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Cancer Medicine Jun 2021Increased risk of a second primary malignancy (SPM) before or after diagnosis of anal squamous cell carcinoma (ASCC) has been reported in a previous single-institution...
BACKGROUND
Increased risk of a second primary malignancy (SPM) before or after diagnosis of anal squamous cell carcinoma (ASCC) has been reported in a previous single-institution study. We hypothesize that patients diagnosed with ASCC are at increased risk for developing SPMs before or after the diagnosis of ASCC. The primary objective of this study was to identify the diagnoses of cancer most likely to occur as SPMs before or after ASCC.
METHODS
This work employs the Surveillance, Epidemiology, and End Results (SEER) Program registry data to conduct a US-population-based study of patients diagnosed with ASCC between 1975 and 2016. In patients diagnosed with ASCC, we evaluated the risk of SPMs and the risk of developing ASCC as an SPM after another cancer using standardized incidence ratios (SIR) for all SPMs by calculating the ratio of observed events in the ASCC cohort compared to expected (O/E) events in a matched reference cohort of the general population.
RESULTS
A total of 7,594 patients with primary ASCC were included. Patients with ASCC were at increased risk of the diagnosis of an SPM (SIR = 1.45), particularly cancers of the lung, vulva, oropharynx, or colon. Patients with ASCC had an increased rate of previous malignancy (SIR = 1.23), especially Kaposi sarcoma or vulvar cancer. Overall elevated incidence of SPMs was unrelated to prior radiation treatment. Radiation treatment was associated with increased risk for SPMs in the female genital system but appeared protective against prostate cancer as SPMs.
CONCLUSIONS
Our findings support increased surveillance and screening for second malignancies in patients with these diagnoses, as patients with ASCC are often either survivors of a prior cancer diagnosis or are at increased risk of developing later malignancies.
Topics: Anus Neoplasms; Carcinoma, Squamous Cell; Colonic Neoplasms; Female; Gastrointestinal Neoplasms; Humans; Incidence; Lung Neoplasms; Lymphoma; Lymphoma, Non-Hodgkin; Male; Melanoma; Neoplasms, Second Primary; Oropharyngeal Neoplasms; Prostatic Neoplasms; Risk; SEER Program; Sarcoma, Kaposi; Skin Neoplasms; United States; Vulvar Neoplasms
PubMed: 33960690
DOI: 10.1002/cam4.3909 -
BMC Cancer Jan 2024Vulvar and vaginal melanoma (VuM & VaM) is a rare gynecologic malignancy with high mortality but low effectiveness to checkpoint immunotherapy compared to cutaneous...
BACKGROUND
Vulvar and vaginal melanoma (VuM & VaM) is a rare gynecologic malignancy with high mortality but low effectiveness to checkpoint immunotherapy compared to cutaneous melanoma. This article aims to elucidate the role of the disordered immune microenvironment in cancer progression in VuM.
METHODS
At first, this article applied single-cell RNA sequencing (scRNA-seq) to the VuM obtained from a 68-year-old female patient, and constructed a single-cell atlas of VuM consist of 12,243 single cells. Then this article explores the genomic complexity and core signal channel in VuM microenvironment.
RESULTS
This article provides new insights about the pathogenesis of VuM based on single-cell resolution data. It was found that the activation of CD8 T cell contributed to induce tumor angiogenesis and immune escape, and the activation of the antigen-presenting molecular function participated in melanoma metastasis.
CONCLUSION
This article provided new insights into underlining VuM molecular regulation and potential signaling involved in immunotherapy, which would benefit the clinical practice and administration.
Topics: Female; Humans; Aged; Melanoma; Skin Neoplasms; Vulvar Neoplasms; Single-Cell Analysis; Immunotherapy; Tumor Microenvironment
PubMed: 38233802
DOI: 10.1186/s12885-024-11839-0 -
The Pan African Medical Journal 2020Primary malignant melanoma of the female genital tract is an extremely rare tumor. It most commonly affects the vulva then the cervix and the vagina. Vulvar cancer...
Primary malignant melanoma of the female genital tract is an extremely rare tumor. It most commonly affects the vulva then the cervix and the vagina. Vulvar cancer accounts for about 1% (all sites) of melanomas. In order of frequency, it occurs in the vagina, uterus and ovary. Less than 200 cases of vulvar cancers have been described worldwide. We here report a clinical case of malignant vulvar melanoma in a 72-year-old postmenopausal woman. Partial hemivulvectomy and bilateral superficial inguinal lymphadenectomy were performed. The postoperative course was favorable and the patient was discharged on postoperative day 15.
Topics: Aged; Democratic Republic of the Congo; Female; Humans; Lymph Node Excision; Melanoma; Vulvar Neoplasms
PubMed: 32849979
DOI: 10.11604/pamj.2020.36.124.19138 -
Journal of Gynecologic Oncology Nov 2019immunotherapy with immune checkpoint inhibitors has become one of the standard therapeutic modalities for patients with advanced melanoma. Melanoma of the female lower...
OBJECTIVE
immunotherapy with immune checkpoint inhibitors has become one of the standard therapeutic modalities for patients with advanced melanoma. Melanoma of the female lower genital tract is a rare and aggressive disease, with poor long-term clinical outcomes. To date, no study evaluated the role of immunotherapy in metastatic melanoma of the lower genital tract.
METHODS
Data of women with metastatic melanoma of the lower genital tract were prospectively collected. Survival outcomes over time was assessed using Kaplan-Meier model.
RESULTS
Seven cases of metastatic melanoma of the lower genital tract (vulva [n=2], vagina [n=4], and uterine cervix [n=1]) treated with immune checkpoint inhibitors are reviewed. Two patients had metastatic disease at diagnosis, while 5 patients developed metastatic disease at a mean (standard deviation) time of 9.9 (±3.0) months from primary diagnosis. Four patients received an anti-cytotoxic T lymphocyte-associated antigen 4 (CTLA4) (ipilimumab) and 3 received an anti-programmed cell death 1 (PD-1) (pembrolizumab [n=2], nivolumab [n=1]) therapy. The response rate to immunotherapy was 28.5%. Patients receiving an anti-PD-1 experienced a better progression-free survival than patients treated with anti-CTLA4 (p=0.01, log-rank test). Although not reaching statistical significance, overall survival was better in patients having an anti-PD-1 therapy in comparison to anti-CTLA4 (p=0.15, log-rank test).
CONCLUSION
Results from our series confirm the poor prognosis of women with metastatic melanoma of the lower genital tract, thus supporting the need of exploring new treatment modalities. Further studies are warranted to improve knowledge on the role of immunotherapy in metastatic melanoma of the lower genital tract.
Topics: Aged; Antibodies, Monoclonal, Humanized; Antineoplastic Combined Chemotherapy Protocols; Female; Humans; Immunotherapy; Ipilimumab; Melanoma; Middle Aged; Neoplasm Recurrence, Local; Retrospective Studies; Survival Rate; Treatment Outcome; Urogenital Neoplasms
PubMed: 31576688
DOI: 10.3802/jgo.2019.30.e94 -
Case Reports in Women's Health Apr 2021Cellular angiofibroma is a recently described rare benign soft-tissue tumor more commonly presenting in middle-aged women, often mimicking malignancy. The vulva is most...
Cellular angiofibroma is a recently described rare benign soft-tissue tumor more commonly presenting in middle-aged women, often mimicking malignancy. The vulva is most common location. Complete local excision is the best curative treatment and usually there is no recurrence after surgery. We describe a 49-year-old woman with a painless tumor in the left ischiorectal fossa. It was a random finding in a routine computed tomography (CT) scan after resection of ear melanoma 3 years previously. Ultrasonography showed a solid mass, and further magnetic resonance imaging (MRI) suggested a rhabdomyosarcoma. Altogether, these findings indicated malignant disease. An uncomplicated simple excision of the tumor was done in the operating theatre. The mass measured 7×5×5 cm and the histopathological examination found that it was a cellular angiofibroma, a benign lesion. There were no postoperative complications. This case report highlights the need for multidisciplinary team management of rare tumors such as cellular angiofibromas.
PubMed: 33665138
DOI: 10.1016/j.crwh.2021.e00295 -
Dermatology Reports Jun 2023Melanocytic lesions, especially in delicate anatomical locations such as the vulva, penis, mons pubis , are challenging to diagnose. The patients may delay physical...
Melanocytic lesions, especially in delicate anatomical locations such as the vulva, penis, mons pubis , are challenging to diagnose. The patients may delay physical examinations due to anxiety or discomfort from the location of the lesion. In terms of therapy options, the surgical approach is not always the preferred one, but it is the one that could lead to a definitive solution to the problem. A limited number of studies do not exclude that atypical nevi of genital type could be considered as melanoma precursors. Single case reports have identified atypical genital nevi of the labia majora as a risk factor for genital melanoma development. Lesions that occupy a larger area than the labia majora and extend into the areas around them are particularly problematic, because the result of a single biopsy could be misleading. Therefore, careful physical examinations are mandatory. Mechanical irritation in the genital area, and in particular in the labia majora region, is an additional reason for choosing the surgical-reconstructive therapeutic option. We present a 13-year-old female with a progressive divided nevus, located in the area of the vulva and labia majora, extending to the mucosa. A biopsy was taken in order to rule out malignancy. Immunohistochemistry was performed with specific melanocyte markers S-100, HMB-45 and SOX confirming the benign origin of the lesion. A diagnosis of atypical melanocytic nevus of genital type was made. For prevention a surgical excision was advised but later on declined by the patient's parents. Further close observation of the lesion was recommended.
PubMed: 37426374
DOI: 10.4081/dr.2023.9667 -
Journal For Immunotherapy of Cancer Dec 2019Acute interstitial nephritis is an immune-related adverse event that can occur in patients receiving immune checkpoint inhibitor therapy. Differentiating checkpoint...
BACKGROUND
Acute interstitial nephritis is an immune-related adverse event that can occur in patients receiving immune checkpoint inhibitor therapy. Differentiating checkpoint inhibitor-associated acute interstitial nephritis from other causes of acute kidney injury in patients with cancer is challenging and can lead to diagnostic delays and/or unwarranted immunosuppression. In this case report, we assess the use of F-flourodeoxyglucose positron-emission tomography imaging as an alternative diagnostic modality in the evaluation of potential acute interstitial nephritis.
CASE PRESENTATION
A 55-year-old woman with metastatic vulvar melanoma underwent treatment with two cycles of ipilimumab plus nivolumab, followed by seven cycles of nivolumab combined with radiation therapy. During her treatment, she developed non-oliguric acute kidney injury to a creatinine of 4.5 mg/dL from a baseline of 0.5 mg/dL. A clinical diagnosis of acute interstitial nephritis was made, and steroids were initiated, with rapid improvement of her acute kidney injury. Retrospectively, four positron-emission tomography scans obtained for cancer staging purposes were reviewed. We found a markedly increased F-flourodeoxyglucose uptake in the renal cortex at the time acute interstitial nephritis was diagnosed compared to baseline. In three cases of acute kidney injury due to alternative causes there was no increase in F-flourodeoxyglucose uptake from baseline.
CONCLUSIONS
To our knowledge, this is the first report describing increased F-flourodeoxyglucose uptake in the renal cortex in a patient with checkpoint inhibitor-associated acute interstitial nephritis. Our findings suggest that F-flourodeoxyglucose positron-emission tomography may be a valuable test for diagnosing immune-mediated nephritis, particularly in patients where timely kidney biopsy is not feasible.
Topics: Acute Disease; Antineoplastic Agents, Immunological; Antineoplastic Combined Chemotherapy Protocols; Female; Fluorodeoxyglucose F18; Humans; Middle Aged; Neoplasms; Nephritis, Interstitial; Positron Emission Tomography Computed Tomography; Positron-Emission Tomography
PubMed: 31864416
DOI: 10.1186/s40425-019-0820-9