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1.
Medicine (Baltimore) ; 100(10): e25047, 2021 Mar 12.
Artigo em Inglês | MEDLINE | ID: mdl-33725889

RESUMO

RATIONALE: Nevus sebaceous (NS) is a lesion caused by congenital hyperplastic disorder of the sebaceous glands. It commonly noted in the scalp and face and rarely in the trunk, neck, or oral mucosa. We present a rare case of a lesion arising in the genital region. PATIENT CONCERNS: A 47-year-old woman complained of a gradual increase in the size of her bilateral labia minora over 2 years, which affected her sexual life and caused walking difficulty. She was admitted to the Department of Obstetrics and Gynecology. On physical examination, no ulcer, discharge, and vulval or vaginal bleeding were found. The bilateral inguinal lymph nodes were not palpable, bilateral labia minora were asymmetric, and the right side was evidently bigger than the left. The labia minora had serrated edges and numerous papillae with a maximum diameter of 0.5 cm. The vagina, cervix, and uterus with its attachments were normal. Blood samples tested negative for human immunodeficiency virus, human papilloma virus, hepatitis B virus, and hepatitis C virus. DIAGNOSIS: A diagnosis of NS of the bilateral labia minora was made following histopathological examination of the resected specimen. INTERVENTION: The bilateral labia minora lesions were resected general anesthesia on August 29, 2016. The operation was successful, and intraoperative blood loss was about 10 ml. OUTCOMES: After 40 months of postoperative follow-up, no recurrence or appearance of other tumors were noted. LESSONS: We recommend surgical removal of lesions in the genital area during adolescence or before adulthood. Adolescence may be the best period for surgical intervention owing to a greater risk of malignant change in adulthood. On the other hand, surgical risk should be avoided in children considering the low incidence of malignant transformation.


Assuntos
Nevo/diagnóstico , Neoplasias das Glândulas Sebáceas/diagnóstico , Neoplasias Vulvares/diagnóstico , Diagnóstico Diferencial , Feminino , Procedimentos Cirúrgicos em Ginecologia , Humanos , Pessoa de Meia-Idade , Nevo/patologia , Nevo/cirurgia , Neoplasias das Glândulas Sebáceas/patologia , Neoplasias das Glândulas Sebáceas/cirurgia , Glândulas Sebáceas/patologia , Glândulas Sebáceas/cirurgia , Sífilis/diagnóstico , Vulva/patologia , Neoplasias Vulvares/patologia , Neoplasias Vulvares/cirurgia
4.
Dermatol Online J ; 26(3)2020 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-32609447

RESUMO

A widespread form of eruptive collagenomas in a 12-year-old man is presented for the impressive iconography, challenging differential diagnosis, and histopathological considerations associated with such rare connective tissue disorders. Syndromic forms should be carefully investigated for the different course and prognosis. Treatment is a major unsolved issue as aesthetic concerns are significant, especially in young adults.


Assuntos
Doenças do Tecido Conjuntivo/patologia , Derme/patologia , Nevo/patologia , Neoplasias Cutâneas/patologia , Dorso/patologia , Biópsia/métodos , Corantes , Fibroblastos/patologia , Humanos , Masculino , Adulto Jovem
5.
Clin Dermatol ; 38(2): 257-261, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32513406

RESUMO

Spiders have long been admired for the beauty of their webs. They are celebrated in popular culture as well as in medical eponyms. This contribution provides the historical background for three spider-related eponyms: nevus araneus (spider angioma), arachnodactyly, and the arachnoid mater. Nevus araneus was first named and described by Sir Erasmus Wilson in 1842. Arachnodactyly was described in 1896 by Antoine Marfan using the term pattes d'araignée, which means spider legs. In 1902, Emile Charles Achard proposed the term arachnodactyly for this clinical finding. The arachnoid mater had been named in 1699 by Frederik Ruysch. The clinical management of spider bites from the only two dangerous venomous spiders within the United States, the black widow spider (Latrodectus mactans) and the brown recluse spider (Loxosceles reclusa), is reviewed.


Assuntos
Aracnodactilia , Aracnoide-Máter , Epônimos , Nevo , Aranhas , Animais , Aracnodactilia/patologia , Viúva Negra , Aranha Marrom Reclusa , Humanos , Nevo/patologia , Picaduras de Aranhas/patologia
7.
Orv Hetil ; 161(15): 563-574, 2020 04 01.
Artigo em Húngaro | MEDLINE | ID: mdl-32320191

RESUMO

Our purpose is to summarize the actual knowledge about melanocytic lesions of the ocular surface (conjunctival nevus, primary acquired melanosis and conjunctival melanoma),especially their clinical appearance, differential diagnosis and treatment. Conjunctival nevus is the most common benign, conjunctival melanocytic lesion. Primary acquired melanosis mainly presents in middle-aged or elderly individuals, characterized by proliferation of melanocytes of the conjunctival epithelial layer. Conjunctival melanoma is a rare tumor, it is the second most common malignant ocular surface tumor after ocular surface squamous neoplasia and the third most common ocular malignancy following choroideal malignant melanoma and ocular surface squamous neoplasia. Early recognition and proper management of conjunctival melanoma is indispensable due to its high malignant and metastatic potential. Due to frequent recurrences, the knowledge and use of intra- and postoperative adjuvant treatment modalities, and regular follow-up are necessary. Orv Hetil. 2020; 161(15): 563­574.


Assuntos
Neoplasias da Túnica Conjuntiva/patologia , Melanócitos/patologia , Melanoma/patologia , Nevo Pigmentado/patologia , Nevo/patologia , Neoplasias Cutâneas/patologia , Idoso , Diagnóstico Diferencial , Humanos , Pessoa de Meia-Idade
8.
Cancer Res ; 80(12): 2586-2598, 2020 06 15.
Artigo em Inglês | MEDLINE | ID: mdl-32303578

RESUMO

The angiopoietin (Angpt)-TIE signaling pathway controls vascular maturation and maintains the quiescent phenotype of resting vasculature. The contextual agonistic and antagonistic Tie2 ligand ANGPT2 is believed to be exclusively produced by endothelial cells, disrupting constitutive ANGPT1-TIE2 signaling to destabilize the microvasculature during pathologic disorders like inflammation and cancer. However, scattered reports have also portrayed tumor cells as a source of ANGPT2. Employing ISH-based detection of ANGPT2, we found strong tumor cell expression of ANGPT2 in a subset of patients with melanoma. Comparative analysis of biopsies revealed a higher fraction of ANGPT2-expressing tumor cells in metastatic versus primary sites. Tumor cell-expressed Angpt2 was dispensable for primary tumor growth, yet in-depth analysis of primary tumors revealed enhanced intratumoral necrosis upon silencing of tumor cell Angpt2 expression in the absence of significant immune and vascular alterations. Global transcriptional profiling of Angpt2-deficient tumor cells identified perturbations in redox homeostasis and an increased response to cellular oxidative stress. Ultrastructural analyses illustrated a significant increase of dysfunctional mitochondria in Angpt2-silenced tumor cells, thereby resulting in enhanced reactive oxygen species (ROS) production and downstream MAPK stress signaling. Functionally, enhanced ROS in Angpt2-silenced tumor cells reduced colonization potential in vitro and in vivo. Taken together, these findings uncover the hitherto unappreciated role of tumor cell-expressed ANGPT2 as an autocrine-positive regulator of metastatic colonization and validate ANGPT2 as a therapeutic target for a well-defined subset of patients with melanoma. SIGNIFICANCE: This study reveals that tumor cells can be a source of ANGPT2 in the tumor microenvironment and that tumor cell-derived ANGPT2 augments metastatic colonization by protecting tumor cells from oxidative stress.


Assuntos
Angiopoietina-2/metabolismo , Melanoma/secundário , Nevo/patologia , Neoplasias Cutâneas/patologia , Angiopoietina-2/genética , Animais , Comunicação Autócrina , Biópsia , Linhagem Celular Tumoral , Modelos Animais de Doenças , Progressão da Doença , Feminino , Perfilação da Expressão Gênica , Técnicas de Silenciamento de Genes , Células Endoteliais da Veia Umbilical Humana , Humanos , Estimativa de Kaplan-Meier , Sistema de Sinalização das MAP Quinases , Melanoma/mortalidade , Camundongos , Espécies Reativas de Oxigênio/metabolismo , Pele/patologia , Neoplasias Cutâneas/mortalidade , Análise Serial de Tecidos , Microambiente Tumoral
10.
In Vivo ; 34(2): 703-708, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32111773

RESUMO

BACKGROUND/AIM: Differences in risk factors for melanoma between young adults (18-39 years) and middle-aged (40-60 years) are not well documented. In this study, we aimed to determine differences in risk factors and characteristics of melanoma between these groups. PATIENTS AND METHODS: This retrospective study is a review on 330 patients, including 250 middle-aged and 80 young adults, during the period 2006-2016 in the Tampere university hospital, in Finland. RESULTS: Forty-one per cent of middle-aged and 47% of young adults were defined as higher-risk patients. High nevus count was the most common host risk factor in both groups. Young were more likely to have a family history of melanoma. Middle-aged had more often excessive intermittent sun exposure and a history of sunburn. Host risk characteristics were less commonly associated with thicker melanomas. CONCLUSION: A high number of patients have host risk factors for melanoma. Several differences exist in risk factors and characteristics of melanomas between young adults and middle-aged patients.


Assuntos
Melanoma/patologia , Nevo/patologia , Neoplasias Cutâneas/patologia , Pele/patologia , Adulto , Feminino , Finlândia , Hospitais Universitários , Humanos , Masculino , Melanoma/etiologia , Pessoa de Meia-Idade , Nevo/etiologia , Estudos Retrospectivos , Medição de Risco/métodos , Medição de Risco/estatística & dados numéricos , Fatores de Risco , Pele/efeitos da radiação , Neoplasias Cutâneas/etiologia , Queimadura Solar/complicações , Adulto Jovem
13.
N Z Med J ; 133(1509): 17-27, 2020 02 07.
Artigo em Inglês | MEDLINE | ID: mdl-32027635

RESUMO

AIM: Waitemata District Health Board has implemented a new approach to the management of skin cancers by triaging lesions to specialist-trained general practitioners (GPSI) with the aim of reducing patient wait times and treatment costs. The primary outcome was to determine positive margin rates for the GP surgeons, with secondary outcome being infection rates. METHOD: A retrospective audit was conducted on all excisions (n=2,705) performed between 1 January 2016 and 31 December 2016 by the 13 WDHB GPSIs. Electronic patient records were accessed to review data. Each lesion was classified into benign, in-situ (pre-malignant) and malignant categories. Surgical margins were analysed for non-melanotic skin cancers (NMSC) and determined as positive, close or negative. Infection rates determined by microbiology results and prescribing information and time to treat analyses were conducted. RESULTS: WDHB GPSIs performed 2,705 excisions, 1,887 (69.8%) of which were malignant lesions. Among the 1,486 NMSC excised, a positive surgical margin was observed in 51 (3.4%). There were 294 (10.9%) cases of infection in 2,705 excisions. Median time to treat was 31 days across all lesions. New Zealand papers from the last two decades estimate the NMSC positive margin rate among primary care physicians varies between 16-31%; most recent papers have published rates 6.8-9.5%.European publications describe positive margin rates ranging between 13.9-33.5%. CONCLUSION: This study validates the use of surgically trained GP surgeons and shows their integral role in managing the high volume of skin cancer in New Zealand.


Assuntos
Atenção à Saúde , Medicina Geral/métodos , Clínicos Gerais/educação , Neoplasias Cutâneas/cirurgia , Carcinoma Basocelular/patologia , Carcinoma Basocelular/cirurgia , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/cirurgia , Humanos , Ceratoacantoma/patologia , Ceratoacantoma/cirurgia , Ceratose Actínica/patologia , Ceratose Actínica/cirurgia , Ceratose Seborreica/patologia , Ceratose Seborreica/cirurgia , Margens de Excisão , Auditoria Médica , Melanoma/patologia , Melanoma/cirurgia , Nevo/patologia , Nevo/cirurgia , Nova Zelândia , Garantia da Qualidade dos Cuidados de Saúde , Qualidade da Assistência à Saúde , Reoperação/estatística & dados numéricos , Estudos Retrospectivos , Neoplasias Cutâneas/patologia , Infecção da Ferida Cirúrgica/epidemiologia , Tempo para o Tratamento/estatística & dados numéricos
16.
Am J Surg Pathol ; 44(3): 357-367, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31743128

RESUMO

The accurate recognition of subtle melanomas and their distinction from benign mimics is an oft-recurring diagnostic problem, critical for patient management. Melanomas that bear resemblance to benign nevi (so-called nevoid melanomas, NMs) and benign mitotically active nevi in pregnancy (MANP) are 2 lesions particularly prone to error. Molecular data, including analysis of noncoding regions, in MANP and NM are very limited. This study sought to identify differences in clinical, pathologic, and molecular characteristics between MANP and NMs to facilitate correct diagnosis and reduce the risk of overtreatment or undertreatment. Clinicopathologic characteristics of NM (n=18) and MANP (n=30) were evaluated, and mutation data were analyzed using next-generation sequencing for available cases in each group (NM, n=8; MANP, n=12). All MANP showed innocent histopathologic characteristics apart from increased mitotic activity, frequently in both superficial and deep parts of the lesion (median dermal mitotic rate: 2/mm, range: 1 to 7/mm). All cases of NM demonstrated a characteristic nevoid silhouette, subtle atypical architectural and cytologic features, and variable mitoses (median mitotic rate: 3/mm, range: 1 to 5/mm). Median NM tumor thickness was 1.4 mm. Four of 10 NM patients with follow-up had metastatic disease, including 3 patients who developed widespread metastases, with 1 disease-related death. No other recurrences have been identified (follow-up period: 24 to 60 mo). None of the 15 MANP patients with available follow-up had a recurrence. Most NMs harbored hotspot mutations in NRAS (6/8, 75%). Noncoding mutations were significantly more common in NMs than in MANP (median: 4 vs. 0, P=0.0014). Copy number alterations were infrequent but, when present, were seen in NMs (3/8 NMs vs. 0/12 MANP). All NMs but only 1 of 12 MANP had >1 abnormality in the noncoding regions. Similar to conventional common acquired nevi, MANP mostly harbored driver BRAF mutations, while activating NRAS mutations, noncoding mutations, and copy number alterations were rare. NM and MANP have subtle but recognizable distinguishing histopathologic characteristics that are underpinned by molecular differences. Mutation analysis of targeted noncoding mutations may assist in the diagnosis of difficult lesions.


Assuntos
Biomarcadores Tumorais/genética , Melanoma/diagnóstico , Mutação , Nevo/diagnóstico , Complicações Neoplásicas na Gravidez/diagnóstico , Neoplasias Cutâneas/diagnóstico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Diagnóstico Diferencial , Erros de Diagnóstico , Feminino , Seguimentos , Perfilação da Expressão Gênica , Sequenciamento de Nucleotídeos em Larga Escala , Humanos , Masculino , Melanoma/genética , Melanoma/patologia , Pessoa de Meia-Idade , Nevo/genética , Nevo/patologia , Gravidez , Complicações Neoplásicas na Gravidez/genética , Complicações Neoplásicas na Gravidez/patologia , Neoplasias Cutâneas/genética , Neoplasias Cutâneas/patologia , Adulto Jovem
17.
Melanoma Res ; 30(2): 179-184, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-31574530

RESUMO

A large body of evidence in the scientific literature suggests that the numbers of common and atypical nevi are strong, independent risk factors for the occurrence of cutaneous malignant melanoma. Furthermore, some studies recently found an association between high nevus counts and an improved melanoma prognosis. The aim of this study was to investigate a possible relationship between the number of common and atypical nevi and melanoma prognostic factors. We carried out a retrospective analysis of patients with a histopathologically confirmed diagnosis of melanoma. These patients were treated at the Dermatology Clinic of the University of Florence from January 2000 to December 2013. The main analysis investigated the association of common and atypical nevi with Breslow thickness and ulceration. The number of nevi was investigated as a continuous variable and a categorical variable considering the median number of common nevi, given the skewness of the distribution of common nevi. We analyzed 818 melanoma patients treated from January 2000 to December 2013. We found a sex and nevi interaction: among women, thick melanomas occur more frequently in patients with a low common nevi count (<10); no association was found in men. This sex and nevi interaction was also found considering the association with very thick melanomas (Breslow > 4 mm). Moreover, the presence of an increasing number of atypical nevi was associated with increased risk of ulceration in both sexes. These data provide new perspectives in the differential sex-related biological behavior of melanoma among females and males.


Assuntos
Melanoma/patologia , Nevo/patologia , Neoplasias Cutâneas/patologia , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Fatores de Risco , Caracteres Sexuais
18.
Am J Surg Pathol ; 44(4): 503-508, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-31633488

RESUMO

The distinction of metastatic melanoma from melanocytic nevi in lymph nodes can on occasion be difficult. As diffuse immunohistochemical (IHC) PRAME (PReferentially expressed Antigen in MElanoma) expression is detected in the majority of primary and metastatic melanomas, but rarely in nevi, we reasoned that PRAME could be a useful adjunct marker for the diagnosis of melanocytes in lymph nodes. In this study, we examined 45 nodal melanocytic deposits comprising 30 nodal nevi and 15 melanoma metastases. The latter were diagnostically not straightforward because they either coexisted with nodal nevi or were present in perinodal fibrous tissue. All nodal nevi (30/30) were negative for PRAME, whereas all melanoma metastases (15/15) were diffusely positive for PRAME IHC. We additionally report the novel use of a PRAME/Melan A dual-label immunostain. Our results show that PRAME IHC may be useful in the assessment of diagnostically challenging nodal melanocytic deposits, such as intraparenchymal nodal nevi, metastases confined to the capsular fibrous tissue, or in the setting of small metastases coexisting with a nodal nevus in the same lymph node.


Assuntos
Antígenos de Neoplasias/análise , Biomarcadores Tumorais/análise , Imuno-Histoquímica , Melanoma/química , Nevo/química , Linfonodo Sentinela/química , Neoplasias Cutâneas/química , Adulto , Idoso , Idoso de 80 Anos ou mais , Diagnóstico Diferencial , Feminino , Humanos , Metástase Linfática , Masculino , Melanoma/secundário , Pessoa de Meia-Idade , Nevo/patologia , Valor Preditivo dos Testes , Linfonodo Sentinela/patologia , Neoplasias Cutâneas/patologia
19.
Pigment Cell Melanoma Res ; 33(1): 96-111, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31680437

RESUMO

Primary leptomeningeal melanocytic neoplasms represent a spectrum of rare tumors originating from melanocytes of the leptomeninges, which are the inner two membranes that protect the central nervous system. Like other non-epithelial melanocytic lesions, they bear frequent oncogenic mutations in the heterotrimeric G protein alpha subunits, GNAQ or GNA11. In this study, we used Plp1-creERT to force the expression of oncogenic GNAQQ209L in the multipotent neural crest cells of the ventro-medial developmental pathway, beginning prior to melanocyte cell differentiation. We found that this produces leptomeningeal melanocytic neoplasms, including cranial melanocytomas, spinal melanocytomas, and spinal melanomas, in addition to blue nevus-like lesions in the dermis. GNAQQ209L drove different phenotypes depending upon when during embryogenesis (E9.5, E10.5, or E11.5) it was induced by tamoxifen and which Cre driver (Plp1-creERT, Tyr-creERT2 , or Mitf-cre) was used. Given these differences, we propose that melanocytes go through temporary phases where they become sensitive to the oncogenic effects of GNAQQ209L . R26-fs-GNAQQ209L ; Plp1-creERT mice will be useful for defining biomarkers for potentially aggressive leptomeningeal melanocytomas and for developing new therapeutics for advanced disease.


Assuntos
Neoplasias do Sistema Nervoso Central/genética , Neoplasias do Sistema Nervoso Central/patologia , Subunidades alfa Gq-G11 de Proteínas de Ligação ao GTP/genética , Melanoma/genética , Melanoma/patologia , Células-Tronco Multipotentes/metabolismo , Mutação/genética , Crista Neural/metabolismo , Envelhecimento/patologia , Animais , Modelos Animais de Doenças , Progressão da Doença , Desenvolvimento Embrionário , Feminino , Masculino , Melanócitos/patologia , Neoplasias Meníngeas/patologia , Camundongos Transgênicos , Invasividade Neoplásica , Nevo/patologia , Neoplasias Cutâneas/genética , Neoplasias Cutâneas/patologia , Neoplasias Uveais/patologia
20.
Skin Res Technol ; 26(1): 99-104, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31556144

RESUMO

BACKGROUND: The frequency of nevus-associated melanoma (NAM) has been estimated to be 29% of diagnosed melanomas. MATERIALS AND METHODS: This is an observational retrospective study of 22 cases of NAM diagnosed in the Universitary Hospital Alcorcón between September 2011 and 2018. The main objective was to analyze dermoscopic and RCM features of NAM. We also studied if there was an association between any dermoscopic or RCM parameter and Breslow depth. RESULTS: The most frequent dermoscopic characteristics were multicomponent pattern (50%), multifocal pigmentation (45.5%), atypical network (59.1%), and blue-gray regression structures (77.3%). RCM evidenced pagetoid cells in 95.5% melanomas (abundant in 59.1%), non-edged dermal papillae in 86.4%, atypical cells at the dermal-epidermal junction in 90.9%, and atypical junctional nesting in 81.8%. Deeper Breslow index was associated with red color (mean Breslow 0.65 vs 0.37 in melanomas without red, P = 0.035), shiny white streaks (0.85 vs 0.38, P = 0.041), abundant pagetoid cells (0.68 vs 0.26, P = 0.017), and non-edged papillae (0.59 vs 0.00, P = 0.014). CONCLUSION: RCM is a valuable tool for diagnosing NAM. Even it is very difficult to differentiate NAM from DNM both with dermoscopy and RCM, RCM can help us to detect remnants of a preexisting nevus and estimate Breslow depth.


Assuntos
Melanoma , Nevo , Adulto , Idoso , Dermoscopia , Feminino , Humanos , Masculino , Melanoma/diagnóstico por imagem , Melanoma/epidemiologia , Melanoma/patologia , Microscopia Confocal , Pessoa de Meia-Idade , Nevo/diagnóstico por imagem , Nevo/epidemiologia , Nevo/patologia , Estudos Retrospectivos , Pele/diagnóstico por imagem , Pele/patologia
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