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Lancet (London, England) Aug 2023Cutaneous melanoma is a malignancy arising from melanocytes of the skin. Incidence rates are rising, particularly in White populations. Cutaneous melanoma is typically... (Review)
Review
Cutaneous melanoma is a malignancy arising from melanocytes of the skin. Incidence rates are rising, particularly in White populations. Cutaneous melanoma is typically driven by exposure to ultraviolet radiation from natural sunlight and indoor tanning, although there are several subtypes that are not related to ultraviolet radiation exposure. Primary melanomas are often darkly pigmented, but can be amelanotic, with diagnosis based on a combination of clinical and histopathological findings. Primary melanoma is treated with wide excision, with margins determined by tumour thickness. Further treatment depends on the disease stage (following histopathological examination and, where appropriate, sentinel lymph node biopsy) and can include surgery, checkpoint immunotherapy, targeted therapy, or radiotherapy. Systemic drug therapies are recommended as an adjunct to surgery in patients with resectable locoregional metastases and are the mainstay of treatment in advanced melanoma. Management of advanced melanoma is complex, particularly in those with cerebral metastasis. Multidisciplinary care is essential. Systemic drug therapies, particularly immune checkpoint inhibitors, have substantially increased melanoma survival following a series of landmark approvals from 2011 onward.
Topics: Humans; Melanoma; Skin Neoplasms; Ultraviolet Rays; Sentinel Lymph Node Biopsy; Lymph Node Excision; Melanoma, Cutaneous Malignant
PubMed: 37499671
DOI: 10.1016/S0140-6736(23)00821-8 -
Veterinary Sciences Apr 2022Canine melanocytic neoplasms have a highly variable biological behavior ranging from benign cutaneous melanocytomas to malignant oral melanomas that readily metastasize... (Review)
Review
Canine melanocytic neoplasms have a highly variable biological behavior ranging from benign cutaneous melanocytomas to malignant oral melanomas that readily metastasize to lymph nodes and internal organs. This review focuses on the diagnosis and prognosis of canine melanocytic neoplasms. While pigmented melanocytic neoplasms can be diagnosed with fine-needle aspirates, an accurate prognosis requires surgical biopsy. However, differentiating amelanotic spindloid melanomas from soft tissue sarcomas is challenging and often requires immunohistochemical labeling with a diagnostic cocktail that contains antibodies against Melan-A, PNL-2, TRP-1, and TRP-2 as the current gold standard. For questionable cases, RNA expression analysis for TYR, CD34, and CALD can further differentiate these two entities. The diagnosis of amelanotic melanomas will be aided by submitting overlying and/or lateral flanking epithelium to identify junctional activity. Wide excision of lateral flanking epithelium is essential, as lentiginous spread is common for malignant mucosal melanomas. Combining histologic features (nuclear atypia, mitotic count, degree of pigmentation, level of infiltration, vascular invasion; tumor thickness and ulceration) with the Ki67 index provides the most detailed prognostic assessment. Sentinel lymph nodes should be evaluated in cases of suspected malignant melanomas using serial sectioning of the node combined with immunohistochemical labeling for Melan-A and PNL-2.
PubMed: 35448673
DOI: 10.3390/vetsci9040175 -
Acta Medica Portuguesa Jun 2021
Topics: Diagnosis, Differential; Humans; Melanoma, Amelanotic; Skin Neoplasms
PubMed: 33861192
DOI: 10.20344/amp.13044 -
Current Ophthalmology Reports Dec 2023To provide an up-to-date review of the epidemiology, presentation, diagnosis, and treatment options for conjunctival nevi (CN).
PURPOSE OF REVIEW
To provide an up-to-date review of the epidemiology, presentation, diagnosis, and treatment options for conjunctival nevi (CN).
RECENT FINDINGS
Around 17.2%-42% of all conjunctival tumors have been found to be CN, which most frequently present in White individuals between the first to early third decade of life, with equal distribution between males and females. CN commonly occur in the interpalpebral bulbar conjunctiva with pigmentation ranging from amelanotic to dark. Diagnosis is typically made through slit lamp examination, visualized by a well circumscribed, variably elevated, variably pigmented, solitary lesion with clear cysts distributed throughout the pigment. In ambiguous cases, anterior segment optical coherence tomography (AS-OCT) can highlight the presence of sub-clinical cysts, whose presence points to a diagnosis of nevus. However, excisional biopsy with histopathology examination is the gold standard for identifying CN.
SUMMARY
CN are benign, variably pigmented lesions. They are the most common of the conjunctival melanocytic tumors. Due to the extremely low risk of transformation to malignant melanoma (MM), CN are usually managed with routine observation and photo documentation.
PubMed: 38390435
DOI: 10.1007/s40135-023-00315-w -
Ugeskrift For Laeger Jul 2021Pyogenic granuloma, also known as lobular capillary haemangioma, is a common benign vascular proliferation of not yet fully understood aetiology. Pyogenic granuloma can...
Pyogenic granuloma, also known as lobular capillary haemangioma, is a common benign vascular proliferation of not yet fully understood aetiology. Pyogenic granuloma can occur in all age groups and affect both men and women. Although pyogenic granuloma is a benign lesion, differential diagnosis may include malignant tumours such as amelanotic melanoma, basal cell carcinoma and spindle cell tumour. Surgical excision with primary closure is the usual treatment for pyogenic granuloma/lobular capillary haemangioma and has the lowest rate of recurrence.
Topics: Diagnosis, Differential; Female; Granuloma, Pyogenic; Humans; Male; Melanoma; Neoplasm Recurrence, Local; Skin Neoplasms
PubMed: 34356018
DOI: No ID Found -
Surgical Oncology Clinics of North... Jul 2020Noncutaneous melanomas are rare subtypes of melanoma with high rates of metastatic disease and poor overall survival. One-third to one-half of cases are amelanotic,... (Review)
Review
Noncutaneous melanomas are rare subtypes of melanoma with high rates of metastatic disease and poor overall survival. One-third to one-half of cases are amelanotic, which may contribute to a delay in diagnosis. Immunohistochemistry staining with typical melanoma markers helps confirm the diagnosis. There is no standard staging system across mucosal melanomas. Elective nodal dissection is not recommended and there is a paucity of data to support use of sentinel lymph node biopsy. Mutational analysis should be routinely performed. Systemic therapy options include targeted inhibitors, immunotherapy, and cytotoxic chemotherapy, although further studies are needed to confirm their efficacy.
Topics: Combined Modality Therapy; Disease Management; Humans; Melanoma
PubMed: 32482315
DOI: 10.1016/j.soc.2020.02.004 -
Current Opinion in Pediatrics Aug 2020To inform pediatric providers of the clinical characteristics, underlying genetic drivers, and therapeutic options for skin cancer arising in childhood and adolescence. (Review)
Review
PURPOSE OF REVIEW
To inform pediatric providers of the clinical characteristics, underlying genetic drivers, and therapeutic options for skin cancer arising in childhood and adolescence.
RECENT FINDINGS
The incidence of melanoma in pediatric patients has been declining in the past decades. Pediatric-specific diagnostic criteria should be utilized when assessing lesions concerning for melanoma to better account for the different presentations seen in pediatric disease compared with adults, such as an increased prevalence of amelanotic melanoma or frequent mimic of benign pediatric lesions. Pediatric melanoma often presents with a higher histopathologic stage and a higher Breslow depth as compared with adult melanoma. Pediatric nonmelanoma skin cancer including basal cell carcinoma and squamous cell carcinoma are associated with genetic conditions and immunosuppression, both iatrogenic and inherited.
SUMMARY
Melanoma in pediatric patients often presents differently from conventional adult melanoma, including Spitz melanoma and melanoma associated with congenital melanocytic nevi. Pediatric patients with nonmelanoma skin cancers should be evaluated for predisposing risk factors. More research on therapeutic options for pediatric skin cancer is vital to understanding the tolerance and response of our pediatric patients to therapies that are more frequently utilized in adult disease.
Topics: Adolescent; Adult; Carcinoma, Basal Cell; Child; Humans; Melanoma; Nevus, Pigmented; Skin; Skin Neoplasms
PubMed: 32618791
DOI: 10.1097/MOP.0000000000000917 -
Ugeskrift For Laeger Apr 2023In this case report, a 62-year-old woman was diagnosed with lymph node metastasis from melanoma in the groin. Initially the primary tumour was unknown. The entire skin...
In this case report, a 62-year-old woman was diagnosed with lymph node metastasis from melanoma in the groin. Initially the primary tumour was unknown. The entire skin was examined without any suspicious moles. A PET-CT scan showed an area on the left heel with increased activity. The element surprisingly showed an amelanotic melanoma. Amelanotic melanomas have a significantly worse prognosis compared to pigmented melanomas, presumably because they are detected later and may be very difficult to detect clinically. This case shows the importance of paying attention to unpigmented elements when searching for a primary tumour.
Topics: Female; Humans; Middle Aged; Melanoma, Amelanotic; Positron Emission Tomography Computed Tomography; Skin Neoplasms; Prognosis; Diagnosis, Differential
PubMed: 37114579
DOI: No ID Found -
GE Portuguese Journal of... Sep 2021
PubMed: 34604472
DOI: 10.1159/000512090