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Clinics in Plastic Surgery Oct 2021Rare variants of melanoma include melanoma in pregnancy and pediatric melanoma. Because of their low incidence, treatment recommendations are based on standards of... (Review)
Review
Rare variants of melanoma include melanoma in pregnancy and pediatric melanoma. Because of their low incidence, treatment recommendations are based on standards of treatment for cutaneous melanoma; however, each of these forms requires specific considerations during diagnosis, staging, and treatment.
Topics: Child; Female; Humans; Incidence; Melanoma; Neoplasm Staging; Pediatrics; Pregnancy; Skin Neoplasms
PubMed: 34503730
DOI: 10.1016/j.cps.2021.06.004 -
Journal of the American Academy of... Oct 2016Malignant melanoma is the most common malignancy during pregnancy, and is diagnosed during childbearing age in approximately one-third of women diagnosed with melanoma.... (Comparative Study)
Comparative Study Review
Malignant melanoma is the most common malignancy during pregnancy, and is diagnosed during childbearing age in approximately one-third of women diagnosed with melanoma. The impact of hormonal changes during pregnancy and from iatrogenic hormones on melanoma is controversial. Women undergo immunologic changes during pregnancy that may decrease tumor surveillance. In addition, hormone receptors are found on some melanomas. In spite of these observations, the preponderance of evidence does not support a poorer prognosis for pregnancy-associated melanomas. There is also a lack of evidence that oral contraceptives or hormone replacement therapy worsens melanoma prognosis.
Topics: Biopsy, Needle; Female; Humans; Immunohistochemistry; Incidence; Melanoma; Monitoring, Physiologic; Neoplasm Invasiveness; Neoplasm Staging; Postpartum Period; Pregnancy; Pregnancy Complications, Neoplastic; Pregnancy Outcome; Prenatal Diagnosis; Prognosis; Risk Assessment; Skin Neoplasms; Melanoma, Cutaneous Malignant
PubMed: 27646737
DOI: 10.1016/j.jaad.2016.01.061 -
Surgical Oncology Clinics of North... Apr 2015
Topics: Humans; Melanoma; Neoplasm Staging; Skin Neoplasms
PubMed: 25769720
DOI: 10.1016/j.soc.2015.01.001 -
The Australasian Journal of Dermatology Feb 2023
Topics: Humans; Poroma; Dermoscopy; Skin Neoplasms; Sweat Gland Neoplasms; Diagnosis, Differential
PubMed: 36412254
DOI: 10.1111/ajd.13957 -
Journal of Clinical Pathology Nov 2017Cutaneous angiosarcoma (cAS) is a rare malignant neoplasm with variable clinical presentation. Although a distinct vascular tumour, cAS shares many overlapping... (Review)
Review
Cutaneous angiosarcoma (cAS) is a rare malignant neoplasm with variable clinical presentation. Although a distinct vascular tumour, cAS shares many overlapping histopathological features with other vasoformative and epithelioid tumours or 'mimickers'. cAS shows aggressive behaviour and carries a grave prognosis, thus early diagnosis is of paramount importance to achieve the best possible outcomes. Recently, several genetic studies were conducted leading to the identification of novel molecular targets in the treatment of cAS. Herein, we present a comprehensive review of cAS with discussion of its clinical, histopathological and molecular aspects, the differential diagnosis, as well as current therapies including ongoing clinical trials.
Topics: Biomarkers, Tumor; Biopsy; Diagnosis, Differential; Genetic Predisposition to Disease; Hemangiosarcoma; Humans; Immunohistochemistry; Molecular Diagnostic Techniques; Neoplasm Staging; Phenotype; Predictive Value of Tests; Risk Factors; Skin Neoplasms; Treatment Outcome
PubMed: 28916596
DOI: 10.1136/jclinpath-2017-204601 -
ANZ Journal of Surgery Nov 2020Pleomorphic dermal sarcoma (PDS) is a rare, poorly defined skin neoplasm with features similar to atypical fibroxanthoma, but with adverse histopathological...
BACKGROUND
Pleomorphic dermal sarcoma (PDS) is a rare, poorly defined skin neoplasm with features similar to atypical fibroxanthoma, but with adverse histopathological characteristics indicating metastatic potential such as tumour necrosis, invasion beyond superficial subcutis or vascular and/or perineural infiltration. Optimal treatment for PDS is uncertain and reported outcomes vary due to the rarity of this diagnosis and uncertainty over histopathological categorization. The aim of this study was to review the clinical and histopathological features of PDS in a single Australian centre.
METHODS
A retrospective review of all patients managed at the Peter MacCallum Cancer Centre with PDS between 2003 and 2017 was performed by a search of electronic records and histories reviewed.
RESULTS
A total of 27 patients were identified, mostly elderly males (85.2%, mean age 79.8 years). Lesions were seen most commonly on the head and neck region (96.3%), predominantly on the scalp (63%). Mean tumour radial surgical excision margin was 12.8 mm. Eighteen patients (66.7%) underwent radiotherapy; 13 adjuvant, three neoadjuvant and two with palliative intent. After median follow-up of 46.4 months, two patients had recurrence (7.4%); both had inadequate deep margins at first excision. There were three all-cause deaths in the cohort. There was one disease-specific mortality with metastatic PDS disease at the time of initial presentation.
CONCLUSION
PDS is a rare cutaneous malignancy most commonly found in the head and neck region in elderly men, which is best managed with adequate surgical excision. The role of radiotherapy is undefined and an area for future investigation.
Topics: Aged; Australia; Humans; Male; Neoplasm Recurrence, Local; Retrospective Studies; Sarcoma; Skin Neoplasms
PubMed: 32338819
DOI: 10.1111/ans.15909 -
ANZ Journal of Surgery Oct 2021Spiradenocarcinoma is a rare skin adnexal neoplasm that may behave aggressively. It is often associated with a benign slow-growing spiradenoma that has undergone... (Review)
Review
BACKGROUND
Spiradenocarcinoma is a rare skin adnexal neoplasm that may behave aggressively. It is often associated with a benign slow-growing spiradenoma that has undergone malignant transformation. Given the paucity of cases in the literature, there is a lack of consensus on treatment.
METHODS
The terms 'malignant spiradenoma' or 'spiradenocarcinoma' were systematically used to search the PubMed, MEDLINE and Google Scholar databases. A total of 182 cases of spiradenocarcinoma were identified as eligible for this comprehensive literature review.
RESULTS
Spiradenocarcinoma was commoner in older age and Caucasian race. In most cases, surgical excision for local disease is the mainstay of treatment. Lymph node dissection is usually reserved for those with suspected or confirmed lymph node metastases. High rates of local recurrence (20.8%), metastasis (37.4%) and mortality (19.1%) were identified, prompting some authors to suggest regular follow up including chest X-rays and liver function tests.
CONCLUSIONS
Patients with spiradenocarcinoma may benefit from a magnetic resonance imaging and fluorodeoxyglucose-positron emission tomography/computed tomography to establish the extent of disease. We recommend wide local excision as the treatment of choice to achieve surgical margins of ≥1 cm, with node resection to be determined on a case-to-case basis. Regular follow up is important given the high rate of local recurrence, metastasis and mortality. This should include an examination of the regional lymph nodes. Further research is required to refine an evidence-based approach to spiradenocarcinoma.
Topics: Aged; Humans; Lymph Nodes; Lymphatic Metastasis; Neoplasm Recurrence, Local; Skin Neoplasms; Sweat Gland Neoplasms
PubMed: 33522696
DOI: 10.1111/ans.16626 -
Plastic and Reconstructive Surgery Aug 2018After studying this article, the participant should be able to: 1. Summarize the changes to the American Joint Committee on Cancer Eighth Edition Melanoma Staging... (Review)
Review
LEARNING OBJECTIVES
After studying this article, the participant should be able to: 1. Summarize the changes to the American Joint Committee on Cancer Eighth Edition Melanoma Staging System. 2. List advances in genetic, molecular, and histopathologic melanoma diagnosis and prognostication. 3. Recommend sentinel lymph node biopsy and appropriate surgical margins based on individualized patient needs. 4. Recognize the currently available treatments for in-transit metastasis and advanced melanoma. 5. Describe current and future therapies for melanoma with distant visceral or brain metastases.
SUMMARY
Strides in melanoma surveillance, detection, and treatment continue to be made. The American Joint Committee on Cancer Eighth Edition Cancer Staging System has improved risk stratification of patients, introduced new staging categories, and resulted in stage migration of patients with improved outcomes. This review summarizes melanoma advances of the recent years with an emphasis on the surgical advances, including techniques and utility of sentinel node biopsy, controversies in melanoma margin selection, and the survival impact of time-to-treatment metrics. Once a disease manageable only with surgery, a therapeutic paradigm shift has given a more promising outlook to melanoma patients at any stage. Indeed, a myriad of novel, survival-improving immunotherapies have been introduced for metastatic melanoma and more recently in the high-risk adjuvant setting.
Topics: Combined Modality Therapy; Humans; Lymph Node Excision; Lymphatic Metastasis; Melanoma; Neoplasm Metastasis; Neoplasm Staging; Skin Neoplasms
PubMed: 30045186
DOI: 10.1097/PRS.0000000000004571 -
Journal of Cutaneous Pathology Oct 2016Unified by the common finding of myxoid background, the group of myxoid cutaneous tumors comprises many entities with different lineages, immunohistochemical profiles,... (Review)
Review
Unified by the common finding of myxoid background, the group of myxoid cutaneous tumors comprises many entities with different lineages, immunohistochemical profiles, underlying genetic abnormalities and biologic behaviors. These tumors may have significant histopathologic overlap causing diagnostic difficulty. Careful attention to subtle histopathologic features is key to accurate diagnosis. Immunohistochemical stains and molecular tests are valuable in selected cases. This review discusses selected myxoid tumors and myxoid variants of cutaneous tumors and focuses on key pathologic features and an effective strategy for the use of ancillary tests.
Topics: Humans; Immunohistochemistry; Skin Neoplasms
PubMed: 27252031
DOI: 10.1111/cup.12749 -
International Journal of Molecular... Jan 2024Preferentially Expressed Antigen in Melanoma (PRAME), a member of the cancer/testis antigen family, is central to the field of skin cancer diagnostics and therapeutics.... (Review)
Review
Preferentially Expressed Antigen in Melanoma (PRAME), a member of the cancer/testis antigen family, is central to the field of skin cancer diagnostics and therapeutics. As a nuclear receptor and transcriptional regulator, PRAME plays a critical role in inhibiting retinoic acid signalling, which is essential for cell differentiation and proliferation. Its aberrant overexpression in various malignancies, particularly cutaneous melanoma, is associated with more aggressive tumour phenotypes, positioning PRAME as both a diagnostic and prognostic marker. In melanoma, PRAME is typically highly expressed, in contrast to its weak or absent expression in benign nevi, thereby improving the accuracy of differential diagnoses. The diagnostic value of PRAME extends to various lesions. It is significantly expressed in uveal melanoma, correlating to an increased risk of metastasis. In acral melanomas, especially those with histopathological ambiguity, PRAME helps to improve diagnostic accuracy. However, its expression in spitzoid and ungual melanocytic lesions is inconsistent and requires a comprehensive approach for an accurate assessment. In soft tissue sarcomas, PRAME may be particularly helpful in differentiating melanoma from clear cell sarcoma, an important distinction due to their similar histological appearance but different treatment approaches and prognosis, or in detecting dedifferentiated and undifferentiated melanomas. In non-melanoma skin cancers such as basal cell carcinoma, squamous cell carcinoma, and Merkel cell carcinoma, the variable expression of PRAME can lead to diagnostic complexity. Despite these challenges, the potential of PRAME as a therapeutic target in melanoma is significant. Emerging immunotherapies, including T-cell-based therapies and vaccines targeting PRAME, are being investigated to exploit its cancer-specific expression. Ongoing research into the molecular role and mechanism of action of PRAME in skin cancer continues to open new avenues in both diagnostics and therapeutics, with the potential to transform the management of melanoma and related skin cancers.
Topics: Humans; Male; Antigens, Neoplasm; Biomarkers, Tumor; Diagnosis, Differential; Melanocytes; Melanoma; Prognosis; Skin Neoplasms; Transcription Factors
PubMed: 38338862
DOI: 10.3390/ijms25031582