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1.
Anticancer Res ; 41(4): 2067-2070, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33813415

RESUMEN

BACKGROUND/AIM: Melanoma incidence has increased in the United States over the past few decades, and disparities in patient treatment have been described. Although most patients with melanoma are good candidates for curative treatment, some are considered poor candidates for treatment because of comorbid conditions. We examined whether patient demographics influence treatment contraindication in melanoma. PATIENTS AND METHODS: The National Cancer Database (NCDB) was used to identify patients with melanoma from 2004 through 2015. Multivariate logistic regression was used to determine independent associations, adjusted for confounders. We excluded patients who did not receive treatment for reasons and patients with unknown treatment status. RESULTS: A total of 499,092 patients met the inclusion criteria. Of these, 525 (0.1%) had Treatment contraindicated because of comorbid conditions (TCBC) and 498,567 (99.9%) received treatment. Multivariate logistic regression showed higher odds of TCBC in patients with government insurance (OR=1.34, 95%CI=03-1.73; p=0.03) and patients without insurance (OR=2.75, 95%CI=1.76-4.29; p<0.001) than patients with private insurance. CONCLUSION: Demographic disparities affects treatment decision in oncological patients. Our study demonstrated a significantly higher likelihood of "nontreatment because of comorbid conditions" among melanoma patients with government insurance or without insurance. Greater efforts are needed to address inequalities in melanoma treatment in the United States.


Asunto(s)
Contraindicaciones , Melanoma/epidemiología , Melanoma/terapia , Neoplasias Cutáneas/epidemiología , Neoplasias Cutáneas/terapia , Adulto , Anciano , Anciano de 80 o más Años , Comorbilidad , Bases de Datos Factuales , Femenino , Disparidades en Atención de Salud/estadística & datos numéricos , Humanos , Masculino , Melanoma/patología , Persona de Mediana Edad , Pautas de la Práctica en Medicina/estadística & datos numéricos , Neoplasias Cutáneas/patología , Estados Unidos/epidemiología
2.
Medicine (Baltimore) ; 100(12): e25120, 2021 Mar 26.
Artículo en Inglés | MEDLINE | ID: mdl-33761676

RESUMEN

ABSTRACT: This study was to assess the survival outcome of cutaneous melanoma (CM) patients with surgery vs non-surgery through inverse probability of treatment weighting (IPTW) using the propensity score. Patients diagnosed as CM were selected from the Surveillance, Epidemiology, and End Results Program (SEER) database. The survival outcome was estimated and compared by IPTW using the propensity score. Totally 2203 CM patients were identified, in which 1921 cases received surgical treatment (surgery group), while 282 cases didn't (non-surgery group). The median survival time of surgery and non-surgery groups was respectively 150 months and 15 months (unmatched cohort), 70 months and 40 months (matched cohort) and 130 months vs. 75 months (IPTW-weighted cohort). Compared with the non-surgery group, the surgery group had a lower risk of death in unmatched [hazard ratio (HR): 0.647, 95% confidence interval (CI): 0.509-0.821, P < .001] and matched (HR: 0.636, 95%CI: 0.459-0.882, P < .01) cohorts. In multivariate Cox model of IPTW-weighted cohort, the risk of death in the surgery group decreased notably than the non-surgery group (HR: 0.423, 95%CI: 0.383-0.468, P < .001). In conclusion, CM patients receiving surgical treatment are associated with a better survival outcome compared with those without surgical treatment through IPTW using the propensity score.


Asunto(s)
Procedimientos Quirúrgicos Dermatologicos/mortalidad , Melanoma/mortalidad , Melanoma/cirugía , Neoplasias Cutáneas/mortalidad , Neoplasias Cutáneas/cirugía , Adulto , Anciano , Estudios de Cohortes , Estudios Transversales , Femenino , Humanos , Masculino , Melanoma/patología , Persona de Mediana Edad , Estadificación de Neoplasias , Puntaje de Propensión , Modelos de Riesgos Proporcionales , Programa de VERF , Neoplasias Cutáneas/patología , Resultado del Tratamiento , Adulto Joven
3.
N Z Med J ; 134(1530): 30-37, 2021 02 19.
Artículo en Inglés | MEDLINE | ID: mdl-33651775

RESUMEN

AIM: To investigate the outcomes and effect of a multidisciplinary 'see and treat' pigmented lesion clinic, run jointly by dermatology and general surgery, on the diagnosis and treatment of melanoma at Auckland District Health Board (DHB). METHOD: All patients attending the newly established Pigmented Lesion Clinic (PLC) between 1 March 2019 and 31 August 2019 were included in the study. They were compared against a retrospective cohort of patients seen for suspected or biopsy-proven melanomas during the same corresponding period in 2016. RESULTS: 251 new patients attended the PLC, compared to 148 new patients seen at Auckland DHB in 2016. There was a significant reduction in proportion of pigmented lesions requiring biopsy (35.2% vs 64.3%, p<0.001), with a benign-to-malignant ratio of 2.4:1. Fifty-three melanomas were treated through the PLC, with a significant reduction in mean waiting time from referral to first specialist assessment (22.6 vs 35.1 days, p=0.038), and from referral to wide local excision (50.6 vs 99.1 days, p<0.001). 86.5% of patients received full skin check, from which additional skin malignancies were detected in 1-per-5.3 patients. CONCLUSION: The novel PLC model has led to reduction in unnecessary excisional biopsies of benign pigmented lesions, while streamlining and improving timely access to specialist review and surgical treatment for patients with melanomas.


Asunto(s)
Melanoma/diagnóstico , Melanoma/patología , Nevo Pigmentado/patología , Neoplasias Cutáneas/diagnóstico , Neoplasias Cutáneas/patología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Instituciones de Atención Ambulatoria , Dermatología/métodos , Errores Diagnósticos , Femenino , Humanos , Masculino , Melanoma/cirugía , Persona de Mediana Edad , Modelos Estadísticos , Invasividad Neoplásica , Nueva Zelanda , Valor Predictivo de las Pruebas , Derivación y Consulta/estadística & datos numéricos , Estudios Retrospectivos , Neoplasias Cutáneas/cirugía , Adulto Joven
4.
Medicine (Baltimore) ; 100(8): e24866, 2021 Feb 26.
Artículo en Inglés | MEDLINE | ID: mdl-33663112

RESUMEN

ABSTRACT: Skin cutaneous melanoma (SKCM) is a prevalent skin cancer whose metastatic form is dangerous due to its high morbidity and mortality. Previous studies have systematically established the vital role of oxidative stress (OS) in melanoma progression. This study aimed to identify prognostic OS genes closely associated with SKCM and illustrate their potential mechanisms. Transcriptome data and corresponding clinical traits of patients with SKCM were retrieved from The Cancer Genome Atlas and Gene Expression Omnibus databases. A weighted gene co-expression network analysis was conducted to identify relationships between clinical features and OS genes in specific modules. Subsequently, Cox regression analysis was performed on candidate OS genes; four hub prognosis-associated OS genes (AKAP9, VPS13C, ACSL4, and HMOX2) were identified to construct a prognostic model. After a series of bioinformatics analysis, our prognostic model was identified significantly associated with the overall survival of patients with SKCM and metastatic ability of the cancer. Furthermore, our risk model demonstrated improved diagnostic accuracy in the Cancer Genome Atlas and Gene Expression Omnibus cohorts. In addition, we established 2 nomograms based on either risk score or hub genes, which displayed favorable discriminating ability for SKCM. Our results provide novel insight into the potential applications of OS-associated genes in SKCM.


Asunto(s)
Regulación Neoplásica de la Expresión Génica , Melanoma/genética , Metástasis de la Neoplasia/genética , Estrés Oxidativo/genética , Neoplasias Cutáneas/genética , Biomarcadores de Tumor/genética , Biología Computacional/métodos , Conjuntos de Datos como Asunto , Humanos , Melanoma/patología , Metaanálisis en Red , Nomogramas , Modelos de Riesgos Proporcionales , Curva ROC , Medición de Riesgo , Neoplasias Cutáneas/patología
5.
Methods Mol Biol ; 2265: 591-620, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33704742

RESUMEN

Melanoma accounts for 4% of all skin cancer malignancies, with only 14% of diagnosed patients surviving for more than 5 years after diagnosis. Until now, there is no clear understanding of the detailed molecular contributors of melanoma pathogenesis. Accordingly, more research is needed to understand melanoma development and prognosis.All the treatment approaches that are currently applied have several significant limitations that prevent effective use in melanoma. One major limitation in the treatment of cancer is the acquisition of multidrug resistance (MDR). The MDR results in significant treatment failure and poor clinical outcomes in several cancers, including skin cancer. Treatment of melanoma is especially retarded by MDR. Despite the current advances in targeted and immune-mediated therapy, treatment arms of melanoma are severely limited and stand as a significant clinical challenge. Further, the poor pharmacokinetic profile of currently used chemotherapeutic agents is another reason for treatment failure. Therefore, more research is needed to develop novel drugs and carrier tools for more effective and targeted treatment.Nucleic acid therapy is based on nucleic acids or chemical compounds that are closely related, such as antisense oligonucleotides, aptamers, and small-interfering RNAs that are usually used in situations when a specific gene implicated in a disorder is deemed a therapeutically beneficial target for inhibition. However, the proper application for nucleic acid therapies is hampered by the development of an effective delivery system that can maintain their stability in the systemic circulation and enhance their uptake by the target cells. In this chapter, the prognosis of the different types of melanoma along with the currently used medications is highlighted, and the different types of nucleic acids along with the currently available nanoparticle systems for delivering these nucleic acids into melanoma cells are discussed. We also discuss recently conducted research on the use of different types of nanoparticles for nucleic acid delivery into melanoma cells and highlight the most significant outcomes.


Asunto(s)
Antineoplásicos , Sistemas de Liberación de Medicamentos , Resistencia a Múltiples Medicamentos , Resistencia a Antineoplásicos , Melanoma/tratamiento farmacológico , Nanopartículas , Ácidos Nucleicos , Neoplasias Cutáneas/tratamiento farmacológico , Antineoplásicos/química , Antineoplásicos/farmacología , Resistencia a Múltiples Medicamentos/efectos de los fármacos , Resistencia a Múltiples Medicamentos/genética , Resistencia a Antineoplásicos/efectos de los fármacos , Resistencia a Antineoplásicos/genética , Humanos , Melanoma/genética , Melanoma/metabolismo , Melanoma/patología , Nanopartículas/química , Nanopartículas/uso terapéutico , Ácidos Nucleicos/química , Ácidos Nucleicos/farmacología , Neoplasias Cutáneas/genética , Neoplasias Cutáneas/metabolismo , Neoplasias Cutáneas/patología
6.
Methods Mol Biol ; 2235: 1-12, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33576966

RESUMEN

In addition to intravascular dissemination, angiotropic melanoma cells have the propensity to spread along the external surface of blood vessels in a pericytic location, or pericytic mimicry. Such continuous migration without intravasation has been termed "extravascular migratory metastasis" or EVMM. In order to visualize this mechanism of tumor propagation, we used a murine brain melanoma model utilizing green fluorescent human melanoma cells and red fluorescent lectin-tagged murine vessels. This model allows the direct microscopic visualization and mapping of the interaction of melanoma cells with the brain vasculature. In this chapter, we describe the methodology of lectin perfusion to label the entire angioarchitecture in conjunction with confocal microscopy imaging to study the pericyte mimicry of the angiotropic GFP+ melanoma cells.


Asunto(s)
Melanoma/diagnóstico por imagen , Invasividad Neoplásica/diagnóstico por imagen , Imagen Óptica/métodos , Animales , Línea Celular Tumoral , Movimiento Celular/fisiología , Femenino , Proteínas Fluorescentes Verdes/química , Inmunohistoquímica/métodos , Lectinas/química , Masculino , Melanoma/patología , Ratones , Ratones Desnudos , Microscopía Confocal/métodos , Neovascularización Patológica/patología , Perfusión/métodos , Pericitos , Neoplasias Cutáneas/patología
7.
BMJ Case Rep ; 14(2)2021 Feb 04.
Artículo en Inglés | MEDLINE | ID: mdl-33541959

RESUMEN

Perianal Paget disease (PPD) is a rare neoplastic condition defined by the presence of atypical Paget cells in the perianal skin, the aetiology of which remains largely unknown. It can be divided in primary forms, arising as an intraepithelial disease or manifestation of an underlying skin adenocarcinoma or secondary forms resulting from epidermotropic spread or metastasis of a concealed carcinoma. Indeed, because of its rarity, clear options regarding the treatment of these patients are yet to be clarified. A high level of suspicion is needed whenever dealing with any unhealed perianal skin lesions and, therefore, the need for close long-term follow-up must be highlighted. Herein, two cases of PPD, one primary and another secondary, treated at the same institution, are presented in an attempt to document the involved complexity and to bring further insight into the understanding of this entity.


Asunto(s)
Adenocarcinoma/patología , Enfermedad de Paget Extramamaria/patología , Neoplasias Cutáneas/patología , Anciano , Canal Anal/patología , Neoplasias Óseas/patología , Femenino , Humanos , Masculino , Neoplasias de Tejido Conjuntivo/patología , Enfermedad de Paget Extramamaria/terapia , Perineo/patología
8.
ACS Appl Mater Interfaces ; 13(6): 7115-7126, 2021 Feb 17.
Artículo en Inglés | MEDLINE | ID: mdl-33543935

RESUMEN

The success of cancer therapy is always accompanied by severe side effects due to the high amount of toxic antitumor drugs that off-target normal organs/tissues. Herein, we report the development of a trifunctional layered double hydroxide (LDH) nanosystem for combined photochemotherapy of skin cancer at very low therapeutic doses. This nanosystem (ICG/Cu-LDH@BSA-DOX) is composed of acid-responsive bovine serum albumin-doxorubicin prodrug (BSA-DOX) and indocyanine green (ICG)-intercalated Cu-doped LDH nanoparticle. ICG/Cu-LDH@BSA-DOX is able to release DOX in an acid-triggered manner, efficiently and simultaneously generates heating and reactive oxygen species (ROS) upon 808 nm laser irradiation, and synergistically induces apoptosis of skin cancer cells. In vivo therapeutic evaluations demonstrate that ICG/Cu-LDH@BSA-DOX nearly eradicated the tumor tissues upon one-course treatment using very low doses of therapeutic agents (0.175 mg/kg DOX, 0.5 mg/kg Cu, and 0.25 mg/kg ICG) upon very mild 808 nm laser irradiation (0.3 W/cm2 for 2 min). This work thus provides a novel strategy to design anticancer nanomedicine for efficient combination cancer treatment with minimal side effects in clinical applications.


Asunto(s)
Antibióticos Antineoplásicos/farmacología , Doxorrubicina/farmacología , Hidróxidos/farmacología , Melanoma/terapia , Fotoquimioterapia , Neoplasias Cutáneas/terapia , Animales , Antibióticos Antineoplásicos/química , Línea Celular Tumoral , Proliferación Celular/efectos de los fármacos , Cobre/química , Cobre/farmacología , Relación Dosis-Respuesta a Droga , Doxorrubicina/química , Ensayos de Selección de Medicamentos Antitumorales , Hidróxidos/química , Verde de Indocianina/química , Verde de Indocianina/farmacología , Rayos Láser , Melanoma/metabolismo , Melanoma/patología , Ratones , Estructura Molecular , Tamaño de la Partícula , Especies Reactivas de Oxígeno/metabolismo , Albúmina Sérica Bovina/química , Neoplasias Cutáneas/metabolismo , Neoplasias Cutáneas/patología , Propiedades de Superficie
9.
J Surg Oncol ; 123(3): 789-797, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33595889

RESUMEN

Surgical resection is the treatment for early cutaneous melanoma and is often curative. Some patients, however, will subsequently relapse. High-risk features in the primary tumor and regional lymph node metastasis highlight patient subsets that are at increased risk for recurrent disease. Immunotherapy in the form of checkpoint inhibitors ipilimumab, nivolumab, and pembrolizumab have been shown to improve recurrence-free survival for node-positive melanoma in the adjuvant setting and will be the focus of this review.


Asunto(s)
Inmunoterapia/métodos , Melanoma/terapia , Neoplasias Cutáneas/terapia , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Ensayos Clínicos Fase III como Asunto , Terapia Combinada , Humanos , Melanoma/inmunología , Melanoma/patología , Melanoma/cirugía , Estadificación de Neoplasias , Ensayos Clínicos Controlados Aleatorios como Asunto , Neoplasias Cutáneas/inmunología , Neoplasias Cutáneas/patología , Neoplasias Cutáneas/cirugía
10.
BMJ Case Rep ; 14(2)2021 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-33526526

RESUMEN

Pilomatrixoma is a benign subcutaneous tumour arising from the sebaceous glands. Mutation in the CTNNB1 gene is seen, suggesting beta-catenin misregulation may be the cause of pilomatrixoma. The preoperative diagnosis may be improved by the awareness of the fact that pilomatrixoma is a common and benign skin tumour of the head and neck region. It presents as a well-defined mass, which may be firm to hard in consistency, usually attached to the skin, but not to the underlying tissue. The colour of overlying skin appears a reddish-brown tinge, indicating that it could be a case of pilomatrixoma. Here, we report a case of pilomatrixoma of the cheek in a woman along with the CT findings and histopathological appearances. Dental surgeons should consider it as one of the differential diagnosis in superficial head and neck swelling with calcification.


Asunto(s)
Calcinosis/diagnóstico por imagen , Enfermedades del Cabello/diagnóstico por imagen , Neoplasias de Cabeza y Cuello/diagnóstico por imagen , Pilomatrixoma/diagnóstico por imagen , Neoplasias Cutáneas/diagnóstico por imagen , Adulto , Calcinosis/patología , Femenino , Enfermedades del Cabello/patología , Enfermedades del Cabello/cirugía , Neoplasias de Cabeza y Cuello/patología , Neoplasias de Cabeza y Cuello/cirugía , Humanos , Pilomatrixoma/patología , Pilomatrixoma/cirugía , Neoplasias Cutáneas/patología , Neoplasias Cutáneas/cirugía , Tomografía Computarizada por Rayos X
12.
BMJ Case Rep ; 14(2)2021 Feb 08.
Artículo en Inglés | MEDLINE | ID: mdl-33558380

RESUMEN

Cancers can develop the ability to evade immune recognition and destruction. Immune checkpoint inhibitors (ICIs) are drugs targeting these immune evasion mechanisms. ICIs have significantly improved outcomes in several cancers including metastatic melanoma. However, data on toxicities associated with allograft transplant recipients receiving ICI is limited. We describe a case of a 71-year-old woman who was diagnosed with metastatic melanoma 13 years after renal transplantation. She was commenced on the ICI nivolumab. She developed acute renal transplant rejection 15 days after administration of the first dose. She continues on haemodialysis but has demonstrated complete oncological response. This case demonstrates the risk of acute renal transplant rejection versus improved oncological outcomes. Patients and clinicians must consider this balance when initiating ICI therapy in allograft transplant recipients. Patients should be fully consented of the potential consequences of acute renal transplant rejection including lifelong dialysis.


Asunto(s)
Antineoplásicos Inmunológicos/efectos adversos , Rechazo de Injerto/inducido químicamente , Trasplante de Riñón , Melanoma/tratamiento farmacológico , Nivolumab/efectos adversos , Neoplasias Cutáneas/tratamiento farmacológico , Anciano , Femenino , Humanos , Fallo Renal Crónico/cirugía , Neoplasias Pulmonares/tratamiento farmacológico , Neoplasias Pulmonares/secundario , Metástasis Linfática , Melanoma/patología , Cuero Cabelludo/patología , Neoplasias Cutáneas/patología , Factores de Tiempo , Trasplante Homólogo
13.
Nat Med ; 27(2): 301-309, 2021 02.
Artículo en Inglés | MEDLINE | ID: mdl-33558722

RESUMEN

The association among pathological response, recurrence-free survival (RFS) and overall survival (OS) with neoadjuvant therapy in melanoma remains unclear. In this study, we pooled data from six clinical trials of anti-PD-1-based immunotherapy or BRAF/MEK targeted therapy. In total, 192 patients were included; 141 received immunotherapy (104, combination of ipilimumab and nivolumab; 37, anti-PD-1 monotherapy), and 51 received targeted therapy. A pathological complete response (pCR) occurred in 40% of patients: 47% with targeted therapy and 33% with immunotherapy (43% combination and 20% monotherapy). pCR correlated with improved RFS (pCR 2-year 89% versus no pCR 50%, P < 0.001) and OS (pCR 2-year OS 95% versus no pCR 83%, P = 0.027). In patients with pCR, near pCR or partial pathological response with immunotherapy, very few relapses were seen (2-year RFS 96%), and, at this writing, no patient has died from melanoma, whereas, even with pCR from targeted therapy, the 2-year RFS was only 79%, and OS was only 91%. Pathological response should be an early surrogate endpoint for clinical trials and a new benchmark for development and approval in melanoma.


Asunto(s)
Melanoma/tratamiento farmacológico , Recurrencia Local de Neoplasia/tratamiento farmacológico , Proteínas Proto-Oncogénicas B-raf/genética , Neoplasias Cutáneas/tratamiento farmacológico , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Protocolos de Quimioterapia Combinada Antineoplásica/administración & dosificación , Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Supervivencia sin Enfermedad , Femenino , Humanos , Inmunoterapia/efectos adversos , Ipilimumab/administración & dosificación , Ipilimumab/efectos adversos , Masculino , Melanoma/genética , Melanoma/inmunología , Melanoma/patología , Persona de Mediana Edad , Terapia Molecular Dirigida , Terapia Neoadyuvante/efectos adversos , Recurrencia Local de Neoplasia/genética , Recurrencia Local de Neoplasia/inmunología , Recurrencia Local de Neoplasia/patología , Nivolumab/administración & dosificación , Nivolumab/efectos adversos , Receptor de Muerte Celular Programada 1/antagonistas & inhibidores , Receptor de Muerte Celular Programada 1/genética , Neoplasias Cutáneas/genética , Neoplasias Cutáneas/inmunología , Neoplasias Cutáneas/patología , Adulto Joven
15.
Medicine (Baltimore) ; 100(5): e24284, 2021 Feb 05.
Artículo en Inglés | MEDLINE | ID: mdl-33592872

RESUMEN

BACKGROUND: Head and neck melanomas (HNMs) behave differently from cutaneous melanomas in other sites, and the efficacy of sentinel lymph node biopsy (SLNB) for patients with HNMs remains controversial. METHODS: Studies on prognosis following SLNB were included. The prognostic role of SLNB and other potential predictors were analyzed using pooled relative risk (RR) or hazard ratio (HR). RESULTS: Pooled statistics showed that SLNB improved overall survival of HNMs patients (HR = 0.845; 95% CI: 0.725-0.986; P = .032). The positive status of SN was proved as a risk factor of poor prognosis in HNMs (HR = 3.416; 95% CI: 1.939-6.021; P < .001). SLNB did not have significant correlation with lower recurrences (RR = .794; 95% CI: 0.607-1.038; P = .091). CONCLUSIONS: SLNB is associated with better overall survival and the SN status is a promising risk factor of poor prognosis for HNMs patients.


Asunto(s)
Neoplasias de Cabeza y Cuello/patología , Melanoma/patología , Biopsia del Ganglio Linfático Centinela/métodos , Neoplasias Cutáneas/patología , Humanos , Pronóstico , Medición de Riesgo/métodos
16.
J Med Case Rep ; 15(1): 69, 2021 Feb 17.
Artículo en Inglés | MEDLINE | ID: mdl-33593408

RESUMEN

BACKGROUND: Retiform Hemangioendothelioma (RH) is an extremely rare vascular tumor of intermediate biological behavior, which is prone to local recurrence but rarely shows metastasis to distant sites. It may harbor areas resembling Dabska tumor in some cases and angiosarcoma, which in its well differentiated form may exhibit similar pathological appearance in some areas, making it problematic to rule out a possibility of a malignant diagnosis on a core biopsy. Therefore, complete surgical resection with negative margins is essential for accurate diagnosis and local control. RESULTS: In our series, two of the three Pakistani cases were in females, with an age range between 18 and 50 years. Our first patient presented with symptoms of cardiac compromise and pulmonary hypertension. Her computed tomography scan showed multiple tumor masses within the mediastinum. The second patient presented with an ulcerated lesion on his scalp, at right temple. The third patient presented with a hard growth on her left 4th toe which was amputated. Histologically, all cases exhibited retiform arborizing vascular spaces lined by bland endothelial cells with hobnail nuclei, characteristic of retiform hemangioendothelioma. Immunohistochemical markers CD31, CD34 and ERG confirmed the vascular nature of the tumor. The first and the second patient are alive and healthy at 4 and 7 months follow up respectively, while the third patient is lost to follow up. CONCLUSION: Owing to the rate of local recurrence, RH should always be considered in the differential diagnosis of vascular tumors showing arborizing blood vessels, as it may have an atypical presentation and it should be carefully differentiated from Dabska tumor and an angiosarcoma.


Asunto(s)
Neoplasias de Cabeza y Cuello/diagnóstico , Hemangioendotelioma/diagnóstico , Neoplasias del Mediastino/diagnóstico , Neoplasias Primarias Múltiples/diagnóstico , Cuero Cabelludo , Neoplasias Cutáneas/diagnóstico , Adolescente , Adulto , Biopsia , Femenino , Neoplasias de Cabeza y Cuello/patología , Hemangioendotelioma/patología , Humanos , Masculino , Neoplasias del Mediastino/patología , Persona de Mediana Edad , Neoplasias Primarias Múltiples/patología , Neoplasias Cutáneas/patología , Dedos del Pie
17.
Nat Commun ; 12(1): 1214, 2021 02 22.
Artículo en Inglés | MEDLINE | ID: mdl-33619278

RESUMEN

Melanoma is the most lethal skin malignancy, driven by genetic and epigenetic alterations in the complex tumour microenvironment. While large-scale molecular profiling of melanoma has identified molecular signatures associated with melanoma progression, comprehensive systems-level modeling remains elusive. This study builds up predictive gene network models of molecular alterations in primary melanoma by integrating large-scale bulk-based multi-omic and single-cell transcriptomic data. Incorporating clinical, epigenetic, and proteomic data into these networks reveals key subnetworks, cell types, and regulators underlying melanoma progression. Tumors with high immune infiltrates are found to be associated with good prognosis, presumably due to induced CD8+ T-cell cytotoxicity, via MYO1F-mediated M1-polarization of macrophages. Seventeen key drivers of the gene subnetworks associated with poor prognosis, including the transcription factor ZNF180, are tested for their pro-tumorigenic effects in vitro. The anti-tumor effect of silencing ZNF180 is further validated using in vivo xenografts. Experimentally validated targets of ZNF180 are enriched in the ZNF180 centered network and the known pathways such as melanoma cell maintenance and immune cell infiltration. The transcriptional networks and their critical regulators provide insights into the molecular mechanisms of melanomagenesis and pave the way for developing therapeutic strategies for melanoma.


Asunto(s)
Redes Reguladoras de Genes , Melanoma/patología , Modelos Biológicos , Neoplasias Cutáneas/patología , Microambiente Tumoral , Línea Celular Tumoral , Reparación del ADN , ADN de Neoplasias/metabolismo , Regulación Neoplásica de la Expresión Génica , Silenciador del Gen , Humanos , Interferón gamma/metabolismo , Melanoma/genética , Miosina Tipo I/metabolismo , Invasividad Neoplásica , Pronóstico , Empalme del ARN/genética , ARN Mensajero/genética , ARN Mensajero/metabolismo , Reproducibilidad de los Resultados , Transducción de Señal , Neoplasias Cutáneas/genética , Análisis de Supervivencia , Microambiente Tumoral/genética , Regulación hacia Arriba/genética
18.
Medicine (Baltimore) ; 100(7): e24767, 2021 Feb 19.
Artículo en Inglés | MEDLINE | ID: mdl-33607825

RESUMEN

ABSTRACT: Cutaneous squamous cell carcinoma usually extends beyond the visible margin. Little is known about the predictors for cutaneous squamous cell carcinoma with subclinical extension in Chinese individuals. This study aimed to construct a nomogram for predicting the probability of subclinical extension of cutaneous squamous cell carcinoma in Chinese patients.A retrospective analysis was conducted using data from Mohs micrographic surgery-treated cutaneous squamous cell carcinoma patients at a single institution between December 1, 2009 and October 31, 2019. Subclinical extension was defined as a lesion requiring ≥ 2 Mohs stages or with final safe margins of ≥ 5 mm. A nomogram predicting the probability of subclinical extension was constructed using the predictors identified in multivariable analysis.Of 274 patients included, 119 (43.4%) had subclinical extension. In multivariable analysis, male sex (odds ratio [OR], 2.45; 95% confidence interval [CI], 1.40-4.29; P = .002), lesions on mucocutaneous areas (OR, 3.71; 95% CI, 1.34-10.32; P = .012) and extremities (OR, 2.40; 95% CI, 1.20-4.78; P = .013), maximum diameter of 10 to 19 mm (OR, 14.15; 95% CI, 4.24-47.28; P < .001), and 20 to 29 mm (OR, 9.21; 95% CI, 2.80-30.29; P < .001) were associated with subclinical extension. A nomogram incorporating these 3 variables demonstrated promising predictive ability (C statistics = 0.78; 95% CI, 0.67-0.89).The nomogram incorporating sex, tumor location, and maximum diameter can provide individualized prediction for subclinical extension in Chinese patients with cutaneous squamous cell carcinoma. This information may help surgeons determine appropriate margins at the first Mohs stage.


Asunto(s)
Carcinoma de Células Escamosas/cirugía , Márgenes de Escisión , Cirugía de Mohs/métodos , Nomogramas , Neoplasias Cutáneas/cirugía , Anciano , Anciano de 80 o más Años , Carcinoma de Células Escamosas/patología , Estudios de Casos y Controles , China , Femenino , Humanos , Masculino , Persona de Mediana Edad , Recurrencia Local de Neoplasia/patología , Estudios Retrospectivos , Factores de Riesgo , Neoplasias Cutáneas/patología
19.
J Zoo Wildl Med ; 51(4): 1025-1034, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33480586

RESUMEN

Mast cell tumors in nondomestic felids are rarely reported and their biological characteristics are not well described. A retrospective review of the pathology records of 52 zoo-housed cheetahs (Acinonyx jubatus) identified five cases of mast cell tumor, involving four closely related individuals. The age at initial presentation varied from 14 mo to 6 yr. Four cases presented as solitary or multiple cutaneous masses that were mostly slow growing, up to 20 mm diameter, and predominantly nonulcerated. The diagnosis was made by fine needle aspiration cytology of a lesion in one case and by excisional biopsy in the others. Histopathologically, the lesions resembled low- to intermediate-grade canine mast cell tumors, with variations in the degree of anisocytosis and anisokaryosis. Surgical excision was incomplete for 80% of the cutaneous lesions, but local recurrence was not observed in any case. One animal with cutaneous lesions subsequently developed fatal visceral mastocytosis involving the spleen, liver, and adrenal gland. There was no evidence of lymph node invasion or paraneoplastic gastrointestinal signs in any of the cases.


Asunto(s)
Acinonyx , Mastocitoma/veterinaria , Neoplasias Cutáneas/veterinaria , Animales , Femenino , Masculino , Mastocitoma/patología , Mastocitoma/cirugía , Neoplasias Cutáneas/patología , Neoplasias Cutáneas/cirugía
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