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2.
Medicine (Baltimore) ; 98(40): e17469, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31577777

RESUMO

Skin cancer and precancerous skin lesions cause significant soft-tissue defects following tumor ablation. Recently, keystone flaps have gained popularity due to their simplicity, versatility, and reliability.We evaluated the efficacy of modified keystone flaps for soft-tissue reconstruction following skin tumor ablation in 2 medical centers.We reviewed the medical records of patients who received modified keystone flaps following the removal of skin tumors from January 2017 to December 2017. The diagnosis, site, flap size, and complications were recorded.Forty-one modified keystone flaps were evaluated, and the wound dimensions ranged from 1 cm × 1 cm to 18 cm × 9.5 cm, with an average size of 9.8 cm × 6.4 cm. With our selection strategy, specific modified keystone flaps were designed for the soft-tissue defects. The flap dimensions ranged from 2.2 cm × 1 cm to 26 cm × 10 cm, with an average size of 14.3 cm × 7.5 cm. Two patients developed minor wound dehiscence (4.9%), and 1 patient developed partial flap loss (2.4%), but all of these patients healed after local wound care without the need for surgical intervention.Our selection strategy for modified keystone flaps is a feasible and reliable option for reconstruction following skin tumor excision.


Assuntos
Carcinoma/cirurgia , Procedimentos Cirúrgicos Dermatológicos , Retalho Perfurante , Sarcoma/cirurgia , Neoplasias Cutâneas/cirurgia , Adulto , Idoso , Carcinoma/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Estudos Retrospectivos , Sarcoma/patologia , Neoplasias Cutâneas/patologia , Resultado do Tratamento
3.
An Bras Dermatol ; 94(4): 455-457, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31644621

RESUMO

Agminated nevus refers to the presence of multiple nevi grouped in a circumscribed skin area; it is rarely reported in the literature. This report presents the case of a 10-year-old female patient with a history of Langerhans cell histiocytosis, who presents multiple nevi in the lumbar and inguinal region. In the histopathological study, an atypical melanocytic nevus was reported. Wood's lamp examination discarded the presence of nevus spilus, and the diagnosis of agminated nevus was reached. The association of this type of nevus with Langerhans cell histiocytosis is rare, and only four cases were found reported in the indexed literature. The reason for this association is unknown, thus a new theory about its origin is presented here.


Assuntos
Histiocitose de Células de Langerhans/patologia , Nevo Pigmentado/patologia , Neoplasias Cutâneas/patologia , Criança , Dermoscopia , Feminino , Humanos , Região Lombossacral
4.
An Bras Dermatol ; 94(4): 458-460, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31644622

RESUMO

Melanoma is widely known as the most lethal skin cancer. Specific tumor-related mortality can be significantly reduced if diagnosis and treatment are properly performed during initial phases of the disease. The current search for biomarkers in early-stage melanomas is a high-priority challenge for physicians and researchers. We aimed to assess the immunoexpression of BRAFV600E and KIT in a case series consisting of 44 early-stage melanomas. Formalin-fixed paraffin-embedded samples were systematically evaluated using a semi-quantitative method based on scores of percentage and intensity for immunostained tumor cells. We observed significant concordance between BRAFV600E and KIT immunoexpression in thin invasive melanomas. Our findings corroborate previous evidence showing abnormal expression of proteins associated with MAPK intracellular signaling pathway in early-stage melanomas.


Assuntos
Melanoma/patologia , Proteínas Proto-Oncogênicas B-raf/análise , Proteínas Proto-Oncogênicas c-kit/análise , Neoplasias Cutâneas/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Progressão da Doença , Feminino , Humanos , Imuno-Histoquímica , Masculino , Pessoa de Meia-Idade , Proteínas Quinases Ativadas por Mitógeno/análise , Mutação , Estadiamento de Neoplasias , Proteínas Proto-Oncogênicas B-raf/genética , Proteínas Proto-Oncogênicas c-kit/genética , Estudos Retrospectivos , Adulto Jovem
5.
Magy Onkol ; 63(3): 239-245, 2019 09 18.
Artigo em Húngaro | MEDLINE | ID: mdl-31538441

RESUMO

Skin cancers represent the most common type of malignancy. The incidence rate of melanoma and non-melanoma skin cancer depicts a continuous rise worldwide, which is attributed mainly (but not exclusively) to the growing incidence of non-melanoma skin cancer in the elderly population. Most skin cancer types are sensitive to immunotherapy. Melanoma, Merkel cell carcinoma, cutaneous squamous cell carcinoma showed response rates of at least 40% for PD-1 inhibitor therapy as reported in recent articles. In this article we review the current and future immunotherapy agents and procedures for skin cancers.


Assuntos
Imunoterapia/mortalidade , Imunoterapia/métodos , Receptor de Morte Celular Programada 1/genética , Neoplasias Cutâneas/patologia , Neoplasias Cutâneas/terapia , Carcinoma de Célula de Merkel/imunologia , Carcinoma de Célula de Merkel/patologia , Carcinoma de Célula de Merkel/terapia , Carcinoma de Células Escamosas/imunologia , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/terapia , Intervalo Livre de Doença , Feminino , Humanos , Hungria , Masculino , Melanoma/imunologia , Melanoma/patologia , Melanoma/terapia , Terapia de Alvo Molecular/métodos , Prognóstico , Medição de Risco , Neoplasias Cutâneas/imunologia , Neoplasias Cutâneas/mortalidade , Análise de Sobrevida , Resultado do Tratamento
7.
Medicina (B Aires) ; 79(4): 265-270, 2019.
Artigo em Espanhol | MEDLINE | ID: mdl-31487245

RESUMO

Malignant melanoma (MM) is the more aggressive form of skin cancer with a mortality rate in Argentina 1997-2001 = 1.1/100 000 in men and 0.6 in women. BRAF proto-oncogene is focus of intense research; its mutation is one of the main tumor promoters and occurs in approximately 50% of MM. Several drugs with clinical activity on BRAF mutations have been approved. The aim of the study is to evaluate the mutational status of BRAF (exon 15) in cutaneous MM biopsies and its relationship with histopathological characteristics. We carried out an observational, retrospective study of samples fixed in formaldehyde and paraffin embedded; reviewing age, sex, diagnosis, histopathological data, tumor size and percentage, viability for molecular analysis and melanin presence. We evaluated BRAF mutations with PCR/Sanger sequencing. For statistics we used Student's t test, Chi square, Wilcoxon and Fisher's exact test. We were able to purify and sequence 76% (38/49) samples, 13/38 (34%) from women and 25/38 (66%) from men, the median age being 70 years. Most frequent location: thorax 14/35 (40%). Histological type: Superficial spreading 18/38 (47%). Clark's levels, 11/38 (29%): I-II and 27/38 (71%): III, IV and V. Breslow's median: 1.6 mm. Radial growth phase 11/38 (29%) and 27/38 (71%) vertical. Presented mutations 16/38 (42%). As reported by other authors, no association was found between the mutational state of exon 15 and clinical or histopathological parameters.


Assuntos
Melanoma/genética , Mutação/genética , Proteínas Proto-Oncogênicas B-raf/genética , Neoplasias Cutâneas/genética , Adulto , Idoso , Idoso de 80 Anos ou mais , Análise Mutacional de DNA , Feminino , Humanos , Masculino , Melanoma/patologia , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase em Tempo Real , Estudos Retrospectivos , Neoplasias Cutâneas/patologia
9.
Anticancer Res ; 39(9): 5083-5087, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31519619

RESUMO

BACKGROUND/AIM: Keratinocyte carcinoma (KC) is a marker of increased risk of other cancer types. To assess if this association exhibits a dose-response relationship, a case-control study was carried out. PATIENTS AND METHODS: This was a clinic-based study of cases with KC plus another type of cancer matched by age, race (all Caucasian), sex and histologic type to controls with KC only (n=48 matched pairs). RESULTS: Compared with the KC only group, those with KC plus another cancer had a mean number of lesions that were 43%, 35%, and 41% greater for basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and total KC, respectively. The odds ratio (OR) of developing another type of cancer increased from 1.0 to 1.09 (95% confidence interval (CI)=0.23-5.13) to 2.12 (95%CI=0.50-9.08) according to whether the patient had zero, one, or ≥two BCC lesions; for SCC, the corresponding ORs were 1.0, 1.24 (95%CI=0.48-3.24), and 1.39 (95%CI=0.29-6.61). CONCLUSION: A dose-response relationship seems to exist between the number of skin lesions and the risk of another type of cancer, but the lack of statistical significance weakens this evidence.


Assuntos
Queratinócitos/patologia , Segunda Neoplasia Primária/epidemiologia , Segunda Neoplasia Primária/etiologia , Neoplasias Cutâneas/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma Basocelular/epidemiologia , Carcinoma Basocelular/etiologia , Carcinoma Basocelular/patologia , Carcinoma de Células Escamosas/epidemiologia , Carcinoma de Células Escamosas/etiologia , Carcinoma de Células Escamosas/patologia , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Segunda Neoplasia Primária/patologia , Razão de Chances , Medição de Risco , Fatores de Risco , Neoplasias Cutâneas/patologia , South Carolina/epidemiologia
10.
Hautarzt ; 70(9): 670-676, 2019 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-31482274

RESUMO

Extramammary Paget's disease (EPD) is a rare, slowly growing, cutaneous adenocarcinoma with an incidence of 0.1-2.4 per 1,000,000 inhabitants. Histologically, EPD is characterized by the presence of epidermal Paget's cells, similarly to mammary Paget's disease. The EPD is typically divided into primary EPD (type I) and secondary EPD (type II associated with colorectal carcinoma and type III associated with urogenital carcinoma). From a clinical point of view, EPD is unspecific commonly mimicking chronic inflammatory skin disorders. This unspecific clinical picture can impede and delay the diagnosis of EPD. The treatment of choice for local EPD is the micrographically controlled excision. The extent of the infiltration of adnexal structures should be histologically determined prior to topical therapies, such as imiquimod and superficial ablative therapy. The complete excision of the tumor can be challenging due to ill-defined borders. In the metastatic stage the EPD has a poor prognosis. Controlled clinical trials for systemic treatment are still lacking.


Assuntos
Adenocarcinoma/patologia , Doença de Paget Extramamária/patologia , Neoplasias Cutâneas/patologia , Adenocarcinoma/cirurgia , Humanos , Doença de Paget Extramamária/cirurgia , Neoplasias Cutâneas/cirurgia
11.
Pol J Pathol ; 70(1): 26-32, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31556548

RESUMO

The distinction between atypical Spitz lesions, conventional melanocytic nevi including Spitz nevi, and malignant melanomas may be difficult in some cases or may even be impossible. The histological assessment of these lesions is necessary to ensure correct diagnosis and treatment. Nevertheless, pathologists may be subject to suboptimal concordance in the diagnosis of some atypical lesions. In literature, certain atypical lesions have been defined differently: the terms atypical and metastasising Spitz tumour, malignant Spitz nevus, borderline and intermediate melanocytic tumour, melanocytic tumour of uncertain malignant potential MELTUMP, and low-grade malignant melanoma have been introduced to designate this heterogeneous group of pathological entities and variants. This review focuses on some issues concerning the historical background, diagnostic state-of-the-art, evolution, and classification of these complicated lesions.


Assuntos
Melanoma/diagnóstico , Nevo de Células Epitelioides e Fusiformes/diagnóstico , Neoplasias Cutâneas/diagnóstico , Diagnóstico Diferencial , Humanos , Melanoma/patologia , Nevo de Células Epitelioides e Fusiformes/patologia , Neoplasias Cutâneas/patologia
13.
Anticancer Res ; 39(8): 4085-4093, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31366492

RESUMO

BACKGROUND/AIM: The identification of novel prognostic biomarkers for melanoma metastasis is essential to improve patient outcomes. To this aim, we characterized miRNA expression profiles in relation to metastasis in melanoma and correlated miRNAs expression with clinical-pathological factors. MATERIALS AND METHODS: MiR-145-5p, miR-150-5p, miR-182-5p, miR-203-3p, miR-205-5p and miR-211-5p expression levels were analyzed in primary cutaneous melanomas, including thin and thick melanomas, and in melanoma metastases by quantitative Real-Time PCR. RESULTS: A significantly lower miR-205-5p expression was found in metastases compared to primary melanomas. Furthermore, a progressive down-regulation of miR-205-5p expression was observed from loco-regional to distant metastasis. Significantly lower miR-145-5p and miR-203-3p expression levels were found in cases with Breslow thickness >1 mm, high Clark level, ulceration and mitotic rate ≥1/mm2 Conclusion: Our findings point to miR-205-5p as potential biomarker of distant metastases and to miR-145-5p and miR-203-3p as markers of aggressiveness in melanoma.


Assuntos
Melanoma/genética , MicroRNAs/genética , Neoplasias Cutâneas/genética , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores Tumorais/genética , Feminino , Regulação Neoplásica da Expressão Gênica/genética , Humanos , Masculino , Melanoma/patologia , Pessoa de Meia-Idade , Metástase Neoplásica , Prognóstico , Neoplasias Cutâneas/patologia
14.
Anticancer Res ; 39(8): 4393-4398, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31366535

RESUMO

BACKGROUND/AIM: Metastatic breast cancer (MBC) represents a wide spectrum of heterogeneous conditions with different secondary spread sites, time to relapse and biology. MBC is still considered an incurable disease despite the fact that survival rates have improved in the last years. Cutaneous metastases are a rare site for metastatic spread and indicate advanced disease. The aim of this study is to demonstrate the excellent therapeutic result following endocrine therapy only in MBC with just skin involvement. CASE REPORT: We present a case of an 82-year-old woman with no family history of breast cancer (BC), who was diagnosed with de novo metastatic estrogen/progesterone receptor-positive and HER2-negative invasive lobular BC. The only site of secondary spread was the skin. She was treated with just endocrine therapy for 116 months with which she achieved and maintained long-term complete clinical response (CR). DISCUSSION: To our knowledge this is the only case of lobular BC with de novo metastatic manifestation as multiple skin metastases, which achieved CR following the aromatase inhibitor treatment (anastrozole) with such impressive long-term overall survival.


Assuntos
Anastrozol/administração & dosagem , Neoplasias da Mama/tratamento farmacológico , Recidiva Local de Neoplasia/tratamento farmacológico , Neoplasias Cutâneas/tratamento farmacológico , Idoso de 80 Anos ou mais , Anastrozol/efeitos adversos , Inibidores da Aromatase/administração & dosagem , Mama/efeitos dos fármacos , Mama/patologia , Neoplasias da Mama/patologia , Intervalo Livre de Doença , Feminino , Humanos , Recidiva Local de Neoplasia/patologia , Neoplasias Cutâneas/patologia , Neoplasias Cutâneas/secundário
15.
Rev Med Liege ; 74(7-8): 436-440, 2019 Jul.
Artigo em Francês | MEDLINE | ID: mdl-31373461

RESUMO

The treatment of locally advanced or metastatic cutaneous squamous cell carcinoma (cSCC) essentially relies on surgery and eventually radiotherapy of the treated site and afferent lymph nodes. Unfortunately, some cases are no candidates for surgery or radiotherapy and a systemic treatment may be indicated. Chemotherapies are only partially efficacious and associated with potential toxicities. A recent study evaluating the efficacy and tolerance of cemiplimab, a PD1 antagonist for locally advanced and metastatic cSCC demonstrated an objective response rate of 49 % and 47 % for locally advanced and metastatic cSCC, while maintaining a response of at least 6 months of 63 % and 60 %, respectively. We present a clinical case of a patient with a locally advanced cSCC of the forehead with bone resorption and cervical lymphadenopathies. After failure of multiple surgical interventions and radiotherapies, he responded partially to cemiplimab immunotherapy with a good safety profile.


Assuntos
Anticorpos Monoclonais , Carcinoma de Células Escamosas , Neoplasias Cutâneas , Anticorpos Monoclonais/uso terapêutico , Carcinoma de Células Escamosas/tratamento farmacológico , Carcinoma de Células Escamosas/patologia , Humanos , Masculino , Neoplasias Cutâneas/tratamento farmacológico , Neoplasias Cutâneas/patologia
16.
Mol Biol (Mosk) ; 53(4): 648-653, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31397438

RESUMO

Acral melanoma is one of the most aggressive and fast-growing forms of cutaneous melanoma and is characterized by a predominant location on the palms and feet. Primary tumors, metastases, and normal tissue samples from five acral melanoma patients were examined by massive parallel sequencing, focusing on the coding regions of 4100 genes involved in the origin and progression of hereditary and oncology diseases. Somatic mutations were found in genes related to cell division, proliferation, and apoptosis (BRAF, NRAS, VAV1, GATA1, and GCM2); cell adhesion (CTNND2 and ITGB4); angiogenesis (VEGFA); and the regulation of energy metabolism (BCS1L). Comparisons of target DNA sequences between morphologically normal and primary tumor tissues and between normal and metastatic tissues identified the candidate genes responsible for rapid metastasis in acral melanoma.


Assuntos
Melanoma/genética , Melanoma/patologia , Mutação , Metástase Neoplásica/genética , Neoplasias Cutâneas/genética , Neoplasias Cutâneas/patologia , Humanos , Análise de Sequência de DNA
17.
Hautarzt ; 70(9): 677-683, 2019 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-31428801

RESUMO

Cylindromas are rare tumors of adnexal structures in adults. They are predominantly found on the scalp and face. More impressive than incidentally diagnosed solitary cylindromas are multiple tumors in patients with familial Brooke-Spiegler syndrome. If many large cylindromas appear on the head, they are termed turban tumor. Sudden growth or ulceration should raise suspicion for malignant transformation.


Assuntos
Carcinoma Adenoide Cístico/patologia , Síndromes Neoplásicas Hereditárias/patologia , Neoplasias Cutâneas/patologia , Adulto , Face , Humanos , Couro Cabeludo
18.
Hautarzt ; 70(9): 700-706, 2019 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-31428802

RESUMO

BACKGROUND: Whilst cutaneous angiosarcoma is rare tumour which primarily affects elderly patients, its management presents a significant therapeutic challenge. Indeed, complete surgical excision is often not possible due to the location and the diffuse and extensive nature of the tumour. Therefore, current treatment strategies often include chemo- and/or radiotherapy. METHODS: We report our experience of combined chemo- and radiotherapy in the clinical course of 6 patients with cutaneous angiosarcoma who were treated between 2007 and 2018. RESULTS: All patients presented non-resectable tumours and were treated with radiotherapy in combination with the administration of liposomal, pegylated doxrubicin (25 mg/m2 every 2 weeks). The mean duration of progression-free survival was 8 months (5-14 months), corresponding to an overall survival of 13 months (13-34 months). A partial response was seen in 4 patients and 1 patient developed progressive disease. One patient abandoned therapy after one administration. Two patients developed severe adverse events which led to termination of therapy after 1.5 months and 7 months, i.e. after 4 and 15 cycles respectively. DISCUSSION: Combined radio- and chemotherapy with liposomal, pegylated doxorubicin is a useful therapeutic option in the management of cutaneous angiosarcoma. Given the short-lived response rate, new treatment options are urgently required.


Assuntos
Antibióticos Antineoplásicos/uso terapêutico , Quimiorradioterapia/métodos , Doxorrubicina/análogos & derivados , Doxorrubicina/uso terapêutico , Hemangiossarcoma/terapia , Neoplasias Cutâneas/terapia , Administração Metronômica , Idoso , Hemangiossarcoma/patologia , Humanos , Lipossomos , Polietilenoglicóis/uso terapêutico , Neoplasias Cutâneas/patologia , Taxa de Sobrevida , Resultado do Tratamento
19.
Hautarzt ; 70(9): 661-669, 2019 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-31468069

RESUMO

Atypical fibroxanthoma (AFX) or undifferentiated pleomorphic sarcoma (UPS) is a rare malignant neoplastic disease of the skin. At the beginning of the 1960s AFX was described as an independent entity and superficial variant of malignant fibrous histiocytoma (MFH). Since then, many controversies on the classification have arisen mainly because in many cases dedifferentiated neoplasms from other origins were falsely diagnosed as AFX. A relevant deep expansion, the invasion of nerves and vessels or the presence of tumor necrosis are described as being typical for UPS; however, in the first-line they represent risk factors for recurrence. In view of the clinical and histological features it is meaningful to consider AFX and UPS as one disease. In recent years many studies on the molecular pathological background have attempted to make a better classification of the neoplasm, without being able to so far name a certain specific histopathological or molecular pathological characteristic. The AFX/UPS is still in essence a morphological and immunohistochemical diagnosis by exclusion.


Assuntos
Histiocitoma Fibroso Maligno/patologia , Neoplasias Cutâneas/patologia , Diagnóstico Diferencial , Humanos , Recidiva Local de Neoplasia , Patologia Molecular
20.
Hautarzt ; 70(9): 684-690, 2019 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-31468071

RESUMO

BACKGROUND: Merkel cell carcinoma (MCC) is a rare but aggressive form of skin cancer in which Merkel cell polyomavirus infection and chronic exposure to ultraviolet radiation are key risk factors. Immune checkpoint inhibition has revolutionized the treatment of locally advanced, inoperable and metastatic MCC. AIM: To outline the modern management of MCC based on advances in our understanding of MCC tumour biology and the development of immune checkpoint inhibitors, namely inhibitors of programmed cell death protein (PD)-1- and PD­1 ligand 1 (PD-L1). METHODS: A review of the scientific literature listed in PubMed. RESULTS: First line therapy with the PD-L1 blocking antibody avelumab is associated with a response rate of 62%. In the second line setting, for example after chemotherapy, the response rate only reaches 33%. However, in patients who responded in the second line setting, 69% remained relapse free after 2 years. Treatment responses occurred on average after 6.1 weeks of therapy. First line treatment with pembrolizumab (anti-PD­1 antibody) is associated with a 2-year survival rate of 69% and the median survival rate has not been reached. Whilst the various chemotherapy regimens are associated with similar response rates, these are typically short lived. DISCUSSION: Checkpoint inhibition offers an effective treatment option for patients with MCC. Avelumab is currently licensed as a treatment for metastatic disease. Chemotherapy remains an option to reduce tumor load, or in the context of resistance and/or contraindications to immune checkpoint therapy. Adjuvant and neoadjuvant use of checkpoint inhibition in MCC may represent a future treatment strategy pending the results of on-going clinical trials.


Assuntos
Anticorpos Monoclonais/administração & dosagem , Carcinoma de Célula de Merkel/tratamento farmacológico , Carcinoma de Célula de Merkel/imunologia , Neoplasias Cutâneas/tratamento farmacológico , Neoplasias Cutâneas/imunologia , Anticorpos Monoclonais/efeitos adversos , Antineoplásicos/administração & dosagem , Antineoplásicos/efeitos adversos , Antígeno B7-H1/antagonistas & inibidores , Carcinoma de Célula de Merkel/patologia , Humanos , Recidiva Local de Neoplasia , Neoplasias Cutâneas/patologia , Resultado do Tratamento , Raios Ultravioleta
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