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BMJ (Clinical Research Ed.) Jun 2024
Topics: Humans; Skin Neoplasms; Melanoma; Diagnosis, Differential; Nevus, Pigmented
PubMed: 38857912
DOI: 10.1136/bmj-2023-077845 -
Dermatologic Surgery : Official... May 2024Serial excision remains the most commonly used surgical procedure for treating congenital melanocytic nevus (CMN). It is critical to remove as much of the lesion as...
BACKGROUND
Serial excision remains the most commonly used surgical procedure for treating congenital melanocytic nevus (CMN). It is critical to remove as much of the lesion as possible with each procedure to reduce the number of procedures and to shorten the treatment duration.
OBJECTIVE
To investigate the clinical efficacy of W-plasty serial excision for the repair of postoperative CMN defects.
METHODS
A retrospective analysis of patients with medium CMN was conducted from April 2018 to March 2022. Treatment options were divided into elliptical serial excision (10 cases) and W-plasty serial excision (10 cases).
RESULTS
Follow-up occurred over 6 months. The number of elliptical excision procedures was 2 to 4 (mean 2.9). The scar-to-lesion length ratio was 1.5 to 2.0 (mean 1.7). The mean Vancouver Scar Scale (VSS) score was 5.40 ± 0.42. The number of W-plasty excision procedures was 2 to 3 (mean 2.2). The scar-to-lesion length ratio was 1.2 to 1.5 (mean 1.4). The mean VSS score was 2.70 ± 0.26. W-plasty excision was superior to elliptical excision regarding the number of procedures and the effect on postoperative scars.
CONCLUSION
W-plasty serial excision can be considered a suitable option for the excision of medium CMN, leading to excellent results.
PubMed: 38809166
DOI: 10.1097/DSS.0000000000004245 -
Expert Review of Medical Devices May 2024Differentiation of iris and ciliary body lesions as benign or malignant and cystic or solid is important. The aim of this study was to compare anterior segment...
OBJECTIVES
Differentiation of iris and ciliary body lesions as benign or malignant and cystic or solid is important. The aim of this study was to compare anterior segment swept-source optical coherence tomography (AS SS-OCT) and ultrasound biomicroscopy (UBM) findings in iris and ciliary body tumors.
RESEARCH DESIGN AND METHODS
Forty-two eyes of 38 cases with iris and ciliary body tumors imaged with UBM and AS SS-OCT between September 2018 and September 2023 were evaluated retrospectively.
RESULTS
Of 42 eyes, 14 had melanoma, 14 iris pigment epithelial (IPE) cysts, 7 nevi, 3 Lisch nodules, 2 iris stromal cysts, 1 pars plana cysts, and 1 iris mammillations. An equivalent (100%) visualization of the anterior tumor margin was obtained with both techniques. Compared to AS SS-OCT, UBM was superior for posterior margin visualization in melanocytic tumors and IPE cysts. Bland-Altman plots demonstrated good agreement between UBM and AS SS-OCT for melanocytic tumors < 2.5 mm in base diameter and < 2 mm in thickness.
CONCLUSIONS
Although, UBM is the gold standard for ciliary body and iridociliary tumors. AS SS-OCT should be considered as an excellent alternative to UBM, especially in minimally elevated iris lesions.
Topics: Humans; Tomography, Optical Coherence; Microscopy, Acoustic; Ciliary Body; Male; Female; Middle Aged; Adult; Retrospective Studies; Aged; Uveal Neoplasms; Anterior Eye Segment; Iris Neoplasms; Young Adult; Iris Diseases; Iris; Adolescent
PubMed: 38803101
DOI: 10.1080/17434440.2024.2344668 -
ArXiv May 2024Automated region of interest detection in histopathological image analysis is a challenging and important topic with tremendous potential impact on clinical practice....
Automated region of interest detection in histopathological image analysis is a challenging and important topic with tremendous potential impact on clinical practice. The deep-learning methods used in computational pathology may help us to reduce costs and increase the speed and accuracy of cancer diagnosis. We started with the UNC Melanocytic Tumor Dataset cohort that contains 160 hematoxylin and eosin whole-slide images of primary melanomas (86) and nevi (74). We randomly assigned 80% (134) as a training set and built an in-house deep-learning method to allow for classification, at the slide level, of nevi and melanomas. The proposed method performed well on the other 20% (26) test dataset; the accuracy of the slide classification task was 92.3% and our model also performed well in terms of predicting the region of interest annotated by the pathologists, showing excellent performance of our model on melanocytic skin tumors. Even though we tested the experiments on the skin tumor dataset, our work could also be extended to other medical image detection problems to benefit the clinical evaluation and diagnosis of different tumors.
PubMed: 38800658
DOI: No ID Found -
Journal of Oral and Maxillofacial... 2024In a scenario where there is an increased incidence of oral squamous cell carcinoma (OSCC) in younger age groups, the diagnosis of pseudo-malignant lesions that mimic...
In a scenario where there is an increased incidence of oral squamous cell carcinoma (OSCC) in younger age groups, the diagnosis of pseudo-malignant lesions that mimic the histopathology of a moderate or even high-grade carcinoma becomes imperative for oral pathologists. Though paediatric malignancies such as melanomas and thyroid carcinomas and even OSCCs have been reported in young children, they are rare in the pre-pubertal age group. Melanocytic naevi such as Spitz naevi (SNs) or atypical SNs is, however, more common in this age group and could create some difficulty in diagnosis due to its histological variations that could mimic a malignancy. Hence, the need for a cautious correlation between clinical and histopathological features becomes manifold. Adjunct tools that use diagnostic and molecular techniques such as immunohistochemistry (IHC) and comparative genomic hybridisation (CGH) help in diagnosis and in differentiating certain types of SNs from Spitzoid melanomas or melanomas. A case that histopathologically resembled a moderately differentiated squamous cell carcinoma without any evidence of melanocytic content proved to be a melanocytic naevus after clinical correlation of both age and immunohistochemical analysis. This case report with review brings to light the importance of being aware of such pseudo-malignant lesions in our daily practice.
PubMed: 38800450
DOI: 10.4103/jomfp.jomfp_10_23 -
Cancers May 2024Spitz and Spitzoid lesions represent one of the most challenging melanocytic neoplasms in dermatopathology. Nosologic classification has been more recently improved by...
Spitz and Spitzoid lesions represent one of the most challenging melanocytic neoplasms in dermatopathology. Nosologic classification has been more recently improved by the discovery of novel molecular drivers, particularly translocations. In the current study, we aimed to use an unbiased approach to explore the gene expression profile of a group of melanocytic Spitz and Spitzoid melanocytic lesions ranging from benign lesions to melanoma, including intermediate lesions such as SPARK nevi and atypical Spitz tumors/melanocytomas. Using unsupervised analysis of gene expression data, we found some distinct hierarchical clusters of lesions, including groups characterized by and translocations. Few non-ALK translocated tumors demonstrated increased ALK expression, confirmed by immunohistochemistry. Spitz tumors with overlapping features of dysplastic nevi, so-called SPARK nevi, appear to have a common gene expression profile by hierarchical clustering. Finally, weighted gene correlation network analysis identified gene modules variably regulated in subtypes of these cases. Thus, gene expression profiling of Spitz and Spitzoid lesions represents a viable instrument for the characterization of these lesions.
PubMed: 38791877
DOI: 10.3390/cancers16101798 -
Current Oncology (Toronto, Ont.) May 2024This study investigates the differential expression of miRNA gene subtypes in tumoral versus benign nevi in individuals with melanoma, aiming to identify clinically... (Observational Study)
Observational Study
This study investigates the differential expression of miRNA gene subtypes in tumoral versus benign nevi in individuals with melanoma, aiming to identify clinically significant correlations that could serve as reliable markers for assessing tumor stage and progression. Conducted between 2019 and 2022, this descriptive, quantitative observational research analyzed 90 formalin-fixed paraffin-embedded (FFPE) samples from the Pius Brinzeu County Emergency Clinical Hospital, Timisoara, including 45 samples of advanced-stage melanoma and 45 samples of pigmented nevi. miRNA purification and analysis were performed using the miRNeasy Kit and the Human Cancer PathwayFinder miScript miRNA PCR Array, with statistical analysis (including logistic regression) to determine associations with cancer staging, such as high Breslow index risk, number of mitoses, and vascular invasion. After the analysis and comparison of 180 miRNA gene subtypes, we selected 10 of the most upregulated and 10 most downregulated genes. The results revealed that hsa-miR-133b, hsa-miR-335-5p, hsa-miR-200a-3p, and hsa-miR-885-5p were significantly upregulated in melanoma samples, with fold changes ranging from 1.09 to 1.12. Conversely, hsa-miR-451a and hsa-miR-29b-3p showed notable downregulation in melanoma, with fold changes of 0.90 and 0.92, respectively. Additionally, logistic regression analysis identified hsa-miR-29b-3p (OR = 2.51) and hsa-miR-200a-3p (OR = 2.10) as significantly associated with an increased risk of a high Breslow index, while hsa-miR-127-3p and hsa-miR-451a were associated with a reduced risk. Conclusively, this study underscores the significant alterations in miRNA expression in melanoma compared to benign nevi and highlights the potential of specific miRNAs as biomarkers for melanoma progression. The identification of miRNAs with significant associations to melanoma characteristics suggests their utility in developing non-invasive, cost-effective diagnostic tools and in guiding therapeutic decisions, potentially improving patient outcomes in melanoma management.
Topics: Humans; Melanoma; MicroRNAs; Male; Female; Middle Aged; Biomarkers, Tumor; Disease Progression; Skin Neoplasms; Aged; Adult; Gene Expression Regulation, Neoplastic; Nevus, Pigmented
PubMed: 38785501
DOI: 10.3390/curroncol31050220 -
BMJ Case Reports May 2024A girl in her middle childhood presented to the outpatient department (OPD) with a congenital melanocytic naevi (CMN) of the right nasal alar lobule. Her parents had... (Review)
Review
A girl in her middle childhood presented to the outpatient department (OPD) with a congenital melanocytic naevi (CMN) of the right nasal alar lobule. Her parents had aesthetic concerns and expressed their desire to get the lesion removed. The full-thickness excision of CMN was performed with the reconstruction of the defect using the nasolabial and dorsal nasal advancement flap with conchal cartilage to shape the contour of the ala.
Topics: Humans; Nevus, Pigmented; Female; Surgical Flaps; Nose Neoplasms; Skin Neoplasms; Child; Nose; Plastic Surgery Procedures; Rhinoplasty
PubMed: 38782429
DOI: 10.1136/bcr-2024-260577 -
Current Oncology Reports May 2024Melanoma in younger individuals has different clinical presentations, histologic characteristics and prognosis from older patients. This review summarizes key... (Review)
Review
PURPOSE OF REVIEW
Melanoma in younger individuals has different clinical presentations, histologic characteristics and prognosis from older patients. This review summarizes key differences and important new insights into pediatric and young adult melanoma, as well as recent evolutions in treatment.
RECENT FINDINGS
Molecular techniques have improved the classification of melanocytic neoplasms, and are especially useful in the workup of the diagnostically challenging lesions frequent in this age group. Molecular evaluation highlights differences between melanoma and atypical lesions with Spitz-like morphology, and should routinely be incorporated for diagnosing and classifying Spitzoid melanocytic to guide prognostication and treatment. Once diagnosed, the management of bona fide melanoma in children and young adults is largely similar to older patients, while the optimal management of lesions such as atypical Spitz tumors remains uncertain. Increased awareness of the presentation and diagnostic characteristics of melanoma in young individuals will allow earlier detection, and improved diagnostic techniques will allow optimum management without over- or under-treatment.
PubMed: 38780675
DOI: 10.1007/s11912-024-01542-5 -
Actas Dermo-sifiliograficas May 2024No studies focused on counting the interdigital acquired melanocytic nevi (AMN) of the foot (IDNf) have ever been conducted. Therefore, our objective was to study the...
BACKGROUND AND OBJECTIVES
No studies focused on counting the interdigital acquired melanocytic nevi (AMN) of the foot (IDNf) have ever been conducted. Therefore, our objective was to study the relationship between the presence of IDNf and the total number of AMN in the feet and the rest of the body, the racial phenotypic characteristics, and other risk factors for melanoma.
MATERIAL AND METHODS
We conducted a cross-sectional observational study with 255 patients ≥18 years old who attended our Dermatology Unit from September 2020 through February 2021, and included all AMN ≥ 1 mm from the feet and ≥ 2 mm from the rest of the bod. The association between the variables was studied using univariate and multivariate logistic regression models.
RESULTS
The presence of IDNf was significantly and independently associated with the presence of plantar AMN and body counts ≥ 50 AMN. However, no significant differences were observed regarding sex, age, personal history of melanoma, presence of nevi on the dorsum of the foot, history of sunburn or UV rays, or racial phenotypic characteristics.
CONCLUSIONS
The presence of IDNf is associated with a higher count of plantar nevi and total AMN in the body, meaning that interdigital spaces of the foot-anatomical expansions of the sole and other possibly genetic causes-could be responsible for the number of AMN found in this location, as these regions are not photoexposed.
PubMed: 38777223
DOI: 10.1016/j.ad.2024.04.024