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1.
Medicina (Kaunas) ; 57(6)2021 May 31.
Artigo em Inglês | MEDLINE | ID: mdl-34072742

RESUMO

Background and Objectives: Thus far, tumor control for choroidal melanoma after teletherapeutic radiation is clinically difficult. In contrast to brachytherapy, the tumor height does not necessarily have to shrink as a result of teletherapy. Therefore, the objective of this study was to evaluate tumor vascularization determined by color Doppler flow imaging (CDFI) as a possible approach for monitoring the therapy response after teletherapy of choroidal melanoma. Materials and Methods: A single-center retrospective pilot study of 24 patients was conducted, all of whom had been diagnosed with choroidal neoplasm, treated and followed up. Besides tumor vascularization, the following parameters were collected: age, gender, tumor entity, location, radiation dose, knowledge of relapse, tumor height, radiation-related complications, occurrence of metastases, visual acuity in logMAR. Results: The level of choroidal melanoma vascularization markedly decreased in all included subjects after treatment with the CyberKnife® technology. Initially, the level of vascularization was 2.1 (SD: 0.76 for n = 10); post-therapeutically, it averaged 0.14 (SD: 0.4). Regarding the tumor apex, CDFI sonography also demonstrated a significant tumor regression (mean value pre-therapeutically: 8.35 mm-SD: 3.92 for n = 10; mean value post-therapeutically: 4.86 mm-SD: 3.21). The level of choroidal melanoma vascularization declined in the patient collective treated with ruthenium-106 brachytherapy. The pre-therapeutic level of vascularization of 2 (SD: 0 for n = 2) decreased significantly to a level of 0 (mean: 0-SD: 0). The tumor height determined by CDFI did not allow any valid statement regarding local tumor control. In contrast to these findings, the patient population of the control group without any radiation therapy did not show any alterations in vascularization. Conclusions: Our data suggest that the determination of the tumor vascularization level using CDFI might be a useful and supplementary course parameter in the follow-up care of choroidal melanoma to monitor the success of treatment. This especially applies to robot-assisted radiotherapy using CyberKnife®. Further studies are necessary to validate the first results of this assessment.


Assuntos
Braquiterapia , Neoplasias da Coroide , Melanoma , Neoplasias da Coroide/diagnóstico por imagem , Neoplasias da Coroide/radioterapia , Neoplasias da Coroide/cirurgia , Seguimentos , Humanos , Melanoma/diagnóstico por imagem , Melanoma/radioterapia , Melanoma/cirurgia , Recidiva Local de Neoplasia , Projetos Piloto , Estudos Retrospectivos , Resultado do Tratamento
2.
BMJ Case Rep ; 14(6)2021 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-34088697

RESUMO

This case report demostrates an unusual occurence of orbital metastasis along with liver metastasis 5 years following enucleation for ciliochoroidal melanoma with no extraocular extension. It exemplifies that metastasis of the tumour can occur in the ipsilateral orbit after enucleation. Importance of close clinical follow-up after enucleation for choroidal melanoma, careful socket examination, and regular systemic metastatic workup is demonstrated. To the best of our knowledge, this is the first case report of uveal melanoma with ipsilateral orbital metastasis.


Assuntos
Neoplasias da Coroide , Melanoma , Neoplasias Uveais , Neoplasias da Coroide/diagnóstico por imagem , Neoplasias da Coroide/cirurgia , Humanos , Melanoma/cirurgia , Órbita , Neoplasias Uveais/cirurgia
4.
BMJ Case Rep ; 14(5)2021 May 27.
Artigo em Inglês | MEDLINE | ID: mdl-34045197

RESUMO

A 49-year-old gentleman presented with a 1-day history of painful deterioration of vision in his right eye. He was lifting heavy weights just before this visual loss. On examination, his vision was perception of light in that eye, with a medically uncontrollable high intraocular pressure and hyphaema almost completely filling his anterior chamber. An ultrasound performed suggested a working diagnosis of a Valsalva related 'eight ball' bleed. After an anterior chamber washout, he had another episode of bleeding three days later. A pars plana vitrectomy was performed and the sample obtained was sent off to the laboratory, revealing a choroidal melanoma. Following enucleation, the histology confirmed a large necrotic spindle cell melanoma, with a haemorrhagic background. Fortunately, no liver metastasis was found. Since his diagnosis 3 years ago, he continues to be followed up in an artificial eye clinic and has regular liver scans under the care of his oncologist.


Assuntos
Neoplasias da Coroide , Melanoma , Neoplasias Uveais , Câmara Anterior , Neoplasias da Coroide/diagnóstico , Neoplasias da Coroide/cirurgia , Humanos , Masculino , Melanoma/diagnóstico , Melanoma/cirurgia , Pessoa de Meia-Idade , Vitrectomia
5.
Kyobu Geka ; 74(5): 401-403, 2021 May.
Artigo em Japonês | MEDLINE | ID: mdl-33980805

RESUMO

A 74-year-old man had previously been treated for primary malignant melanoma of the bladder. Three years after surgery, 8 mm round nodule in the right lower lobe was found on chest computed tomography. The nodule increased to 11 mm after three months, and resected with a diagnosis of metastatic malignant melanoma. By pathology, it was diagnosed as an intrapulmonary hematoma.


Assuntos
Neoplasias Pulmonares , Melanoma , Idoso , Hematoma/diagnóstico por imagem , Hematoma/cirurgia , Humanos , Pulmão , Neoplasias Pulmonares/diagnóstico por imagem , Masculino , Melanoma/diagnóstico por imagem , Melanoma/cirurgia , Tomografia Computadorizada por Raios X
6.
Ann Surg Oncol ; 28(7): 3470-3478, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33900501

RESUMO

BACKGROUND: The utility of sentinel lymph node biopsy (SLNB) for non-ulcerated T1b melanoma is debated and associated costs are poorly characterized. Prior work using institutional registries may overestimate the incidence of nodal positivity in this population. OBJECTIVE: The aim of this study was to estimate the use of SLNB, positivity prevalence, and procedural costs in patients with non-ulcerated T1b melanoma using a population-based registry. METHODS: We identified patients with clinically node-negative, non-ulcerated melanoma 0.8-1.0 mm thick (T1b according to the 8th edition standard of the American Joint Committee on Cancer) in the Surveillance, Epidemiology, and End Results database from 2010 to 2016. The prevalence of SLNB procedures and positive sentinel nodes were calculated. Factors associated with SLNB and sentinel node positivity were assessed using logistic regression. Medicare reimbursement costs and patient out-of-pocket expenses for SLNB and wide local excision (WLE) versus WLE alone were estimated. RESULTS: Among 7245 included patients, 3835(53%) underwent SLNB, 156 (4.1%, 95% confidence interval 3.5-4.7) of whom had a positive SLNB. Younger age, >1 mitosis per mm2, female sex, and truncal tumor location were associated with higher odds of positivity. The estimated SLNB cost to identify one patient with stage III disease was $71,700 (range $54,648-$83,172). Out-of-pocket expenses for a Medicare patient were estimated to be $652 for a WLE and SLNB and $79 for a WLE alone. CONCLUSIONS: In this population-based study, only 4% of selected non-ulcerated T1b patients had a positive SLNB, which is lower than prior reports. At the population level, SLNB is associated with high costs per prognostic information gained.


Assuntos
Melanoma , Linfonodo Sentinela , Neoplasias Cutâneas , Idoso , Feminino , Humanos , Medicare , Melanoma/cirurgia , Prognóstico , Sistema de Registros , Estudos Retrospectivos , Linfonodo Sentinela/cirurgia , Biópsia de Linfonodo Sentinela , Neoplasias Cutâneas/cirurgia , Estados Unidos/epidemiologia
7.
An Bras Dermatol ; 96(3): 263-277, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33849752

RESUMO

Mohs micrographic surgery is a specialized form of skin cancer surgery that has the highest cure rates for several cutaneous malignancies. Certain skin cancers can have small extensions or "roots" that may be missed if an excised tumor is serially cross-sectioned in a "bread-loaf" fashion, commonly performed on excision specimens. The method of Mohs micrographic surgery is unique in that the dermatologist (Mohs surgeon) acts as both surgeon and pathologist, from the preoperative considerations until the reconstruction. Since Dr. Mohs's initial work in the 1930s, the practice of Mohs micrographic surgery has become increasingly widespread among the dermatologic surgery community worldwide and is considered the treatment of choice for many common and uncommon cutaneous neoplasms. Mohs micrographic surgery spares the maximal amount of normal tissue and is a safe procedure with very few complications, most of them managed by Mohs surgeons in their offices. Mohs micrographic surgery is the standard of care for high risks basal cell carcinomas and cutaneous squamous cell carcinoma and is commonly and increasingly used for melanoma and other rare tumors with superior cure rates. This review better familiarizes the dermatologists with the technique, explains the difference between Mohs micrographic surgery and wide local excision, and discusses its main indications.


Assuntos
Carcinoma Basocelular , Carcinoma de Células Escamosas , Melanoma , Neoplasias Cutâneas , Carcinoma Basocelular/cirurgia , Carcinoma de Células Escamosas/cirurgia , Humanos , Melanoma/cirurgia , Cirurgia de Mohs , Neoplasias Cutâneas/cirurgia
8.
Pan Afr Med J ; 38: 115, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33912285

RESUMO

Malignant melanoma of the vulva is a rare and aggressive tumour with dismal prognosis. It tends to recur and metastasize early. Surgical excision with or without regional lymph node dissection is still the treatment of choice with adjuvant therapy decided on a case by case. Furthermore, HIV infection has been associated with more aggressive disease. Herein we present a 45-year-old HIV-infected female patient on antiretroviral therapy who presented with vulval ulcer for one year. On examination, she had ulcerated nodule on the labia majora. Radiology showed vulvovaginal tumour without involvement of the adjacent organs. Malignant melanoma was confirmed on both the incisional biopsy and vulvectomy. She responded poorly to radiotherapy. Furthermore, she presented with recurrence and metastatic disease a month after surgery. She was lost to follow-up clinic.


Assuntos
Infecções por HIV/complicações , Melanoma/diagnóstico , Neoplasias Vulvares/diagnóstico , Fármacos Anti-HIV/administração & dosagem , Biópsia , Terapia Combinada , Feminino , Infecções por HIV/tratamento farmacológico , Humanos , Melanoma/patologia , Melanoma/cirurgia , Pessoa de Meia-Idade , Neoplasias Vulvares/patologia , Neoplasias Vulvares/cirurgia
9.
Rev. medica electron ; 43(2)mar.-abr. 2021. graf
Artigo em Espanhol | LILACS, CUMED | ID: biblio-1251945

RESUMO

El melanoma subungueal es un subgrupo del melanoma acral lentiginoso. Con frecuencia se diagnostica en etapa avanzada, dada la escasez de síntomas; de ahí que la evaluación y el tratamiento oportuno mejoran el pronóstico. Se presenta el caso de un paciente de 44 años de edad, que acude a consulta de Ortopedia con melanoniquia de tres meses de evolución. Había sido tratado en la atención primaria de salud por un hematoma secundario a un trauma directo sobre la falange distal del primer artejo del pie izquierdo. Fue seguido por consulta externa de Ortopedia y, al no experimentar una evolución adecuada, fue evaluado por la Comisión Provincial de Tumores Periféricos. Se le realizó una biopsia por punch (sacabocado), que arrojó el resultado de melanoma subungueal. Se realizó la amputación del primer artejo y del proximal del primer metatarsiano, una vez verificada la no existencia de lesiones metastásicas, con excelente resultado estético y funcional, sin mostrar recidiva en su seguimiento, a dos años de su intervención(AU)


Subungual melanoma is a subgroup of lentiginous acral melanoma. It is often diagnosed in an advanced stage by a shortage of symptoms, so timely evaluation and treatment improve prognosis. This is the case of a 44-year-old patient who goes to orthopedics with melanonichia 3 months of evolution. He had been treated for a bruise secondary to direct trauma to the distal phalanx of the first left foot ailre in primary health care. It was followed by external orthopedic consultation and by not following an adequate evolution was evaluated by the provincial commission of peripheral tumors. He was given a punch biopsy resulting in a subungual melanoma. The amputation of the first artejo and proximal first metatarsal was carried out, once verified the non-existence of metastatic lesions, with excellent aesthetic and functional result, without showing relapse in its follow-up to two years(AU)


Assuntos
Humanos , Masculino , Biópsia por Agulha/métodos , Amputação/métodos , Melanoma/cirurgia
10.
Artigo em Inglês | MEDLINE | ID: mdl-33804881

RESUMO

Mucosal melanomas of the head and neck region are uncommon pathologies that can affect the oral cavity, and are characterized by a high rate of mortality. Considering the lack of knowledge regarding risk and prognostic factors, current best clinical practice is represented by a large surgical excision with disease-free margins, eventually associated with a reconstructive flap. Indeed, given the frequent necessity of postoperative radiotherapy and fast healing process, a reconstruction of the surgical gap is advisable. Even if several flaps have been most commonly used, the submental island flap represents a valid alternative thanks to local advantages and similar oncologic outcomes compared to free flaps.


Assuntos
Neoplasias de Cabeça e Pescoço , Melanoma , Procedimentos Cirúrgicos Reconstrutivos , Humanos , Melanoma/cirurgia , Pescoço , Palato Duro/cirurgia , Estudos Retrospectivos , Retalhos Cirúrgicos/cirurgia
11.
BMJ Case Rep ; 14(4)2021 Apr 28.
Artigo em Inglês | MEDLINE | ID: mdl-33910795

RESUMO

Malignant melanoma of the anal canal is a rare and aggressive tumour associated with significant mortality. Early diagnosis and early curative surgical resection have shown to offer a survival advantage. We present a case of 53-year-old woman, who was accidentally diagnosed to have a localised lesion of malignant melanoma of the anal canal on histopathology report of the specimen of haemorrhoidectomy done for thrombosed external haemorrhoids. She refused any form of treatment and did not return for follow-up. Two years after the initial diagnosis, she presented with intestinal obstruction. The malignant melanoma had become advanced with multiple metastases to the lungs, the liver, the peritoneum and the spine. The patient underwent a diverting loop ileostomy. At the time of surgery, it was found that the primary malignant melanoma of anal canal had contiguously involved the entire large intestine up to the ileocaecal junction and hence transverse colostomy could not be done.


Assuntos
Melanoma , Segunda Neoplasia Primária , Neoplasias Cutâneas , Canal Anal , Colostomia , Feminino , Humanos , Melanoma/complicações , Melanoma/diagnóstico , Melanoma/cirurgia , Pessoa de Meia-Idade , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/cirurgia
12.
Ann Surg Oncol ; 28(7): 3480-3489, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33856603

RESUMO

BACKGROUND: Management of patients with sentinel lymph node (SLN)-positive melanoma has changed dramatically over the last few years such that completion lymph node dissection (CLND) has become uncommon, and many patients receive adjuvant immunotherapy or targeted therapy. This study seeks to characterize patterns and predictors of early recurrence in this setting. PATIENTS AND METHODS: All patients with primary cutaneous melanoma undergoing sentinel lymph node biopsy (SLNB) between 3/2016 and 12/2019 were identified. The subset with a positive SLN who did not undergo CLND were examined for further analysis of outcomes and predictors of recurrence. RESULTS: Overall, 215 patients with SLN-positive melanoma who did not have CLND were identified. Adjuvant systemic therapy was administered to 102 (47%), with 93% of this subset receiving immunotherapy (n = 95). Median follow-up from SLNB was 20 months (IQR 12-28.5 months), and 57 patients (27%) recurred during this time. The SLN basin was the most common site of recurrence (n = 38, 67% of recurrence), with isolated nodal recurrence being the most common first site of recurrent disease (n = 22, 39% of recurrence). On multivariable analysis, lymphovascular invasion (LVI) of the primary tumor, two or more involved nodes, and > 1 mm nodal deposit were independently associated with higher rates of nodal relapse. CONCLUSIONS: Nodal recurrence is a primary driver of early disease relapse for patients with SLN-positive melanoma who do not undergo CLND in the era of effective adjuvant systemic therapy. LVI, ≥ 2 nodes, or > 1 mm nodal disease identifies patients at particularly high risk of nodal relapse.


Assuntos
Melanoma , Linfonodo Sentinela , Neoplasias Cutâneas , Humanos , Excisão de Linfonodo , Melanoma/cirurgia , Recidiva Local de Neoplasia/cirurgia , Estudos Retrospectivos , Linfonodo Sentinela/cirurgia , Biópsia de Linfonodo Sentinela , Neoplasias Cutâneas/cirurgia
13.
Medicine (Baltimore) ; 100(12): e25120, 2021 Mar 26.
Artigo em Inglês | MEDLINE | ID: mdl-33761676

RESUMO

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.


Assuntos
Procedimentos Cirúrgicos Dermatológicos/mortalidade , Melanoma/mortalidade , Melanoma/cirurgia , Neoplasias Cutâneas/mortalidade , Neoplasias Cutâneas/cirurgia , Adulto , Idoso , Estudos de Coortes , Estudos Transversais , Feminino , Humanos , Masculino , Melanoma/patologia , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Pontuação de Propensão , Modelos de Riscos Proporcionais , Programa de SEER , Neoplasias Cutâneas/patologia , Resultado do Tratamento , Adulto Jovem
14.
Methods Mol Biol ; 2265: 345-359, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33704726

RESUMO

Circulating extracellular vesicles in biofluids have become an interesting approach to analyse disease biomarkers. There are multiple methods for isolation of extracellular vesicles, though differential ultracentrifugation is still considered as the gold-standard isolation technique for exosomes. Furthermore, exosomes purified by this method have been demonstrated to display functional activity in vitro and in vivo and exhibit great versatility for subsequent analysis including proteomics, electron microscopy, mass spectrometry, or nucleic acid analysis. Here, we describe the method for isolation of exosomes from lymphatic exudate (seroma) obtained postlymphadenectomy for liquid biopsy approaches.


Assuntos
Exossomos/metabolismo , Excisão de Linfonodo , Vasos Linfáticos/metabolismo , Melanoma/metabolismo , Melanoma/cirurgia , Humanos
16.
N Z Med J ; 134(1530): 30-37, 2021 02 19.
Artigo em Inglês | MEDLINE | ID: mdl-33651775

RESUMO

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.


Assuntos
Melanoma/diagnóstico , Melanoma/patologia , Nevo Pigmentado/patologia , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/patologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Instituições de Assistência Ambulatorial , Dermatologia/métodos , Erros de Diagnóstico , Feminino , Humanos , Masculino , Melanoma/cirurgia , Pessoa de Meia-Idade , Modelos Estatísticos , Invasividade Neoplásica , Nova Zelândia , Valor Preditivo dos Testes , Encaminhamento e Consulta/estatística & dados numéricos , Estudos Retrospectivos , Neoplasias Cutâneas/cirurgia , Adulto Jovem
17.
BMC Pediatr ; 21(1): 121, 2021 03 11.
Artigo em Inglês | MEDLINE | ID: mdl-33706747

RESUMO

BACKGROUND: Malignant melanoma (MM) arises predominantly after adolescence and is uncommon in children. Congenital MM in newborns is even rarer with a dearth of published literature; as a consequence, there is no uniform standard for the pathogenesis and treatment for neonatal malignant melanoma. Herein we report a case of giant congenital nodular MM in a newborn, including its clinical, imaging, pathological and molecular pathological features. This case is the largest giant congenital primary nodular malignant melanoma in utero in neonates currently reported in China. CASE PRESENTATION: A female neonatal patient was found to have a 2.97 cm× 1.82 cm×1.50 cm mass with a clear boundary at the right acromion in color Doppler ultrasound examination at 24 weeks of gestation. The mass increased to 3.0 cm×5.0 cm×9.0 cm at birth, and local ulceration was seen. MRI demonstrated that the mass was located on the right shoulder and underarm in a lobulated appearance, and surrounded the right scapula which was deformed. Clinical stage:IV(AJCC 8th Edition (2017)). α-Fetoprofein (AFP) by hematological examination: 1210ng/ml, NSE: 21.28ng/ml, LDH: 842U/L. The patient underwent surgical resection of the tumor, and was pathologically diagnosed as neonatal congenital malignant melanoma; immunohistochemistry (IHC): S-100 (+), HMB45 (+), Melan A (+), and Tyrosinase (+). Molecular pathological examination for BRAF V600E showed no mutations (Quantitative Real-time PCR, qPCR); And so were NRAS, C-kit (exons 9,11,13,14,17,18), and TERT (promoter locus, C228T and C250T) (Sanger sequencing). Non-surgical therapies were not carried out after the surgical resection of the tumor. After 6 months of follow-up, the child developed normally, and color Doppler ultrasound showed no obvious tumor growth or abnormality in the original tumor site. CONCLUSIONS: It is extremely rare to see giant congenital primary nodular MM in utero in neonates. The pathogenesis, treatment and prognosis of congenital MM need further research. The diagnosis mainly depends on histopathology and immunohistochemistry, and it needs to be differentiated from malignant lymphoma and primitive neuroectodermal tumor. The current treatment strategy for MM relies on the surgical excision of the mass. Research directed at molecular detection for genetic mutations would contribute to targeted therapy and better prognosis.


Assuntos
Melanoma , Neoplasias Cutâneas , Criança , China , Feminino , Humanos , Imuno-Histoquímica , Recém-Nascido , Melanoma/diagnóstico por imagem , Melanoma/cirurgia , Prognóstico , Neoplasias Cutâneas/diagnóstico por imagem , Neoplasias Cutâneas/cirurgia
18.
Dermatol Ther ; 34(3): e14908, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33619813

RESUMO

Due to the COVID-19 crisis, many scheduled medical and surgical activities have been suspended. This interruption to the healthcare system can negatively affect the diagnosis and management of melanoma. Neglecting melanoma throughout the outbreak may be associated with increased rates of mortality, morbidity, and healthcare expenses. We performed a retrospective review of all dermatological and surgical activity performed in our Melanoma Skin Unit between 23 February 2020 and 21 May 2020 and compared these data with those from the same period in 2019. During the lockdown period, we observed a decrease in dermatologic follow-up (DFU) (-30.2%) and in surgical follow-up (SFU) (-37%), and no modification of melanoma diagnosis (-3%). Finally, surgical excisions (SE) (+ 31.7%) increased, but sentinel lymph node biopsy (SLNB) (-29%) and lymph node dissections(LND) (-64%) decreased compared to the same period in 2019. Our experience supports the continuation of surgical and diagnostic procedures in patients with melanoma during the COVID-19 pandemic. Surgical and follow-up procedures for the diagnosis and treatment of melanoma should not be postponed considering that the pandemic is lasting for an extended period.


Assuntos
COVID-19 , Melanoma , Neoplasias Cutâneas , Controle de Doenças Transmissíveis , Humanos , Itália/epidemiologia , Excisão de Linfonodo , Melanoma/diagnóstico , Melanoma/epidemiologia , Melanoma/cirurgia , Pandemias , Estudos Retrospectivos , SARS-CoV-2 , Biópsia de Linfonodo Sentinela , Neoplasias Cutâneas/epidemiologia , Neoplasias Cutâneas/cirurgia
19.
J Surg Oncol ; 123(3): 789-797, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33595889

RESUMO

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.


Assuntos
Imunoterapia/métodos , Melanoma/terapia , Neoplasias Cutâneas/terapia , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Ensaios Clínicos Fase III como Assunto , Terapia Combinada , Humanos , Inibidores de Checkpoint Imunológico/uso terapêutico , Melanoma/imunologia , Melanoma/patologia , Melanoma/cirurgia , Estadiamento de Neoplasias , Ensaios Clínicos Controlados Aleatórios como Assunto , Neoplasias Cutâneas/imunologia , Neoplasias Cutâneas/patologia , Neoplasias Cutâneas/cirurgia
20.
Rev. bras. cir. cardiovasc ; 36(1): 112-115, Jan.-Feb. 2021. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1155784

RESUMO

Abstract A 71 year-old male with a history of multiple excisions of an initial Clark's level V melanoma of the breast followed by combined radiation and interferon treatment, as well as a recurrence, 3 years later, of a BRAF-positive tumor of the shoulder, with subsequent therapy with dabrafenib and trametinib, presented again with progressive intracardiac masses causing significant right ventricular outflow obstruction. Additionally, the patient complained of dyspnea and fatigue on exertion, thus he was scheduled for surgical resection.


Assuntos
Humanos , Masculino , Idoso , Neoplasias Cutâneas/cirurgia , Neoplasias Cardíacas/cirurgia , Neoplasias Cardíacas/diagnóstico por imagem , Melanoma/cirurgia , Melanoma/tratamento farmacológico , Mutação , Recidiva Local de Neoplasia
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