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1.
Dermatol Clin ; 40(1): 25-36, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34799033

RESUMO

Patients are commonly referred to pediatric dermatology for the evaluation of pigmented lesions. For families, pediatricians, and dermatologists alike, malignancy is the main fear. In the past few decades, there has been evolving literature to inform diagnosis and management. This article provides an update on the clinical, histopathologic, and ancillary testing for 3 categories of particularly challenging pigmented lesions: congenital melanocytic nevi, spitzoid neoplasms, and pediatric melanoma.


Assuntos
Dermatologia , Melanoma , Nevo de Células Epitelioides e Fusiformes , Neoplasias Cutâneas , Criança , Diagnóstico Diferencial , Humanos , Melanoma/diagnóstico , Nevo de Células Epitelioides e Fusiformes/diagnóstico , Neoplasias Cutâneas/diagnóstico
2.
Dermatol Clin ; 40(1): 37-49, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34799034

RESUMO

Melanonychia including melanonychia striata in children poses a diagnostic dilemma. Atypical clinical features often raise the possibility of malignancy, and a nail unit biopsy may be recommended. Commensurate with atypical clinical features, the histopathology may also appear alarming. However, accumulating data illustrate that most cases of melanonychia striata are benign and suggest that an alternate approach is often warranted for pediatric patients. Herein, we review the existing data regarding pediatric melanonychia striata and offer an evidence-based approach to its evaluation and management.


Assuntos
Melanoma , Doenças da Unha , Nevo Pigmentado , Neoplasias Cutâneas , Criança , Humanos , Melanoma/diagnóstico , Doenças da Unha/diagnóstico , Doenças da Unha/terapia , Unhas , Neoplasias Cutâneas/diagnóstico
3.
Dermatol Clin ; 40(1): 51-59, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34799035

RESUMO

Melanocytic nevi are congenital or acquired benign melanocytic neoplasms. The reason for the appearance of melanocytic nevi is not precisely known. Melanocytic nevi frequently occur in children, constituting a common reason for consultation in pediatric dermatology clinics. In our experience, many parents and caregivers present doubts and fears based more on popular beliefs than on data with valid scientific evidence. This review answers their frequently asked questions, such as the risk of malignancy, the importance of nevi location, the warning signs of malignant transformation, best prevention strategies, and optimal management, based on the most recent scientific evidence available.


Assuntos
Melanoma , Nevo Pigmentado , Nevo , Neoplasias Cutâneas , Transformação Celular Neoplásica , Criança , Humanos
4.
BMC Ophthalmol ; 21(1): 385, 2021 Nov 02.
Artigo em Inglês | MEDLINE | ID: mdl-34727878

RESUMO

BACKGROUND: To assess the impact of brachytherapy on macular microvasculature utilizing optical coherence tomography angiography (OCTA) in treated choroidal melanoma. METHODS: In this retrospective observational case series, we reviewed the recorded data of the patients with unilateral extramacular choroidal melanoma treated with ruthenium - 106 (106Ru) plaque radiotherapy with a follow-up period of more than 6 months. Automatically measured OCTA retinal parameters were analysed after image processing. RESULTS: Thirty-one eyes of 31 patients with the mean age of 51.1 years were recruited. Six eyes had no radiation maculopathy (RM). From 25 eyes with RM, nine eyes (36%) revealed a burnout macular microvasculature with imperceptible vascular details. Twenty-one non-irradiated fellow eyes from the enrolled patients were considered as the control group. Foveal and optic disc radiation dose had the highest value to predict the burnout pattern (ROC, AUC: 0.763, 0.727). Superficial and deep foveal avascular zone (FAZ) were larger in irradiated eyes in comparison to non-irradiated fellow eyes (1629 µm2 vs. 428 µm2, P = 0.005; 1837 µm2 vs 268 µm2, P = 0.021; respectively). Foveal and parafoveal vascular area density (VAD) and vascular skeleton density (VSD) in both superficial and deep capillary plexus (SCP and DCP) were decreased in all irradiated eyes in comparison with non-irradiated fellow eyes (P < 0.001). Compared with non-irradiated fellow eyes, irradiated eyes without RM had significantly lower VAD and VSD at foveal and parafoveal DCP (all P < 0.02). However, these differences at SCP were not statistically significant. CONCLUSION: The OCTA is a valuable tool for evaluating RM. Initial subclinical microvascular insult after 106Ru brachytherapy is more likely to occur in DCP. The deep FAZ area was identified as a more critical biomarker of BCVA than superficial FAZ in these patients.


Assuntos
Degeneração Macular , Melanoma , Angiofluoresceinografia , Humanos , Melanoma/radioterapia , Pessoa de Meia-Idade , Vasos Retinianos/diagnóstico por imagem , Estudos Retrospectivos , Radioisótopos de Rutênio , Tomografia de Coerência Óptica
5.
Pan Afr Med J ; 40: 24, 2021.
Artigo em Francês | MEDLINE | ID: mdl-34733392

RESUMO

Malignant melanoma is a disease with high metastatic potential which starts in melanocytes. The liver is the organ most often targeted for metastatic spread. Nonetheless, primary liver melanoma is very rare. Few cases have been described. We here report the case of a female patient with primary liver melanoma diagnosed based on liver biopsy results and confirmed by histological and immunohistochemical analyses as well as by providing a comprehensive assessment excluding other localizations.


Assuntos
Neoplasias Hepáticas/diagnóstico , Melanoma/diagnóstico , Biópsia , Feminino , Humanos , Neoplasias Hepáticas/patologia , Melanoma/patologia , Pessoa de Meia-Idade
6.
Zhonghua Yan Ke Za Zhi ; 57(11): 857-860, 2021 Nov 11.
Artigo em Chinês | MEDLINE | ID: mdl-34743472

RESUMO

Two male patients presented with painless vision loss to blindness in one eye, and the radiography examinations revealed an intraocular mass suspicious for choroidal melanoma. They underwent enucleation. The histopathological and immunohistochemical findings were compatible with the diagnosis of intraocular perivascular epithelioid cell tumor. Because of its rarity, intraocular perivascular epithelioid cell tumor is easy to be confused with other intraocular tumors on histopathological and immunohistochemical examinations. (Chin J Ophthalmol, 2021, 57: 857-860).


Assuntos
Neoplasias da Coroide , Melanoma , Neoplasias de Células Epitelioides Perivasculares , Neoplasias Uveais , Neoplasias da Coroide/diagnóstico por imagem , Humanos , Masculino , Melanoma/diagnóstico por imagem , Neoplasias de Células Epitelioides Perivasculares/diagnóstico por imagem , Neoplasias Uveais/diagnóstico por imagem , Transtornos da Visão
7.
Zhonghua Yan Ke Za Zhi ; 57(11): 861-864, 2021 Nov 11.
Artigo em Chinês | MEDLINE | ID: mdl-34743473

RESUMO

Primary orbital melanoma (POM) is a sort of extremely rare orbital malignancy. It often associates with melanin lesion such as congenital ocular melanocytosis and blue nevus. The most common clinical manifestation of POM is progressive painless proptosis. There are some difficulties in diagnosing this disease. MRI shows characteristic expression of this disease as an important way to diagnose POM, while pathology is the gold standard. Surgery is the mainstay of treatment in patients with POM. In addition, adjuvant radiotherapy and chemotherapy should be considered. This article systematically reviews the research progress of pathogenesis, clinical manifestation, auxiliary examination, differential diagnosis and treatment of POM, in order to provide some thoughts for the future study of the rare malignancy. (Chin J Ophthalmol, 2021, 57: 861-864).


Assuntos
Melanoma , Neoplasias Orbitárias , Diagnóstico Diferencial , Humanos , Imageamento por Ressonância Magnética , Melanoma/diagnóstico , Melanoma/terapia , Neoplasias Orbitárias/diagnóstico por imagem , Neoplasias Orbitárias/terapia
8.
Acta Biomed ; 92(S1): e2021112, 2021 11 04.
Artigo em Inglês | MEDLINE | ID: mdl-34747384

RESUMO

Malignant gastrointestinal melanoma is usually a metastatic lesion. We report the case of a 79-year-old female asymptomatic patient. Colonoscopy revealed one plane 15 mm pigmented lesion in the caecum. Neither CT scan of the abdomen nor right hemicolectomy revealed no metastatic disease. Histopathological examination of the surgical specimen was indicative of malignant melanoma.A set of additional enquires such as laboratory and imaging tests did not point out any suspicious lesions in the skin, eye, leptomeninges or other sites. Therefore, we made the diagnosis of primary colonic melanoma.The diagnosis of this disease is still a challange and often demanding for a multidisciplinary approach, involving the surgeon, onclogist and even immunotherapy or radiotherapy.


Assuntos
Melanoma , Neoplasias Cutâneas , Idoso , Ceco/diagnóstico por imagem , Colectomia , Diagnóstico Precoce , Feminino , Humanos , Melanoma/diagnóstico por imagem , Neoplasias Cutâneas/diagnóstico
9.
Comput Intell Neurosci ; 2021: 9409508, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34790232

RESUMO

Melanoma is a type of skin cancer that often leads to poor prognostic responses and survival rates. Melanoma usually develops in the limbs, including in fingers, palms, and the margins of the nails. When melanoma is detected early, surgical treatment may achieve a higher cure rate. The early diagnosis of melanoma depends on the manual segmentation of suspected lesions. However, manual segmentation can lead to problems, including misclassification and low efficiency. Therefore, it is essential to devise a method for automatic image segmentation that overcomes the aforementioned issues. In this study, an improved algorithm is proposed, termed EfficientUNet++, which is developed from the U-Net model. In EfficientUNet++, the pretrained EfficientNet model is added to the UNet++ model to accelerate segmentation process, leading to more reliable and precise results in skin cancer image segmentation. Two skin lesion datasets were used to compare the performance of the proposed EfficientUNet++ algorithm with other common models. In the PH2 dataset, EfficientUNet++ achieved a better Dice coefficient (93% vs. 76%-91%), Intersection over Union (IoU, 96% vs. 74%-95%), and loss value (30% vs. 44%-32%) compared with other models. In the International Skin Imaging Collaboration dataset, EfficientUNet++ obtained a similar Dice coefficient (96% vs. 94%-96%) but a better IoU (94% vs. 89%-93%) and loss value (11% vs. 13%-11%) than other models. In conclusion, the EfficientUNet++ model efficiently detects skin lesions by improving composite coefficients and structurally expanding the size of the convolution network. Moreover, the use of residual units deepens the network to further improve performance.


Assuntos
Melanoma , Dermatopatias , Neoplasias Cutâneas , Humanos , Processamento de Imagem Assistida por Computador , Melanoma/diagnóstico por imagem , Redes Neurais de Computação , Neoplasias Cutâneas/diagnóstico por imagem
10.
World J Surg Oncol ; 19(1): 327, 2021 Nov 16.
Artigo em Inglês | MEDLINE | ID: mdl-34781987

RESUMO

BACKGROUND: In-transit metastasis is considered a locoregional disease in cutaneous melanoma (CM) patients. Isolated limb perfusion (ILP) is among the treatment options in selected cases. The aim of this study was to determine the success of pre- and post-perfusion mSIS values in predicting the potential complications and the prognosis of the disease by investigating the early and long-term results of mSIS values calculated before and after ILP in CM cases with in-transit metastases. MATERIALS AND METHODS: Patients who underwent ILP within the period from 2014 to 2020 in our department were retrospectively scanned. A total of 20 patients were found to undergo ILP. The scores obtained from modified inflammation score (mSIS) were formulated according to albumin (Alb) and lymphocyte to monocyte ratio (LMR) scores. RESULTS: The mean follow-up time was 20.47 months. Complications requiring surgical intervention developed in three patients. According to the Wieberdink local toxicity classification, the majority (70%) of the patients were found to be grade II. Based on pre-perfusion mSIS values, 8 patients were classified as mSIS 0 while six patients were classified as mSIS 1 and 2. Based on post-perfusion mSIS values, 14 patients and one patient were classified as mSIS 2 (70%) and mSIS 0, respectively. Accordingly, univariate analysis showed that mSIS 1 and mSIS 2 were negative prognostic factors for mean survival in the pre-perfusion period (HR 0.162, 95% CI 0.036-0.729; p = 0.018 and HR: 0.223, 95% CI 0.049-1.019; p = 0.053) whereas albumin (Alb) and lymphocyte to monocyte ratio (LMR) were not independent prognostic factors for mean survival. CONCLUSION: The mSIS values calculated in the pre-perfusion period can give an opinion about the OS of the patients whereas post-perfusion mSIS values may predict potential surgical complications and local toxicities.


Assuntos
Melanoma , Neoplasias Cutâneas , Humanos , Inflamação , Melanoma/diagnóstico , Perfusão , Prognóstico , Estudos Retrospectivos , Neoplasias Cutâneas/diagnóstico
11.
Gerodontology ; 38(4): 445-448, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34786758

RESUMO

OBJECTIVE: To report a rare case of intraoral extensive blue nevus in an elder patient. BACKGROUND: Oral blue nevi is a well-recognised skin melanocytic neoplasm that rarely occurs in the oral cavity and may mimic melanoma in the early stages. METHODS: An incisional biopsy was performed, and the diagnosis was blue nevus. CONCLUSION: Both the clinician and pathologist must be aware of such a presentation to diagnose and treat appropriately.


Assuntos
Melanoma , Neoplasias Bucais , Nevo Azul , Neoplasias Cutâneas , Idoso , Biópsia , Diagnóstico Diferencial , Humanos , Neoplasias Bucais/diagnóstico , Nevo Azul/diagnóstico , Neoplasias Cutâneas/diagnóstico
12.
BMJ Case Rep ; 14(11)2021 Nov 02.
Artigo em Inglês | MEDLINE | ID: mdl-34728505

RESUMO

We present here the second documented case of severe immune checkpoint inhibitor-induced myocarditis successfully treated with abatacept. The patient was started on pembrolizumab for stage IIIA malignant melanoma, and after the first dose was admitted for worsening shortness of breath and weakness. Her symptoms were refractory to high-dose steroids and she decompensated rapidly necessitating cardiopulmonary resuscitation and subsequent intubation and mechanical ventilation. Intravenous immunoglobulin and plasmapheresis did not invoke significant improvement, so abatacept was then initiated. She began to show improvement and was eventually discharged to a skilled nursing facility. This case highlights a severe adverse reaction to an immunomodulator class steadily growing in its application. Providers of all specialties should be aware of the side effects and treatment options. Our case demonstrates that continued investigation into the utilisation of CTLA-4 agonists in the treatment of severe adverse reactions like myocarditis caused by pembrolizumab is required.


Assuntos
Melanoma , Miastenia Gravis , Miocardite , Abatacepte/efeitos adversos , Feminino , Humanos , Inibidores de Checkpoint Imunológico , Melanoma/tratamento farmacológico , Miastenia Gravis/induzido quimicamente , Miastenia Gravis/tratamento farmacológico , Miocardite/induzido quimicamente , Miocardite/diagnóstico , Miocardite/tratamento farmacológico
13.
BMJ Case Rep ; 14(11)2021 Nov 02.
Artigo em Inglês | MEDLINE | ID: mdl-34728513

RESUMO

A 57-year-old woman diagnosed with primary melanoma was managed with a wide variety of treatments over 18 years. Given her long history of disease, the array of therapies she has received range from those no longer recommended to those recently approved. This case highlights the extraordinary rate at which both the medical and surgical melanoma treatment landscape has evolved, alongside how professional consensus has changed over the past two decades. It also demonstrates the innovation and collaboration required between the patient and the multidisciplinary team, as well as how external factors such as national guidelines, eligibility for clinical trials and drug funding in the National Health Service (NHS) alter a management plan, presenting yet another set of challenges when managing cancer patients in the modern era.


Assuntos
Melanoma , Medicina Estatal , Feminino , Humanos , Melanoma/terapia , Pessoa de Meia-Idade
14.
J Med Case Rep ; 15(1): 555, 2021 Nov 11.
Artigo em Inglês | MEDLINE | ID: mdl-34758866

RESUMO

BACKGROUND: Pituitary metastases are rare, often deriving from lung or breast cancer owing to the upper vena cava proximity. Pituitary metastases can manifest with signs and symptoms of pituitary tumors, consequent to mass effect (headache, visual impairment) and/or hormonal alterations (hyperprolactinemia, hypopituitarism, and diabetes insipidus). Immune checkpoint inhibitors burst immunity against tumors, significantly increasing patients' survival, but their autoimmune side effects frequently involve the skin, the gastrointestinal tract, and the endocrine glands (pituitary, thyroid, pancreas). CASE PRESENTATION: A 77-year-old Caucasian man had undergone trans-nasal sphenoidal surgery for a nonsecreting pituitary macroadenoma in 2001, without remnant or endocrine deficits. In 2016, he was operated for a shoulder melanoma. In February 2018, imaging evaluation demonstrated metastases in lung, liver, and femur. Therefore, treatment with pembrolizumab (anti-programmed death 1) was scheduled in May 2018, but, before starting this therapy, a brain computed tomography performed for a sudden loss of consciousness detected a sellar mass of 17 × 12 mm, which extended to the pituitary stalk and compressed the optic chiasma. Focused magnetic resonance imaging confirmed the size and characteristics of the lesion, while emergency evaluation of the hormonal profile demonstrated an impairment of adrenal and thyroid function. The pituitary lesion demonstrated a remarkable shrinkage (8 × 6 mm), which was confirmed by subsequent imaging evaluations. CONCLUSIONS: This is the first case reporting on effectiveness of immune checkpoint inhibitors in a patient with pituitary metastasis from a melanoma.


Assuntos
Hipopituitarismo , Melanoma , Neoplasias Hipofisárias , Idoso , Anticorpos Monoclonais Humanizados , Humanos , Masculino , Melanoma/tratamento farmacológico , Hipófise , Neoplasias Hipofisárias/diagnóstico por imagem , Neoplasias Hipofisárias/tratamento farmacológico
15.
Clin Dermatol ; 39(5): 911-919, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34785022

RESUMO

The coronavirus disease 2019 (COVID-19) pandemic has led to lockdowns for much of the world. In Italy, all health procedures not directly related to COVID-19 were reduced or suspended, thus limiting patient access to hospitals. Any delay in cancer treatment presents the additional risk of tumors progressing from being curable to incurable. Specifically, melanoma survival rate strictly depends on tumor thickness, which, in turn, is a function of time. To estimate the impact on melanoma progression caused by the reduction in dermatologic services during the COVID-19 lockdown, a retrospective observational cohort study was conducted. This study was designed to compare the clinical and histologic characteristics of the primary melanomas removed in the first 2 months after the end of the lockdown (May-July 2020) in 12 Italian centers characterized by different COVID-19 case frequencies. The control group was represented by the melanomas removed during the same period in the previous 3 years. Overall, 1,124 melanomas were considered: 237 as part of the study group and 887 from the control group (average, 295), with a 20% reduction. Breslow thickness, as well as high-risk histotypes and melanomas with vertical growth, increased for all melanomas. Ulcerated and high mitotic index melanomas increased, particularly in northern Italy. In Italy, the lockdown led to a significant worsening of melanoma severity, causing a staging jump, with a consequent worsening of outcomes.


Assuntos
COVID-19 , Melanoma , Neoplasias Cutâneas , Controle de Doenças Transmissíveis , Humanos , Itália/epidemiologia , Melanoma/diagnóstico , Melanoma/epidemiologia , Estudos Retrospectivos , SARS-CoV-2 , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/epidemiologia
16.
Health Technol Assess ; 25(64): 1-178, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34792018

RESUMO

BACKGROUND: Malignant melanoma is the fifth most common cancer in the UK, with rates continuing to rise, resulting in considerable burden to patients and the NHS. OBJECTIVES: The objectives were to evaluate the effectiveness and cost-effectiveness of current and alternative follow-up strategies for stage IA and IB melanoma. REVIEW METHODS: Three systematic reviews were conducted. (1) The effectiveness of surveillance strategies. Outcomes were detection of new primaries, recurrences, metastases and survival. Risk of bias was assessed using the Cochrane Collaboration's Risk-of-Bias 2.0 tool. (2) Prediction models to stratify by risk of recurrence, metastases and survival. Model performance was assessed by study-reported measures of discrimination (e.g. D-statistic, Harrel's c-statistic), calibration (e.g. the Hosmer-Lemeshow 'goodness-of-fit' test) or overall performance (e.g. Brier score, R 2). Risk of bias was assessed using the Prediction model Risk Of Bias ASsessment Tool (PROBAST). (3) Diagnostic test accuracy of fine-needle biopsy and ultrasonography. Outcomes were detection of new primaries, recurrences, metastases and overall survival. Risk of bias was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool. Review data and data from elsewhere were used to model the cost-effectiveness of alternative surveillance strategies and the value of further research. RESULTS: (1) The surveillance review included one randomised controlled trial. There was no evidence of a difference in new primary or recurrence detected (risk ratio 0.75, 95% confidence interval 0.43 to 1.31). Risk of bias was considered to be of some concern. Certainty of the evidence was low. (2) Eleven risk prediction models were identified. Discrimination measures were reported for six models, with the area under the operating curve ranging from 0.59 to 0.88. Three models reported calibration measures, with coefficients of ≥ 0.88. Overall performance was reported by two models. In one, the Brier score was slightly better than the American Joint Committee on Cancer scheme score. The other reported an R 2 of 0.47 (95% confidence interval 0.45 to 0.49). All studies were judged to have a high risk of bias. (3) The diagnostic test accuracy review identified two studies. One study considered fine-needle biopsy and the other considered ultrasonography. The sensitivity and specificity for fine-needle biopsy were 0.94 (95% confidence interval 0.90 to 0.97) and 0.95 (95% confidence interval 0.90 to 0.97), respectively. For ultrasonography, sensitivity and specificity were 1.00 (95% confidence interval 0.03 to 1.00) and 0.99 (95% confidence interval 0.96 to 0.99), respectively. For the reference standards and flow and timing domains, the risk of bias was rated as being high for both studies. The cost-effectiveness results suggest that, over a lifetime, less intensive surveillance than recommended by the National Institute for Health and Care Excellence might be worthwhile. There was considerable uncertainty. Improving the diagnostic performance of cancer nurse specialists and introducing a risk prediction tool could be promising. Further research on transition probabilities between different stages of melanoma and on improving diagnostic accuracy would be of most value. LIMITATIONS: Overall, few data of limited quality were available, and these related to earlier versions of the American Joint Committee on Cancer staging. Consequently, there was considerable uncertainty in the economic evaluation. CONCLUSIONS: Despite adoption of rigorous methods, too few data are available to justify changes to the National Institute for Health and Care Excellence recommendations on surveillance. However, alternative strategies warrant further research, specifically on improving estimates of incidence, progression of recurrent disease; diagnostic accuracy and health-related quality of life; developing and evaluating risk stratification tools; and understanding patient preferences. STUDY REGISTRATION: This study is registered as PROSPERO CRD42018086784. FUNDING: This project was funded by the National Institute for Health Research Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol 25, No. 64. See the NIHR Journals Library website for further project information.


Assuntos
Melanoma , Neoplasias Cutâneas , Análise Custo-Benefício , Humanos , Melanoma/diagnóstico , Melanoma/cirurgia , Modelos Econômicos , Qualidade de Vida , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/cirurgia , Ultrassonografia
17.
Medicina (Kaunas) ; 57(11)2021 Nov 11.
Artigo em Inglês | MEDLINE | ID: mdl-34833446

RESUMO

Background and Objectives: Epidemiologic data show significant differences in melanoma incidence and outcomes between sexes. The role of hormonal receptors in the pathogenesis of melanocytic lesions remains unclear, thus we performed this study aiming to assess estrogen receptors expression in different melanocytic lesions. Materials and Methods: We performed a cross-sectional study that included 73 consecutively excised melanocytic lesions. Estrogen receptor alpha (ERα), beta (ERß), and G-protein coupled estrogen receptor (GPER) expression was analyzed in melanocytes and keratinocytes of common nevi, dysplastic nevi, melanoma, healthy skin margin, and in sebaceous and sweat gland cells. Results: ERß expression was higher in dysplastic nevi margin melanocytes compared to common nevi (p = 0.046) and in dysplastic nevi keratinocytes compared to melanoma keratinocytes (p = 0.021). ERß expression was significantly higher in margin melanocytes compared to melanoma melanocytes (p = 0.009). No difference in ERß expression was shown between melanocytes of three types of lesions. GPER expression was higher in nuclei and cytoplasm of dysplastic nevi (p = 0.02 and p = 0.036 respectively) and at the margin compared to melanoma. GPER expression was lower in sebaceous glands of tissue surrounding common nevi (p = 0.025) compared to dysplastic nevi. GPER expression was higher in skin margin tissue melanocytes (p = 0.016 nuclear, p = 0.029 cytoplasmic) compared to melanoma melanocytes. There were no differences in ERα expression between the melanocytic lesions. Conclusion: Further large-scale studies are warranted to investigate the potential role of ERß and GPER in the pathogenesis of melanocytic lesions.


Assuntos
Síndrome do Nevo Displásico , Melanoma , Nevo , Neoplasias Cutâneas , Estudos Transversais , Síndrome do Nevo Displásico/genética , Receptor alfa de Estrogênio/genética , Receptor alfa de Estrogênio/metabolismo , Estrogênios , Proteínas de Ligação ao GTP , Humanos , Melanoma/genética , Receptores de Estrogênio , Neoplasias Cutâneas/genética
18.
Ann Palliat Med ; 10(10): 11216-11220, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34763479

RESUMO

Melanoma is derived from malignancies of melanocytes. Anorectal melanoma differs significantly from cutaneous melanoma in clinical presentation, genetic profile, staging system, and response to treatment. Anorectal melanoma is seldom diagnosed because most melanoma occurrences are found in the skin tissues. Here, we report 1 case of advanced anorectal melanoma, including its clinical presentation, laboratory findings, imaging, surgical treatment, and pathology. The patient complained of hematochezia and tenesmus. Colonoscopy, computed tomography (CT) scan and digital rectal examination (DRE) revealed a mass near the pectinate line. The patient underwent proctectomy along with colostomy, and subsequent pathological examinations suggested anorectal melanoma with serosa involvement (positive markers: S100, HMB-45, etc.). Evidence-based analyses (single-nucleotide polymorphism (SNPs) and programmed death-ligand 1 (PD-L1) expression) were conducted on the tumor tissue to identify the sensitivity to adjuvant therapies. SNP tests suggested no definite efficacies of commonly used chemotherapeutic agents, with PD-L1 expression implying poor sensitivity to PD-L1 inhibitors. The postoperative recovery was uneventful and the patient was discharged on day 7 after admission. However, the patient refused adjuvant therapies and died 11 months after surgery. In conclusion, anorectal melanoma tends to be mistaken for other common diseases in this region owing to its non-specific clinical presentations. Multidisciplinary treatments are recommended to yield the best possible outcome, despite poor prognosis.


Assuntos
Neoplasias do Ânus , Melanoma , Neoplasias Retais , Neoplasias Cutâneas , Terapia Combinada , Humanos , Melanoma/genética , Melanoma/terapia , Neoplasias Retais/genética , Neoplasias Retais/terapia , Neoplasias Cutâneas/genética
19.
J Biomed Sci ; 28(1): 76, 2021 Nov 13.
Artigo em Inglês | MEDLINE | ID: mdl-34774050

RESUMO

BACKGROUND: Receptor tyrosine kinase-like orphan receptor 2 (ROR2) is a Wnt5a receptor aberrantly expressed in cancer that was shown to either suppress or promote carcinogenesis in different tumor types. Our goal was to study the role of ROR2 in melanoma. METHODS: Gain and loss-of-function strategies were applied to study the biological function of ROR2 in melanoma. Proliferation assays, flow cytometry, and western blotting were used to evaluate cell proliferation and changes in expression levels of cell-cycle and proliferation markers. The role of ROR2 in tumor growth was assessed in xenotransplantation experiments followed by immunohistochemistry analysis of the tumors. The role of ROR2 in melanoma patients was assessed by analysis of clinical data from the Leeds Melanoma Cohort. RESULTS: Unlike previous findings describing ROR2 as an oncogene in melanoma, we describe that ROR2 prevents tumor growth by inhibiting cell-cycle progression and the proliferation of melanoma cells. The effect of ROR2 is mediated by inhibition of Akt phosphorylation and activity which, in turn, regulates the expression, phosphorylation, and localization of major cell-cycle regulators including cyclins (A, B, D, and E), CDK1, CDK4, RB, p21, and p27. Xenotransplantation experiments demonstrated that ROR2 also reduces proliferation in vivo, resulting in inhibition of tumor growth. In agreement with these findings, a higher ROR2 level favors thin and non-ulcerated primary melanomas with reduced mitotic rate and better prognosis. CONCLUSION: We conclude that the expression of ROR2 slows down the growth of primary tumors and contributes to prolonging melanoma survival. Our results demonstrate that ROR2 has a far more complex role than originally described.


Assuntos
Ciclo Celular , Proliferação de Células , Melanoma/genética , Proteínas Proto-Oncogênicas c-akt/genética , Receptores Órfãos Semelhantes a Receptor Tirosina Quinase/genética , Proteínas Proto-Oncogênicas c-akt/metabolismo
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