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A case of 77-year-old man with extramammary Paget's disease of the bilateral axillae was reported. 9 years ago, he was affected by urinary bladder carcinoma (transitional cell carcinoma, grade 1) and was treated by TUR.At first, he noticed erythema of the bilateral axillae, and subsequent some nodules on the right. As the nodules increased in number, swelling of the right arm appeared. The course had been quite rapid, and his death was caused by bacterial pneumonia after a year and a half since the first clinical appearance. In autopsy, metastasis were observed in lungs, liver, vertebral bodies, spleen, several lymph nodes and so on. It will be the first report in Japan which was died of extramammary Paget's disease of the axillae.

A late phase II study of CPT-11 was conducted to evaluate for antitumor activity and safety in patient with squamous cell carcinoma of skin (SCC) and malignant melanoma (MM) by 22 multi-institutional study group in Japan. Forty-two patients in SCC and 38 in MM were enrolled from June 1990 to November 1992. Patients were administered at a dose of 100 mg/m2 weekly by intravenous infusion.The characteristics of 41 eligible patients with SCC were median age: 67 yr. (43-86), male/female: 31/10, P.S. 0-1/2-3: 35/6, no prior therapy: 27. Thirteen patients including 2 complete responses (CRs) responded to CPT-11. The response rate was 39.4% (13/33) . Two CRs were confirmed histologically. Out of 11 partial responses (PRs) 7 was able to resect completely tumor site after the treatment. Antitumor activity was observed not only in primary site but also in distant metastases such as lungs and lymph nodes.The characteristics of 35 eligible patients with MM were median age: 55yr. (29-81), male/female: 20/15, P.S. 0-1/2-3: 32/3, prior therapy: 30 (chemotherapy 26) . Three patients were achieved PR for a response rate of 9.4% (3/32) . Out of them 2 were recurrence patients with lung metastases, having received prior chemotherapy, DAV.Major adverse reactions were nausea/vomiting, diarrhea, anorexia, leukopenia and anemia for the incidence (≥ grade 2) of 47.4% (36/76), 36.8% (28/76) and 52.6% (40/76), 56.6% (43/76) and 26.3% (20/76), respectively. These adverse reactions were well tolerable and reversible. It was thought that CPT-11 should be given carefully after confirming laboratory data and patients conditions.Inconclusion, CPT-11 is very effective against SCC, but less effective against MM in this study. Further clinical studies of CPT-11 combined with other agents are warranted.

DAPI-DNA顕微蛍光測光を用いて細胞核DNA量の観点から, 悪性黒色腫における radial and vertical growth phaseで悪性度の異なる細胞群が存在すること, 高発癌性疾患である汗孔角化症の皮疹部表皮の腫瘍性クローンが増殖, 発達し悪性化する過程を明らかにした。いずれも皮膚悪性腫瘍の多段階発展過程の一端を示すものと考えた。

顔面肩甲上腕型筋ジストロフィー, ジルベルト症候群, 出血傾向を伴った眼皮膚白皮症患者に合併した無色素性黒色腫の一例を報告した。症例: 58歳, 男性。左上磐部に急速に増大した, 局所熱感, 軽度の発赤を伴う8×7×3cm大の有痛性の皮下腫瘤。表面平滑で弾性硬, 境界不明瞭。組織学的に, 腫瘍細胞はS-100蛋白陽性の異型性の強い明澄細胞。悪性黒色腫の転移を疑い検索したところ, 右前腕に原発巣が認められた。

本邦で予後因子調査を多施設で行うことはほとんどないようである。今回, 厚生省メラノーマ研究班 (がん研究助成金による) の構成施設により予後因子を細目に分けて集計, 解析した。その特徴はTNM分類を基本とし, これに従来, 検討しなかった臨床症状, 例えば斑状, 扁平状, 腫瘤状に加え, ビラン, 潰瘍を形成した場合の予後の変動などについても記載した。また, 小切除 (全切除) , 部分切除と再切除までの期間別による予後, あるいはstageと所属リンパ節廓清の有用性の問題, 切除範囲の大きさと予後などについても解析を試みた。調査施設は9施設, 集計数は649例である。