytoplasm and a prominent inflammatory infiltrate.
  • Metastatic carcinoma, metastatic melanoma, and large cell non-Hodgkin lymphomas should be excluded by immunohistochemistry.

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  • (PMID = 15316312.001).
  • [ISSN] 0147-5185
  • [Journal-full-title] The American journal of surgical pathology
  • [ISO-abbreviation] Am. J. Surg. Pathol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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11. Bacchi CE, Silva TR, Zambrano E, Plaza J, Suster S, Luzar B, Lamovec J, Pizzolitto S, Falconieri G: Epithelioid angiosarcoma of the skin: a study of 18 cases with emphasis on its clinicopathologic spectrum and unusual morphologic features. Am J Surg Pathol; 2010 Sep;34(9):1334-43
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  • [Title] Epithelioid angiosarcoma of the skin: a study of 18 cases with emphasis on its clinicopathologic spectrum and unusual morphologic features.
  • We report 18 cases of cutaneous angiosarcoma with predominant or exclusive epithelioid morphology.
  • Diverging phenotypes included syncytial growth of large cells with clear nuclei and prominent nucleoli, micronodules of tumor cells scattered in dermis, predominance of discohesive plasmacytoid polygonal cells with abundant bright eosinophilic cytoplasm, sheets of clear cells with coarse granular cytoplasm, trabecular and cord arrangement of tumor cells splaying the dermal collagen, or a pseudoglandular appearance owing to clear cell tubular arrangement with open lumina.
  • These cases posed further diagnostic challenges simulating lymphoma, melanoma, lymphoepithelioma-like carcinoma, adnexal carcinoma, and neuroendocrine carcinoma.
  • Therapeutic modalities included combined local excision, chemotherapy, and radiotherapy, depending on patient clinical status.
  • Our data show that epithelioid cutaneous angiosarcoma may have a broad morphological spectrum, raising interpretive challenges on microscopy.
  • [MeSH-major] Epithelioid Cells / pathology. Hemangiosarcoma / pathology. Skin Neoplasms / pathology
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Biomarkers, Tumor / metabolism. Child. Child, Preschool. Combined Modality Therapy. Female. Humans. Male. Middle Aged. Treatment Outcome

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  • (PMID = 20697249.001).
  • [ISSN] 1532-0979
  • [Journal-full-title] The American journal of surgical pathology
  • [ISO-abbreviation] Am. J. Surg. Pathol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers, Tumor
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12. Heinzerling LM, Anliker MD, Müller J, Schlaeppi M, von Moos R: Sarcoidosis induced by interferon-α in melanoma patients: incidence, clinical manifestations, and management strategies. J Immunother; 2010 Oct;33(8):834-9
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  • [Title] Sarcoidosis induced by interferon-α in melanoma patients: incidence, clinical manifestations, and management strategies.
  • Treatment with interferon-α has been recommended for patients with melanoma in case of micrometastases, or high risk melanoma, for example, ulcerated melanoma.
  • Furthermore, regular dermatologic examination and regular imaging to detect recurrence or progression of disease is part of the management of melanoma patients.
  • Sarcoidosis has been described as an adverse effect of treatment with interferon-α.
  • Especially in hepatitis C patients, there is a series of case reports on sarcoidosis induced by interferon treatment whereas in melanoma this has rarely been reported.
  • In a retrospective study, all melanoma patients treated with interferon-α at our hospital between 2007 and 2009 were screened for occurrence of sarcoidosis.
  • Three of 16 melanoma patients treated with interferon-α (19%) presented with sarcoidosis.
  • All 3 patients showed lesions with higher uptake in the positron emission tomography-computed tomography scan leading to the differential diagnosis of melanoma metastases or inflammation.
  • Diagnosis was confirmed by histologic assessment of lesions showing epithelioid granuloma-negative on Ziehl Neelson.
  • Sarcoidosis induced by interferon-α in melanoma patients could be more common than previously thought.
  • This is an important complication to be aware of as it can be mistaken for metastatic spread of melanoma and thus lead to incorrect therapy.
  • [MeSH-major] Immunotherapy. Interferon-alpha / adverse effects. Melanoma / complications. Melanoma / drug therapy. Sarcoidosis / etiology
  • [MeSH-minor] Diagnosis, Differential. Disease Progression. Granuloma. Hepatitis C / epidemiology. Humans. Incidence. Male. Middle Aged. Neoplasm Metastasis. Retrospective Studies. Withholding Treatment

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  • (PMID = 20842053.001).
  • [ISSN] 1537-4513
  • [Journal-full-title] Journal of immunotherapy (Hagerstown, Md. : 1997)
  • [ISO-abbreviation] J. Immunother.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Interferon-alpha
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13. Murakami M, Wada T, Kashiwagi T, Ishida-Yamamoto A, Iizuka H: Nodular malignant melanoma with Spitz nevus-like pathological features finally confirmed by the pathological feature of the sentinel lymph node. J Dermatol; 2007 Dec;34(12):821-8
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  • [Title] Nodular malignant melanoma with Spitz nevus-like pathological features finally confirmed by the pathological feature of the sentinel lymph node.
  • The clinical and histopathological similarities of nodular melanoma and Spitz nevus currently still make a definitive diagnosis difficult.
  • We report here a case of nodular melanoma that was extremely difficult to diagnose both clinically and histopathologically.
  • Although our first impression was malignant melanoma, we asked two dermatopathologists for second opinions; however, one diagnosed a melanoma and the other a Spitz nevus.
  • Histopathological diagnosis to establish whether it was a melanoma metastasis or nodal nevi was also difficult, and we again asked for second opinions from another dermatopathologist in the USA.
  • According to its clinical course and the histopathology of the sentinel lymph node with additional immunohistochemistry, this case was finally diagnosed as a nodular melanoma (T4aN1aM0, stage IIIA).
  • To date, the patient has been given five courses of chemotherapy at 6-month intervals, with no local recurrence or distant metastases so far.
  • [MeSH-major] Head and Neck Neoplasms / pathology. Melanoma / pathology. Scalp. Skin Neoplasms / pathology
  • [MeSH-minor] Adult. Humans. Male. Nevus, Epithelioid and Spindle Cell / pathology. Sentinel Lymph Node Biopsy


14. Schoenfield L, Pettay J, Tubbs RR, Singh AD: Variation of monosomy 3 status within uveal melanoma. Arch Pathol Lab Med; 2009 Aug;133(8):1219-22
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  • [Title] Variation of monosomy 3 status within uveal melanoma.
  • CONTEXT: Determining the most significant prognostic variables in uveal melanoma is important for stratifying patients for metastasis surveillance and possible initiation of chemotherapy or immunotherapy.
  • DESIGN: Eighteen consecutive patients with uveal melanoma who underwent primary enucleation were studied.
  • The chromosomal analysis was also correlated with histologic evaluation for melanoma cell type (spindle vs epithelioid cell), ciliary body involvement, presence of positive periodic acid-Schiff vascular mimicry patterns, scleral or extrascleral spread and size.
  • Lack of concordance between the base and apex did not correlate with melanoma cell type.
  • CONCLUSIONS: Prognostic variables are important in management of neoplasms, and this study points out that the site of tissue biopsy for prognostication in uveal melanoma could affect the results obtained, at least for the presence of monosomy 3.
  • [MeSH-major] Chromosomes, Human, Pair 3 / genetics. Melanoma / genetics. Monosomy. Uveal Neoplasms / genetics

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  • (PMID = 19653713.001).
  • [ISSN] 1543-2165
  • [Journal-full-title] Archives of pathology & laboratory medicine
  • [ISO-abbreviation] Arch. Pathol. Lab. Med.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / DNA, Neoplasm
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15. Lederman M, Meir T, Zeschnigk M, Pe'er J, Chowers I: Inhibitor of apoptosis proteins gene expression and its correlation with prognostic factors in primary and metastatic uveal melanoma. Curr Eye Res; 2008 Oct;33(10):876-84
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  • [Title] Inhibitor of apoptosis proteins gene expression and its correlation with prognostic factors in primary and metastatic uveal melanoma.
  • PURPOSE: Members of the inhibitors of apoptosis proteins (IAPs) family are thought to promote tumor growth and interfere with response to therapy by suppressing apoptosis in several malignancies.
  • We aimed to evaluate the expression of IAPs in uveal melanoma (UM) and its correlation with prognostic factors associated with death from metastatic UM.
  • QPCR results were correlated with apoptosis rate and with prognostic factors in UM, including lesion dimensions, cell type, monosomy 3, and vascular mimicry patterns.
  • BIRC5 and BIRC7 levels were 8.8-fold (p = 0.0003) and 7.0-fold (p = 0.003) higher in tumors (primary and metastatic tissue) vs. normal eye tissue, respectively.
  • BIRC5 levels correlated with presence of monosomy 3 (p = 0.01) and higher levels of BIRC7 correlated with epithelioid cell type (p = 0.048).
  • Considering our findings together with previous reports on their role in a variety of malignancies and in UM cell lines, it is conceivable that IAPs contribute to the remarkable resistance of uveal melanoma to apoptosis-inducing chemotherapy.
  • [MeSH-major] Gene Expression Regulation, Neoplastic. Inhibitor of Apoptosis Proteins / genetics. Liver Neoplasms / genetics. Melanoma / genetics. Uveal Neoplasms / genetics
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Apoptosis / genetics. Cell Line, Tumor. Choroid / metabolism. Chromosome Aberrations. Chromosomes, Human, Pair 3 / genetics. Female. Humans. Immunohistochemistry. Male. Middle Aged. Prognosis. Retina / metabolism. Reverse Transcriptase Polymerase Chain Reaction. Up-Regulation

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  • (PMID = 18853322.001).
  • [ISSN] 1460-2202
  • [Journal-full-title] Current eye research
  • [ISO-abbreviation] Curr. Eye Res.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Inhibitor of Apoptosis Proteins
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16. Durrani AJ, Moir GC, Diaz-Cano SJ, Cerio R: Malignant melanoma in an 8-year-old Caribbean girl: diagnostic criteria and utility of sentinel lymph node biopsy. Br J Dermatol; 2003 Mar;148(3):569-72
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  • [Title] Malignant melanoma in an 8-year-old Caribbean girl: diagnostic criteria and utility of sentinel lymph node biopsy.
  • The incidence of malignant melanoma (MM) is continuing to rise, although childhood MM remains rare.
  • We describe an 8-year-old Afro-Caribbean girl who developed a non pigmented lesion on the tip of her left thumb, which persisted despite treatment in primary care with cryotherapy.
  • She underwent amputation of the distal phalanx of her thumb, together with positive sentinel lymph node (SLN) biopsy and subsequent axillary lymph node clearance and adjuvant chemotherapy.
  • MMs are very rare in this age and skin-type group, therefore requiring strict diagnostic criteria.
  • [MeSH-major] Melanoma / pathology. Sentinel Lymph Node Biopsy / methods. Skin Neoplasms / pathology. Thumb
  • [MeSH-minor] Axilla. Child. Diagnosis, Differential. Female. Humans. Lymph Node Excision. Nevus, Epithelioid and Spindle Cell / pathology

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  • (PMID = 12653752.001).
  • [ISSN] 0007-0963
  • [Journal-full-title] The British journal of dermatology
  • [ISO-abbreviation] Br. J. Dermatol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] England
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17. Requena L, de la Cruz A, Moreno C, Sangüeza O, Requena C: Animal type melanoma: a report of a case with balloon-cell change and sentinel lymph node metastasis. Am J Dermatopathol; 2001 Aug;23(4):341-6
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  • [Title] Animal type melanoma: a report of a case with balloon-cell change and sentinel lymph node metastasis.
  • Animal type melanoma is a rare histopathologic variant of melanoma characterized by sheets and nodules of heavily pigmented epithelioid melanocytes that involve the entire thickness of the dermis.
  • This human neoplasm mimics melanocytic neoplasms seen in gray horses and laboratory animals; thus, is termed animal type melanoma.
  • We report an example of animal type melanoma on the back of a 27-year-old man.
  • The lesion showed areas of melanoma in situ, which ruled out the possibility of metastatic melanoma.
  • In some areas, neoplastic melanocytes exhibited a balloon-cell appearance; in others the neoplasm was composed of sheets and fascicles of heavily pigmented epithelioid melanocytes that permeated the entire dermis and extended into the dermal-subcutaneous interface, mimicking a cellular blue nevus.
  • Epithelioid melanocytes in deeper areas showed abundant, heavily pigmented cytoplasm and pleomorphic nuclei with prominent eosinophilic nucleoli and some mitotic figures.
  • In some sections, a nodule of heavily pigmented epithelioid melanocytes was seen far from the main bulk of the lesion, at the dermal-subcutaneous interface, raising the possibility of a satellite lesion.
  • A lymphoscintigraphy showed a sentinel lymph node in the right axilla and a subsequent axillary lymphadenectomy demonstrated that the architecture of the sentinel lymph node was effaced by metastatic melanoma.
  • The patient received adjuvant chemotherapy with inteferon alfa-2b and four months after this treatment the patient is alive and well, without evidence of recurrences or additional metastases.
  • [MeSH-major] Lymph Nodes / pathology. Melanoma. Skin Neoplasms
  • [MeSH-minor] Adult. Humans. Male. Melanoma, Experimental / pathology. Neoplasm Metastasis

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  • (PMID = 11481528.001).
  • [ISSN] 0193-1091
  • [Journal-full-title] The American Journal of dermatopathology
  • [ISO-abbreviation] Am J Dermatopathol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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18. Gupta D, Neto AG, Deavers MT, Silva EG, Malpica A: Metastatic melanoma to the vagina: clinicopathologic and immunohistochemical study of three cases and literature review. Int J Gynecol Pathol; 2003 Apr;22(2):136-40
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  • [Title] Metastatic melanoma to the vagina: clinicopathologic and immunohistochemical study of three cases and literature review.
  • We report the clinicopathologic features of three cases of malignant melanoma metastatic to the vagina; only one similar case has been previously reported.
  • Two patients had a history of a previous primary malignant melanoma, one a preauricular melanoma treated 7 years earlier and the other a vulvar melanoma treated 2 years earlier.
  • In the third case, a primary malignant melanoma was found on the sole of the right foot after the patient had presented with the vaginal metastases.
  • All were of epithelioid cell type and were positive with S-100 and microphthalmia-transcription factor.
  • One patient underwent wide local excision of tumor followed by chemotherapy, one patient had intracavitary radiotherapy, and one had palliative radiotherapy to the brain only.
  • [MeSH-major] Biomarkers, Tumor / analysis. Melanoma / secondary. Skin Neoplasms / pathology. Vaginal Neoplasms / secondary
  • [MeSH-minor] Adult. Aged. Antigens, Neoplasm. DNA-Binding Proteins / metabolism. Fatal Outcome. Female. Humans. Immunohistochemistry. MART-1 Antigen. Melanoma-Specific Antigens. Microphthalmia-Associated Transcription Factor. Monophenol Monooxygenase / metabolism. Neoplasm Proteins / metabolism. Retrospective Studies. S100 Proteins / metabolism. Transcription Factors / metabolism

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  • (PMID = 12649667.001).
  • [ISSN] 0277-1691
  • [Journal-full-title] International journal of gynecological pathology : official journal of the International Society of Gynecological Pathologists
  • [ISO-abbreviation] Int. J. Gynecol. Pathol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antigens, Neoplasm; 0 / Biomarkers, Tumor; 0 / DNA-Binding Proteins; 0 / MART-1 Antigen; 0 / MITF protein, human; 0 / MLANA protein, human; 0 / Melanoma-Specific Antigens; 0 / Microphthalmia-Associated Transcription Factor; 0 / Neoplasm Proteins; 0 / S100 Proteins; 0 / Transcription Factors; EC 1.14.18.1 / Monophenol Monooxygenase
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19. Miyatani H, Yoshida Y, Ushimaru S, Sagihara N, Yamada S: Slow growing flat-type primary malignant melanoma of the esophagus treated with cap-assisted EMR. Dig Endosc; 2009 Oct;21(4):255-7
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  • [Title] Slow growing flat-type primary malignant melanoma of the esophagus treated with cap-assisted EMR.
  • We report a rare case of flat-type primary malignant melanoma of the esophagus treated with endoscopic mucosal resection (EMR).
  • The histopathological findings showed atypical melanocyte proliferation in the basal layer, spindle cells, and epithelioid cell proliferation with nuclear enlargement and a few mitotic figures.
  • Histopathological examination confirmed the diagnosis of primary malignant melanoma.
  • The patient was discharged without additional surgical resection and/or chemotherapy.
  • There has been no report on a slow growing esophageal melanoma.
  • It is difficult to estimate the malignant behavior of this case.
  • [MeSH-major] Endoscopy. Esophageal Neoplasms / pathology. Esophageal Neoplasms / surgery. Melanoma / pathology. Melanoma / surgery

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  • (PMID = 19961525.001).
  • [ISSN] 1443-1661
  • [Journal-full-title] Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society
  • [ISO-abbreviation] Dig Endosc
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Australia
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20. Tatla T, Hungerford J, Plowman N, Ghufoor K, Keene M: Conjunctival melanoma: the role of conservative surgery and radiotherapy in regional metastatic disease. Laryngoscope; 2005 May;115(5):817-22
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  • [Title] Conjunctival melanoma: the role of conservative surgery and radiotherapy in regional metastatic disease.
  • OBJECTIVE: To evaluate prognostic factors and determine the role of conservative surgery and radiotherapy in managing metastatic conjunctival malignant melanoma (MM) involving preauricular/submandibular lymph nodes.
  • METHOD: A retrospective analysis (1990-2003) of clinical and histopathologic data from 12 patients presenting with regional metastases after failed local treatment for conjunctival MM.
  • Patients received a common, multispecialty, conservative management approach: wide local excision, topical cryotherapy or radiotherapy to conjunctival MM (orbital exenteration for more advanced local disease), lumpectomy, and adjuvant "ring" radiotherapy of regional metastases, with chemotherapy for distant metastases.
  • Epithelioid tumor cells were noted histologically in seven of eight specimens in which cell type could be determined.
  • Eight tumors metastasised to preauricular nodes, three to submandibular and one to both, with a median interval of 23 (range 12-108) months after primary diagnosis.
  • Five patients developed regional nodal recurrence at median interval of 11 (range 6-13) months, 3 of whom were within radiotherapy portals.
  • Eight patients developed distant metastasis at median interval of 44 (range 22-138) months.
  • The mean Kaplan-Meier adjusted survival time after primary diagnosis was 76 months with death ensuing postregional metastasis within a median 18 (range 4-127) months.
  • CONCLUSION: Locoregional metastasis after treatment for conjunctival MM is associated with a poor prognosis.
  • Both epithelioid tumor cells and PAM are associated with disseminating disease and poorer outcome.
  • [MeSH-major] Conjunctival Neoplasms / radiotherapy. Conjunctival Neoplasms / surgery. Melanoma / radiotherapy. Melanoma / surgery
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Combined Modality Therapy. Cryotherapy / methods. Female. Humans. Lymph Nodes. Male. Middle Aged. Neoplasm Recurrence, Local. Ophthalmologic Surgical Procedures / methods. Retrospective Studies. Survival Analysis

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  • (PMID = 15867646.001).
  • [ISSN] 0023-852X
  • [Journal-full-title] The Laryngoscope
  • [ISO-abbreviation] Laryngoscope
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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21. Gupta D, Malpica A, Deavers MT, Silva EG: Vaginal melanoma: a clinicopathologic and immunohistochemical study of 26 cases. Am J Surg Pathol; 2002 Nov;26(11):1450-7
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  • [Title] Vaginal melanoma: a clinicopathologic and immunohistochemical study of 26 cases.
  • Malignant melanomas of the vagina are rare tumors.
  • The neoplastic cells were epithelioid in 15 cases and spindled in three cases; eight cases had both cell types.
  • HMB-45 was strongly positive in 16 (62%), 3 (11%) were focally positive, 1 case showed a rare positive cell, and 6 (23%) were negative.
  • With MART-1, 20 cases (77%) were strongly positive, 1 (4%) showed a rare weakly positive cell, and 5 (19%) were negative.
  • The patients were treated as follows: anterior exenteration with or without lymph node dissection and with or without radiotherapy (RT) or chemotherapy (CT) (7 cases), wide local excision with or without lymph node dissection and RT/CT (10 cases), hysterectomy with vaginectomy with or without RT/CT (3 cases), vaginectomy with RT (1 case), RT (1 case), and RT and CT (1 case).
  • Local recurrence after primary treatment was seen in six patients and distant metastases in 11 patients.
  • This study confirms the poor prognosis of patients with vaginal melanoma.
  • HMB-45 is negative in 23% cases of vaginal melanoma.
  • [MeSH-major] Melanoma / secondary. Vaginal Neoplasms / pathology
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Biomarkers, Tumor / analysis. Combined Modality Therapy. Disease-Free Survival. Female. Humans. Immunohistochemistry. Middle Aged. Neoplasm Invasiveness. Neoplasm Proteins / analysis. Neoplasm Recurrence, Local / pathology. Neoplasm Staging

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  • (PMID = 12409721.001).
  • [ISSN] 0147-5185
  • [Journal-full-title] The American journal of surgical pathology
  • [ISO-abbreviation] Am. J. Surg. Pathol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / Neoplasm Proteins
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22. Gupta D, Deavers MT, Silva EG, Malpica A: Malignant melanoma involving the ovary: a clinicopathologic and immunohistochemical study of 23 cases. Am J Surg Pathol; 2004 Jun;28(6):771-80
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Malignant melanoma involving the ovary: a clinicopathologic and immunohistochemical study of 23 cases.
  • Ovarian malignant melanoma (MM), primary or metastatic, is an extremely rare tumor and in the absence of a previous diagnosis can represent a diagnostic challenge.
  • The tumor size ranged from 4.5 to 23 cm (average 10 cm); the melanoma arising in a cystic teratoma was 0.2 mm in thickness.
  • The tumor cell type was epithelioid in 19 cases, spindled in 2 cases, mixed epithelioid and spindled in 1 case, and small cell in 1 case.
  • In 8 cases, initial diagnoses included sex cord stromal tumor, germ cell tumor, sarcoma, or undifferentiated carcinoma.
  • Treatment performed in 18 of the cases are as follows: oophorectomy with/without chemotherapy (10); total abdominal hysterectomy with bilateral salpingo-oophorectomy with/without chemotherapy (6); vaginal hysterectomy, bilateral salpingo-oophorectomy, and chemotherapy (1); and total abdominal hysterectomy with salpingo-oophorectomy (1).
  • Thirteen patients died of disease (range 2-76 months), 3 are alive with disease (6-18 months), and 2 have no evidence of disease at 24 and 96 months; one was the patient with melanoma arising within a teratoma.
  • In conclusion, MM involving the ovary is a rare disease, predominantly seen in women of reproductive age, and is associated with a poor prognosis.
  • Nodular or diffuse pattern and epithelioid cell type are most frequently seen, and the tumor can be mistaken for germ cell and sex cord stromal tumors.
  • [MeSH-major] Melanoma / pathology. Ovarian Neoplasms / pathology
  • [MeSH-minor] Adolescent. Adult. Antigens, Neoplasm. Calbindin 2. DNA-Binding Proteins / analysis. Ethnic Groups. Female. Humans. Hysterectomy. Immunohistochemistry. Inhibins / analysis. MART-1 Antigen. Melanoma-Specific Antigens. Microphthalmia-Associated Transcription Factor. Middle Aged. Monophenol Monooxygenase / analysis. Neoplasm Metastasis. Neoplasm Proteins / analysis. S100 Calcium Binding Protein G / analysis. S100 Proteins / analysis. Teratoma / pathology. Transcription Factors / analysis. Treatment Outcome

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  • (PMID = 15166669.001).
  • [ISSN] 0147-5185
  • [Journal-full-title] The American journal of surgical pathology
  • [ISO-abbreviation] Am. J. Surg. Pathol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antigens, Neoplasm; 0 / CALB2 protein, human; 0 / Calbindin 2; 0 / DNA-Binding Proteins; 0 / MART-1 Antigen; 0 / MITF protein, human; 0 / MLANA protein, human; 0 / Melanoma-Specific Antigens; 0 / Microphthalmia-Associated Transcription Factor; 0 / Neoplasm Proteins; 0 / S100 Calcium Binding Protein G; 0 / S100 Proteins; 0 / Transcription Factors; 57285-09-3 / Inhibins; EC 1.14.18.1 / Monophenol Monooxygenase
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23. Ryan P, Nguyen VH, Gholoum S, Carpineta L, Abish S, Ahmed NN, Laberge JM, Riddell RH: Polypoid PEComa in the rectum of a 15-year-old girl: case report and review of PEComa in the gastrointestinal tract. Am J Surg Pathol; 2009 Mar;33(3):475-82

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  • PEComa of the gastrointestinal tract, composed of perivascular epithelioid cells with myomelanocytic differentiation, is rare with previous literature limited to 16 case reports.
  • We report PEComa with lymph node involvement occurring in the rectum of a 15-year-old girl, treated by surgical resection and adjuvant chemotherapy.
  • We review the differential diagnosis of intestinal PEComa, which includes malignant melanoma, epithelioid gastrointestinal stromal tumors, clear cell sarcoma of soft parts, alveolar soft part sarcoma, leiomyosarcoma with HMB45 expression, and paraganglioma.
  • Immunohistochemistry can rule out many of these morphologically similar tumors but differentiation from clear cell sarcoma may require reverse transcription-polymerase chain reaction.
  • [MeSH-major] Perivascular Epithelioid Cell Neoplasms / pathology. Rectal Neoplasms / pathology
  • [MeSH-minor] Adolescent. Antineoplastic Agents / therapeutic use. Combined Modality Therapy. Diagnosis, Differential. Digestive System Surgical Procedures. Female. Humans. Immunohistochemistry. Microscopy, Electron, Transmission. Reverse Transcriptase Polymerase Chain Reaction. Tomography, X-Ray Computed

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  • (PMID = 19092636.001).
  • [ISSN] 1532-0979
  • [Journal-full-title] The American journal of surgical pathology
  • [ISO-abbreviation] Am. J. Surg. Pathol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents
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24. Kravtsov VG, Zaĭrat'iants OV: [Clinical and morphological characteristics of gastrointestinal stromal tumors]. Arkh Patol; 2007 Sep-Oct;69(5):54-61
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  • GIST are stromal tumors and the gastrointestinal tract (GIT) and some other organs of spindle-cell or epithelioid-cell structure expressing CD117 (C-kit, KIT), as well as those at different rates and in different combinations, CD34, smooth muscle and/or neurogenic differentiation antigens.
  • This is supported by successful chemotherapy for GIST with a KIT receptor inhibitor.
  • The histogenesis of GIST is associated with GIT somatic stem, the Cajal cell precursors.
  • [MeSH-minor] Antigens, CD34 / biosynthesis. Antigens, CD34 / genetics. Apoptosis / genetics. Enzyme Activation / genetics. Epithelioid Cells / metabolism. Epithelioid Cells / pathology. Gene Expression Regulation, Neoplastic / genetics. Humans. Liver Neoplasms / drug therapy. Liver Neoplasms / genetics. Liver Neoplasms / metabolism. Liver Neoplasms / pathology. Liver Neoplasms / secondary. Melanoma / genetics. Melanoma / metabolism. Melanoma / pathology. Mitosis / genetics. Mutation. Myocytes, Smooth Muscle / metabolism. Myocytes, Smooth Muscle / pathology. Neoplasm Metastasis. Neoplastic Stem Cells / metabolism. Neoplastic Stem Cells / pathology. Peritoneal Neoplasms / drug therapy. Peritoneal Neoplasms / genetics. Peritoneal Neoplasms / pathology. Peritoneal Neoplasms / secondary. Sarcoma / drug therapy. Sarcoma / genetics. Sarcoma / metabolism. Sarcoma / pathology

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  • (PMID = 18074824.001).
  • [ISSN] 0004-1955
  • [Journal-full-title] Arkhiv patologii
  • [ISO-abbreviation] Arkh. Patol.
  • [Language] rus
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] Russia (Federation)
  • [Chemical-registry-number] 0 / Antigens, CD34; EC 2.7.10.1 / Proto-Oncogene Proteins c-kit
  • [Number-of-references] 44
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25. Silva EG, Bodurka DC, Scouros MA, Ayala A: A uterine leiomyosarcoma that became positive for HMB45 in the metastasis. Ann Diagn Pathol; 2005 Feb;9(1):43-5
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  • Uterine smooth muscle tumors are usually spindle cell lesions, but a minority is composed of epithelioid cells.
  • Recently, it has been shown that some of these tumors can be positive for HMB45, and some authors have advocated calling these lesions perivascular epithelioid cell (PEC) tumors or PEComas.
  • The case we describe here clearly shows that the so called PEC is just a smooth muscle cell capable of changing its immunophenotype.
  • The patient involved is a 29-year-old black woman who was found to have an epithelioid leiomyosarcoma of the uterus in November 1995.
  • She was treated with a simple hysterectomy and bilateral salpingo-oophorectomy.
  • She, therefore, also received chemotherapy and was free of disease until October 2002, when a recurrent tumor was detected in her spine.
  • After undergoing resection of the lesion at 2 different times, in 2002 and 2003, the patient was treated with radiotherapy and is currently receiving chemotherapy.
  • On microscopic examination, the tumor in the uterus and liver both proved to be an epithelioid leiomyosarcomas that was diffusely positive for smooth muscle actin.
  • However, although the tumors resected from the spine in 2002 and 2003 showed features similar to those of the uterine neoplasm, but with a lower percentage of cells positive for smooth muscle actin and more clear cells, several of the clear cells were positive for HMB45.
  • To the best of our knowledge, this is the first case of a uterine smooth muscle cell tumor that became positive for HMB45 when it metastasized.
  • [MeSH-minor] Actins / analysis. Adult. Antigens, Neoplasm. Biomarkers, Tumor / analysis. Cell Count. Combined Modality Therapy. Epithelioid Cells / chemistry. Epithelioid Cells / pathology. Female. Humans. Melanoma-Specific Antigens. Neoplasm Metastasis / pathology. Neoplasm Metastasis / therapy

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  • (PMID = 15692950.001).
  • [ISSN] 1092-9134
  • [Journal-full-title] Annals of diagnostic pathology
  • [ISO-abbreviation] Ann Diagn Pathol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Actins; 0 / Antigens, Neoplasm; 0 / Biomarkers, Tumor; 0 / Melanoma-Specific Antigens; 0 / Neoplasm Proteins
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26. Thompson LD, Wieneke JA, Miettinen M: Sinonasal tract and nasopharyngeal melanomas: a clinicopathologic study of 115 cases with a proposed staging system. Am J Surg Pathol; 2003 May;27(5):594-611
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  • [Title] Sinonasal tract and nasopharyngeal melanomas: a clinicopathologic study of 115 cases with a proposed staging system.
  • Primary sinonasal tract mucosal malignant melanomas are uncommon tumors that are frequently misclassified, resulting in inappropriate clinical management.
  • A total of 115 cases of sinonasal tract mucosal malignant melanoma included 59 females and 56 males, 13-93 years of age (mean 64.3 years).
  • The majority of tumors involved the nasal cavity (n = 34), septum alone, or a combination of the nasal cavity and sinuses (n = 39) with a mean size of 2.4 cm.
  • Histologically, the tumors were composed of a variety of cell types (epithelioid, spindled, undifferentiated), frequently arranged in a peritheliomatous distribution (n = 39).
  • Immunohistochemical studies confirmed the diagnosis of sinonasal tract mucosal malignant melanomas with positive reactions for S-100 protein, tyrosinase, HMB-45, melan A, and microphthalmia transcription factor.
  • Sinonasal tract mucosal malignant melanomas need to be considered in the differential diagnosis of most sinonasal malignancies, particularly carcinoma, lymphoma, sarcoma, and olfactory neuroblastoma.
  • Surgery accompanied by radiation and/or chemotherapy was generally used.
  • The majority of patients developed a recurrence (n = 79), with 75 patients dying with disseminated disease (mean 2.3 years), whereas 40 patients are either alive or had died of unrelated causes (mean 13.9 years).
  • A TNM-type classification separated by anatomic site of involvement and metastatic disease is proposed to predict biologic behavior.
  • [MeSH-major] Melanoma / secondary. Nasopharyngeal Neoplasms / pathology. Nose Neoplasms / pathology. Paranasal Sinuses / pathology

  • MedlinePlus Health Information. consumer health - Melanoma.
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  • (PMID = 12717245.001).
  • [ISSN] 0147-5185
  • [Journal-full-title] The American journal of surgical pathology
  • [ISO-abbreviation] Am. J. Surg. Pathol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers, Tumor
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27. Lin SM, Ferrucci S: Primary acquired melanosis of the conjunctiva. Optometry; 2006 May;77(5):223-8

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • Because PAM has the potential of becoming malignant, it is important to recognize PAM and to rule out other causes of pigmented lesions.
  • The presence or absence of atypia is helpful in determining the potential for malignancy, because PAM without atypia is usually benign, whereas PAM with atypia may convert into a conjunctival melanoma.
  • If atypia is present, the presence or absence of epithelioid cells and the pattern of intraepithelial growth are the main factors in determining the likelihood of neoplastic transformation.
  • The patient was subsequently treated with topical 5-fluorouracil chemotherapy.
  • There have been no signs of recurrence to date after his treatment.
  • If atypia is present, treatment options include local excision, cryotherapy, and topical chemotherapy.

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  • (PMID = 16651212.001).
  • [ISSN] 1529-1839
  • [Journal-full-title] Optometry (St. Louis, Mo.)
  • [ISO-abbreviation] Optometry
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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