Preoperative evaluation of sentinel lymph node status in melanoma by means of (99m)Tc-MIBI and lymphoscintigraphy: a case report.

Previous reports have shown that (99m)Tc-sestamibi (MIBI) could detect clinically occult metastatic melanoma lesions. This article reports on a patient with invasive melanoma of the right heel in whom the sentinel node status was preoperatively evaluated with this tracer. Although regional lymph nodes were clinically negative, (99m)Tc-MIBI scintigraphy showed focal increased tracer uptake in the right groin that corresponded to the location of 2 sentinel nodes visualized by lymphoscintigraphy with (99m)Tc-colloidal rhenium sulfide performed the same day. A gamma-probe was used intraoperatively to guide the excision of the sentinel nodes that were further classified as metastatic by histopathology. This double-technique approach is technically feasible and has the potential of selecting a group of patients who might benefit from a selective complete lymphadenectomy.

Scintigraphic evaluation of malignant melanoma lesions with Tc-99m tetrofosmin.

Two cases of malignant melanoma (primary and metastatic lesions) imaged with Tc-99m tetrofosmin are reported. One patient showed intense uptake in a primary skin lesion of the thorax, and the other patient had accumulation in skin, cerebellum, breast, and lymph node metastases. Like Tc-99m MIBI, Tc-99m tetrofosmin imaging may be of clinical relevance in the evaluation of suspicious skin lesions and in patients with known cutaneous malignant melanoma in the assessment of recurrent disease during follow-up evaluation.

Detection of recurrent malignant melanoma with 99mTc-MIBI scintigraphy.

Initial reports suggest that 99mTc-methoxyisobutylisonitrile (MIBI) scanning may be of clinical value in staging patients with malignant melanoma. We carried out a study to evaluate the potential of this technique in the detection of recurrent disease. Whole-body 99mTC-MIBI scans were performed in 81 patients with a history of a surgically excised MM: 28 with known recurrent lesions and 53 during follow-up without evidence of disease. Images started 10 min post-injection, using a dose of 740 MBq. Diagnoses were confirmed by cytological/histological examination or at least one conventional imaging modality. Blinded interpretations of the MIBI scans were performed. Whole-body MIBI scanning correctly detected 68 (92%) of 74 metastatic lesions in the following sites: regional lymph nodes (n=23), non-regional lymph nodes (n=10), skin (n=16), brain/cerebellum (n=6), lung (n=8), bone (n=4) and breast (n=1). The technique failed to detect three subcutaneous regressive lesions (< 1 cm), one liver metastasis, one spleen metastasis and a case of multiple small lesions of the duodenal mucous membrane. In 14 patients the procedure detected previously unknown metastatic lesions. These results suggest that 99mTc-MIBI scanning is an effective imaging modality for whole-body screening of metastatic disease in malignant melanoma patients with the potential to influence treatment planning.

Scintigraphic detection of invasive cutaneous malignant melanoma with Tc-99m MIBI.

Malignant melanoma is a relatively uncommon cancer of increasing incidence. The authors report on two cases of malignant melanoma lesions (primary and lymph node metastasis) imaged with Tc-99m MIBI. One patient revealed intense accumulation of the radiotracer in a primary skin lesion of the thorax, whereas the other patient showed increased Tc-99m MIBI uptake in a lymph node metastasis of the neck. Tc-99m MIBI imaging could be helpful in the evaluation of patients with suspicious skin lesions and in patients with known cutaneous malignant melanoma, in the investigation of lymph nodal invasion, local recurrence, and metastatic spread.

[Bazex's para-neoplastic acrokeratosis. A clinical case with hyperpigmentation]. / Acroqueratosis paraneoplásica de Bazex. Un caso clínico con hiperpigmentación.

We studied a white skin type 3 male patient aged 68 years old with a paraneoplastic acrokeratosis of Bazex, suffering from an oesophagus neoplasm. Cutaneous manifestations preceded in months the cancer. Dermatosis affected fingers of hands and feet, soles, nose and helix. Black melanic hyperpigmentation was the first cutaneous sign and were followed by an hyperkeratosis, becoming the most clinical characteristic of the syndrome. The sequence of these signs induces us to suggest that hormonal factors elaborated by the tumoral cells are the ones responsible for the pigmentary changes since they appeared before the hyperkeratosis.

Adenocarcinoma mucinoso primario del piel / Primary mucious adenocarcinma of skin

Se presenta el caso de un adenocarcinoma mucionoso primitivo de piel, ubicado en la mejilla, con historia de 9 años de evolución signada por la recidiva lesional. Se hace una consideración y análisis de la literatura. La negatividad del antígeno carcino embrionario sugiere una línea de diferenciación más primitiva, quizás de una etapa precoz del germen epitelial (AU)

Adenocarcinoma mucinoso primario del piel / Primary mucious adenocarcinma of skin

Se presenta el caso de un adenocarcinoma mucionoso primitivo de piel, ubicado en la mejilla, con historia de 9 años de evolución signada por la recidiva lesional. Se hace una consideración y análisis de la literatura. La negatividad del antígeno carcino embrionario sugiere una línea de diferenciación más primitiva, quizás de una etapa precoz del germen epitelial

Sindrome de Gorham: presentación de un caso con linfangiomatosis y osteolisis progresiva / Gorham syndrome: presentation of a case with lymphangiomatosis and progressive osteolysis

En definitiva se trata de un Síndrome de Gorham, con osteolisis masiva de cintura pelviana y lesiones de piel características. Desde el punto de vista histopatológico, se trata de un tumor vascular linfático sin malignidad citológica, pero arquitecturalmente de carácter disecante e infiltrante, biológicamente maligno, originado en restos embrionários. Actuarían eventualmente como factores inductores de su desarrollo el traumatismo y estímulos de carácter hormonal

Sindrome de Gorham: presentación de un caso con linfangiomatosis y osteolisis progresiva / Gorham syndrome: presentation of a case with lymphangiomatosis and progressive osteolysis

En definitiva se trata de un Síndrome de Gorham, con osteolisis masiva de cintura pelviana y lesiones de piel características. Desde el punto de vista histopatológico, se trata de un tumor vascular linfático sin malignidad citológica, pero arquitecturalmente de carácter disecante e infiltrante, biológicamente maligno, originado en restos embrionários. Actuarían eventualmente como factores inductores de su desarrollo el traumatismo y estímulos de carácter hormonal (AU)

[Keratosis palmaris and visceral cancer]. / Queratosis palmar y cáncer visceral.

The authors describe the clinical and histological characteristics of palmar keratose associated to visceral cancer. Their clinical forms are small and numerous keratotic rings, large papulae, 4 to 8 mm., scarce two or three lesions and multiple punctiform depressions. The histology shows a compact orthokeratotic hiperkeratosis accompanied in a variable way to an epidermic depression. In a strict sense it is not a paraneoplase, it is a clinic visceral cancer marker. It is suggested to name it oncogenic lenticular acrokeratose.

[Epidemiologic aspects of cancer of the skin in Uruguay]. / Aspectos epidemiológicos del cáncer de piel en Uruguay.

The authors describe the demographic characteristics of Uruguay. The annual rate of mortality by skin cancer, except melanoma, is of 0.6 100,000 inhabitants. It has been calculated an incidence of 725 new cases a year. The Oncology Institute casuistic of 361 cases recorded from 1973 to 1978 show a promedial age of 65 years, all of white race, with neat predominance of male sex for epitheliomes of exposed areas and identical distribution for those of truck and limbs. Most of the patients with head and neck tumours were from rural areas. All this data confirm that the sunlight is the principal induction factor of non melanoma skin cancer in Uruguay.

[Dysplasic nevus syndrome]. / Síndrome nevos displásicos.

We present a case of malignant melanoma arising in a pacient we postulate as a "nevus dysplasia" syndrome carrier. A revision is realized about the subject emphasithing the importance in the recognition and correct valuation of the entity, that is essential for the malignant melanoma prophylaxis.

[Basal cell epitheliomas of the extremities. Presentation of 16 cases]. / Epiteliomas basocelulares de los miembros. Presentación de 16 casos.

The authors study 16 cases of basal cell epithelioma of the limbs, 5 from the upper ones and 11 of the lower ones. They expose their particular clinical characteristics which have not been shown at bibliography there are studied. Are atypical forms all the distal or acral sectors: erythemato-squamous, exofitic and nodular without melanic pigmentation, pearl papulae or telangiectasis, which makes difficult a precise diagnosis. Proximal limb lesions shown the typical semiology of basal cell epitheliomas of head and neck. The exofitic forms have fasted evolution, while the others grow slowly. Histologically it has been demonstrated a clear predominance of solid undifferentiated forms: 12/16. The statistical studies suggest an increase of basal cell epithelioma of the limbs during the lats quinquenium, probably related to a more intensive exposition to sunlight.

[Change in the turnover of HLA ABC molecules in circulating T lymphocytes in mycosis fungoides]. / Alteración del recambio de moléculas HLA ABC en linfocitos T circulantes de micosis fungoides.

The turnover of HLA ABC molecules at T and B lymphocyte surface was analyzed in five cases with mycosis fungoides and six healthy controls. The patients had only skin lesions and are staged from T1 to T3 and No, Bo and Mo. The turnover was analyzed by mean of the decrease of the lysis by complement on sensitisized cells with anti HLA ABC antibodies that were incubated for progressive times at 37 degrees C. The results show a largest turnover for the HLA ABC molecules all T cells surface from mycosis fungoides that was significant (PWilcoxon less than 0.01). The turnover of B cells surface was not different from mycosis fungoide and healthy controls. The observed phenomenon was not specific for mycosis fungoide or T cells because previously has been shown in others lympho-proliferative and autoimmune diseases. The authors suggest that the analyzed T lymphocyte, morphologically normal is functionally altered and the behavious could be a metabolic phenotypic marker for the T cell before his coming at skin lesions.

[Alveolar rhabdomyosarcoma of the skin]. / Rabdomiosarcoma alveolar de localización cutánea.

The authors present the case of an 18 years old male patient with a tumor localized in the skin of the nose, which had a fast evolution provoking in a month regional metastases. Histologically it proved to be an alveolar rhabdomyosarcoma. The clinical and histopathological characters are described, and considerations about the origin of this tumor are made.

[Epidermic and lymphocytary chalone receptors in psoriasis]. / Receptores de chalonas epidérmicas y linfocitarias en la psoriasis.

By Hondius-Boldingh. Laurence and Bullough, Laurence method, the activity of the epidermal chalone receptors was studied in 36 psoriasis and 36 healthy controls. The lymphocyte chalone receptors was also studied in 26 patients, by Garcia Giralt et al. and Lasalvia et al. method. The results showed that the epidermal chalone receptors are significantly decreased in the involved skin, and in a lesser degree in the uninvolved one of the patients with psoriasis. The lymphocyte chalone receptors were normal. This decreasing in the function of the epidermal chalone system by means of different "antireceptor factors", interrupt the physiological cell control of the epidermis. The absence of the chalone specific function, produces an intracelular disbalance which provokes, in particular, the high number of mitosis and the lack of terminal differentiation. These elements admit that in psoriasis there is an abnormal epidermopoyesis. Over a genetic disorder, multiple factors leading to a deffect of the cell membrane. These factors, acquired, local or systemic interfering with the receptors of membrane, would alter the cellular regulation induced my the chalones.

[Epidermic chalone receptors in psoriasis treated with retinoid:Ro 10-9359]. / Receptores de chalonas epidérmicas en psoriasis tratados con retinoide: Ro 10-9359

The epidermic chalone receptor of skin with lesion and without lesion are studied on 20 patients with active psoriasis. The testlest were performed before and two month after oral treatment with RO 10-9359. Roche. The results show significant variation with an increased a the number of receptors after treatment. As these receptors are in the cell membrane, the authors consider that RO 10-9359 action in on the membrane and its surrounding, making in possible to the epithelial cell to begin its autoregulation, autocontrol and differentiation when the specific activity of the chalones become normal.