60 results on '"Melanoma, Amelanotic diagnostic imaging"'
Search Results
2. Amelanotic melanoma in oculocutaneous albinism type 4 detected using violet-light dermoscopy.
- Author
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Kameda E, Matsuzawa T, Togawa Y, Hashimoto R, Saito T, Suzuki T, and Inozume T
- Subjects
- Humans, Male, Female, Dermoscopy, Albinism, Oculocutaneous complications, Albinism, Oculocutaneous diagnosis, Skin Neoplasms pathology, Skin Neoplasms diagnosis, Skin Neoplasms diagnostic imaging, Skin Neoplasms complications, Melanoma, Amelanotic pathology, Melanoma, Amelanotic diagnosis, Melanoma, Amelanotic diagnostic imaging, Melanoma, Amelanotic complications
- Published
- 2024
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3. Thin Amelanotic and Hypomelanotic Melanoma: Clinicopathological and Dermoscopic Features.
- Author
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Paolino G, Pampena R, Di Ciaccio SM, Carugno A, Cantisani C, Di Nicola MR, Losco L, Bortone G, Mercuri SR, Costanzo A, Ardigò M, and Valenti M
- Subjects
- Humans, Male, Middle Aged, Female, Aged, Adult, Cohort Studies, Hypopigmentation pathology, Dermoscopy methods, Melanoma, Amelanotic pathology, Melanoma, Amelanotic diagnostic imaging, Skin Neoplasms pathology, Skin Neoplasms diagnostic imaging, Melanoma diagnostic imaging, Melanoma pathology
- Abstract
Background and Objectives : Amelanotic/hypomelanotic melanomas (AHMs) account for 2-8% of all cutaneous melanomas. Due to their clinical appearance and the lack of specific dermoscopic indicators, AHMs are challenging to diagnose, particularly in thinner cutaneous lesions. The aim of our study was to evaluate the clinicopathological and dermoscopic features of thin AHMs. Identifying the baseline clinical-pathological features and dermoscopic aspects of thin AHMs is crucial to better understand this entity. Materials and Methods : We divided the AHM cohort into two groups based on Breslow thickness: thin (≤1.00 mm) and thick (>1.00 mm). This stratification helped identify any significant clinicopathological differences between the groups. For dermoscopic analysis, we employed the "pattern analysis" approach, which involves a simultaneous and subjective assessment of different criteria. Results : Out of the 2.800 melanomas analyzed for Breslow thickness, 153 were identified as AHMs. Among these, 65 patients presented with thin AHMs and 88 with thick AHMs. Red hair color and phototype II were more prevalent in patients with thin AHMs. The trunk was the most common anatomic site for thin AHMs. Patients with thin AHMs showed a higher number of multiple melanomas. Dermoscopic analysis revealed no significant difference between thin AHMs and thick AHMs, except for a more frequent occurrence of residual reticulum in thin AHMs. Conclusions : Thin AHMs typically affect individuals with lower phototypes and red hair color. These aspects can be related to the higher presence of pheomelanin, which provides limited protection against sun damage. This also correlates with the fact that the trunk, a site commonly exposed to intermittent sun exposure, is the primary anatomical location for thin AHMs. Multiple primary melanomas are more common in patients with thin AHMs, likely due to an intrinsic predisposition as well as greater periodic dermatologic follow-ups in this class of patients. Apart from the presence of residual reticulum, no other significant dermoscopic differences were observed, complicating the differential diagnosis between thin and thick AHMs based on dermoscopy alone.
- Published
- 2024
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4. The combination of dermoscopy and reflectance confocal microscopy increases the diagnostic confidence of amelanotic/hypomelanotic lentigo maligna.
- Author
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Pizzichetta MA, Polesel J, Perrot JL, Rubegni P, Stanganelli I, Magi S, Mazzoni L, Farnetani F, Pellacani G, Garutti M, Puglisi F, and Cinotti E
- Subjects
- Humans, Diagnosis, Differential, Female, Aged, Male, Carcinoma, Basal Cell diagnostic imaging, Carcinoma, Basal Cell pathology, Carcinoma, Basal Cell diagnosis, Carcinoma, Squamous Cell diagnostic imaging, Carcinoma, Squamous Cell pathology, Carcinoma, Squamous Cell diagnosis, Middle Aged, Keratosis, Actinic diagnostic imaging, Keratosis, Actinic pathology, Keratosis, Actinic diagnosis, Melanoma, Amelanotic pathology, Melanoma, Amelanotic diagnostic imaging, Melanoma, Amelanotic diagnosis, Aged, 80 and over, Predictive Value of Tests, Dermoscopy, Microscopy, Confocal methods, Skin Neoplasms pathology, Skin Neoplasms diagnostic imaging, Skin Neoplasms diagnosis, Hutchinson's Melanotic Freckle pathology, Hutchinson's Melanotic Freckle diagnosis, Hutchinson's Melanotic Freckle diagnostic imaging, Sensitivity and Specificity
- Abstract
The dermoscopic diagnosis of amelanotic/hypomelanotic lentigo maligna/lentigo maligna melanoma (AHLM/LMM) may be very difficult in its early stages because of lack of pigment. Reflectance confocal microscopy (RCM) is an imaging technique that is especially helpful for the diagnosis of lentigo maligna. To determine the diagnostic performances of dermoscopy and RCM in the diagnosis of AHLM/LMMs we evaluated dermoscopic and RCM images of consecutive cases of histopathologically confirmed AHLM/LMMs, amelanotic/hypomelanotic basal cell carcinoma and squamous cell carcinoma (AHBCCs/AHSCCs), amelanotic/hypomelanotic benign lesions (AHBLs), and actinic keratoses (AKs) from five participating centers. Sensitivity, specificity, accuracy, predictive values, and level of diagnosis confidence were calculated for both diagnostic procedures. Both dermoscopy and RCM showed diagnostic performance >97% in the diagnosis of AHLM/LMMs versus AHBCC/AHSCCs and their combination slightly improved diagnostic performance, with accuracy increasing from 98.0% to 99.1%. Similarly, RCM in combination with dermoscopy showed a tiny increase in the diagnostic performance in the diagnosis of AHLM/LMMs versus AHBLs (accuracy increased from 87.2% to 88.8%) and versus AKs (accuracy increased from 91.4% to 93.4%). Although the increase in diagnostic performance due to RCM was modest, the combination of dermoscopy and RCM greatly increased the level of confidence; high confidence in the diagnosis of AHLM/LMMs versus AHBLs increased from 36.2% with dermoscopy alone to 76.6% with dermoscopy plus RMC. Based on our results, dermoscopy and RCM should be complementary to improve not only diagnostic accuracy but also the level of diagnostic certainty in the diagnosis of AHLM/LMMs., (© 2024 The Authors. The Journal of Dermatology published by John Wiley & Sons Australia, Ltd on behalf of Japanese Dermatological Association.)
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- 2024
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5. Primary intracranial melanoma, amelanotic variant: Case report.
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Andrés Sanz JA, Ruiz Ginés JA, Iliev H, and Aguas Valiente J
- Subjects
- Humans, Female, Melanins, Magnetic Resonance Imaging, Melanoma, Amelanotic diagnostic imaging, Melanoma, Amelanotic surgery, Brain Neoplasms complications, Brain Neoplasms diagnostic imaging, Brain Neoplasms surgery, Skin Neoplasms
- Abstract
Primary brain melanoma is a very rare tumour (only 0.07% of primary CNS neoplasms) which usually shows with abundant melanin content; whereas hypo/melanotic variants have been scarcely described. We introduce the case of a female patient with headache, left brachial paresis and frontallobar syndrome. The MRI image showed a right frontal mass with homogeneous contrast uptake. As treatment, a complete surgical resection was performed. Pathology was diagnostic for melanoma, with very low melanin content and a high proliferative index. A thorough extension study was performed to rule out an extracranial primary origin. Due to several intercurrent complications, the patient evolved unfavorably, not being able to receive further treatment. The amelanotic variant of primary intracranial malignant melanomas has not been described in detail previously. We will review the literature, focusing on the particularities of management and diagnosis of this clinical entity., (Copyright © 2022. Published by Elsevier España, S.L.U.)
- Published
- 2022
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6. Dermoscopy for the Identification of Amelanotic Acral Melanoma.
- Author
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Koblinski JE, Ahrns HT, Morse MJ, and Seiverling EV
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- Humans, Female, Middle Aged, Dermoscopy, Melanoma, Cutaneous Malignant, Melanoma, Amelanotic diagnostic imaging, Melanoma, Amelanotic therapy, Granuloma, Pyogenic diagnostic imaging, Skin Neoplasms diagnostic imaging, Sweat Gland Neoplasms
- Abstract
Acral lentiginous melanoma is commonly misdiagnosed, and when detected late it portends a poor prognosis. Acral lentiginous melanoma can be mistaken for verruca, pyogenic granuloma, poroma, an ulcer, or other benign skin conditions. Patients with acral skin growths often present initially to a podiatric physician or their primary care physician. It is at this point when the growth is triaged as benign or potentially malignant. Dermoscopy aids in this decision making. Historically, dermoscopy training has been geared toward dermatologists, but there is increasing recognition of the need for dermoscopy training in primary care and podiatric medicine. Dermoscopy is particularly helpful in pink (amelanotic) growths, which can lack the traditional clinical findings of melanoma. A literature review of acral melanoma and dermoscopy was performed in PubMed. We also describe a case of amelanotic acral melanoma in a 58-year-old with a rapidly enlarging painful mass on her heel. The lesion was initially thought to be a pyogenic granuloma and was treated with debridement (curettage). She was ultimately seen in the dermatology clinic, and the findings under dermoscopy were worrisome for amelanotic melanoma. Biopsy confirmed the diagnosis. The cancer metastasized, and the patient died less than 2 years later.
- Published
- 2022
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7. Teledermoscopy: a helpful detection tool for amelanotic and hypomelanotic melanoma.
- Author
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Altayeb A, Dawood S, Atwan A, and Mills C
- Subjects
- Dermoscopy, Humans, Hypopigmentation, Melanoma diagnostic imaging, Melanoma, Amelanotic diagnostic imaging, Skin Neoplasms diagnostic imaging
- Published
- 2021
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8. Acral Amelanotic Melanoma.
- Author
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Bouceiro-Mendes R and Soares-de-Almeida L
- Subjects
- Diagnosis, Differential, Humans, Melanoma, Amelanotic diagnostic imaging, Skin Neoplasms
- Published
- 2021
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9. Amelanotic anorectal malignant melanoma in an ulcerative colitis patient: a rare coincidence or a rare association.
- Author
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Kuriakose Kuzhiyanjal AJ, Nigam GB, and Afzal M
- Subjects
- Female, Humans, Middle Aged, Rectum, Colitis, Ulcerative complications, Inflammatory Bowel Diseases, Melanoma, Amelanotic diagnostic imaging, Skin Neoplasms
- Abstract
Inflammatory bowel disease (IBD) is a chronic inflammatory disorder of the gastrointestinal system, known to be associated with increased risk of carcinogenesis. We report the case of a 55-year-old woman, presenting with symptoms of increased bowel frequency, per rectal bleeding and rectal pain with a background of ulcerative colitis (UC). This was presumptively managed as UC flare, with titration of her medications to control the symptoms. However, a flexible sigmoidoscopy revealed an ulceroproliferative lesion in the rectum, which was identified as an amelanotic anorectal malignant melanoma on immunohistochemistry. No local or distant metastases were noted on radiological imaging. The tumour enlarged progressively and was managed with laparotomy and defunctioning stoma followed by palliative chemotherapy and immunotherapy. This is the first such case reported in literature, highlighting the importance of endoscopic assessment and the need to consider other differential diagnosis in patients with symptoms of IBD flare., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Limited 2021. No commercial re-use. See rights and permissions. Published by BMJ.)
- Published
- 2021
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10. Spontaneous subcapsular and perirenal haemorrhage with retroperitoneal haematoma in a patient with ovarian melanoma metastases.
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Malmusi S, Airoud M, Bellafronte M, and Galassi MC
- Subjects
- Blood Transfusion, Female, Hemorrhage etiology, Humans, Kidney Diseases etiology, Kidney Neoplasms complications, Kidney Neoplasms diagnostic imaging, Melanoma complications, Melanoma diagnostic imaging, Melanoma surgery, Melanoma, Amelanotic complications, Melanoma, Amelanotic diagnostic imaging, Melanoma, Amelanotic surgery, Middle Aged, Ovarian Neoplasms diagnostic imaging, Ovarian Neoplasms surgery, Retroperitoneal Space, Shock etiology, Tomography, X-Ray Computed, Hemorrhage diagnostic imaging, Kidney Diseases diagnostic imaging, Kidney Neoplasms secondary, Melanoma secondary, Melanoma, Amelanotic secondary, Ovarian Neoplasms secondary, Skin Neoplasms pathology
- Abstract
A 47-year-old woman was admitted to our clinic for intensive pain in the left flank region. The transvaginal ultrasound showed a left adnexal solid mass with ascites. She had undergone surgical removal of skin melanoma in 2008, but in September 2019, intracardiac metastasis resulting from it had been discovered. CT performed in March 2020 had been negative for other metastases. A full abdomen ultrasound was not performed. During the night, the patient began to show signs and symptoms of hypovolaemic shock. The patient was urgently transferred to the operating room for a video laparoscopy. A vast left retroperitoneal haematoma was diagnosed along with voluminous enlargement of the left ovary. We proceeded with a left adnexectomy and blood transfusion. Subsequent contrast-enhanced CT revealed a left subcapsular, perirenal haematoma and a voluminous retroperitoneal haematoma. Kidney metastasis was also seen. The final histological diagnosis was metastatic amelanotic malignant melanoma of the ovary., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Limited 2021. No commercial re-use. See rights and permissions. Published by BMJ.)
- Published
- 2021
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11. Clinicopathological and dermoscopic features of amelanotic and hypomelanotic melanoma: a retrospective multicentric study.
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Paolino G, Bearzi P, Pampena R, Longo C, Frascione P, Rizzo N, Raucci M, Carbone A, Cantisani C, Ricci F, Didona D, Frattini F, Bulotta A, Gregorc V, and Mercuri SR
- Subjects
- Dermoscopy, Eye Color, Humans, Retrospective Studies, Melanoma, Amelanotic diagnostic imaging, Skin Neoplasms diagnostic imaging
- Abstract
Background: Amelanotic and hypomelanotic melanoma (AHM) has a higher risk of delayed diagnosis and a significant lower 5-year melanoma-specific survival compared to pigmented melanoma. Our aim was the evaluation of the clinicopathological/dermoscopic features of amelanotic melanoma (AM) and hypomelanotic melanoma (HM)., Methods: All participants had a personal history of AHM. We defined HM as showing clinical/dermoscopic pigmentation in < 25% of the lesion's surface and histopathological focal pigmentation, while AM as melanomas with clinical/dermoscopic and histopathological absence of pigmentation., Results: The most common phenotypic traits among the 145 AHM patients were as follows: phototype II, blue-grey eyes, and dark brown hair. Red hair was present in 23.8% AHM cases (AM = 22.60%; HM = 25.80%). The most affected area was the back (29.5%). A total of 67.1% were classified as AM and 32.9% as HM. The most represented hair colors in AM and HM were, respectively, blonde and dark brown hair. Median Breslow thickness was 1.7 mm, superficial spreading melanoma (SSM) and nodular melanoma (NM) were the most represented histotypes, and mitotic rate > 1 × mm
2 was reported in 73.3% cases, and regression was significantly more present in HM. Dermoscopy showed high prevalence of white structureless zones (63.4%), linear looped vessels (58.8%), linear irregular vessels (50.0%), and arborizing vessels (47.2%). Multivariate logistic regression confirmed the association between the presence of pigmentation and the following: histological regression, dermoscopic globules, and arborizing vessels., Conclusions: Predominance of red hair in AHM patients was not confirmed. AHM affects mostly intermittent sun-exposed body areas. The deeper median Breslow thickness (versus pigmented melanoma), the association of AM with the nodular histotype, and the high mitotic rate highlight the AHM's aggressiveness. HM's higher levels of regression can be explained by the presence of pigmentation, driving the underlying immune response. AHM showed a polymorphous vascular pattern and significant presence of arborizing vessels (especially HM)., (© 2020 the International Society of Dermatology.)- Published
- 2020
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12. The diagnostic accuracy of dermoscopy and reflectance confocal microscopy for amelanotic/hypomelanotic melanoma: a systematic review and meta-analysis.
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Lan J, Wen J, Cao S, Yin T, Jiang B, Lou Y, Zhu J, An X, Suo H, Li D, Zhang Y, and Tao J
- Subjects
- Dermoscopy, Humans, Microscopy, Confocal, Sensitivity and Specificity, Hypopigmentation, Melanoma, Amelanotic diagnostic imaging, Skin Neoplasms diagnostic imaging
- Abstract
Background: Dermoscopy and reflectance confocal microscopy (RCM) are noninvasive techniques for the diagnosis of skin lesions. Their accuracy for amelanotic/hypomelanotic melanoma (AHM) has not been systematically studied., Objectives: We aimed to investigate systematically the accuracy of dermoscopy and RCM and to compare the accuracy between them for diagnosing AHM., Methods: We searched the PubMed, Web of Science, Embase and Cochrane Library databases for eligible studies about dermoscopy, RCM and AHM from inception to 31 June 2019. The quality of the studies was assessed with the Quality Assessment of Diagnostic Accuracy Studies tool. The pooled results were calculated using a random effects model in Stata 14, Meta-DiSc, RevMan 5·3 and SAS 9·4. We also explored the sources of heterogeneity by sensitivity analysis., Results: Seven studies with a total of 1111 lesions were included. The pooled sensitivity and specificity of dermoscopy for the diagnosis of AHM were 61% [95% confidence interval (CI) 0·37-0·81] and 90% (95% CI 0·74-0·97), respectively. The corresponding respective values of RCM for the diagnosis of AHM were 67% (95% CI 0·51-0·81) and 89% (95% CI 0·86-0·92). In three studies including the performance of both RCM and dermoscopy, the relative diagnostic odds ratio of RCM over dermoscopy was 4·69 (95% CI 0·81-27·3) (P = 0·068)., Conclusions: Our study demonstrates that both dermoscopy and RCM offer good diagnostic accuracy with high specificity and moderate sensitivity in the diagnosis of AHM. RCM is more accurate than dermoscopy in diagnosing AHM but the comparison needs to be confirmed. What's already known about this topic? Amelanotic/hypomelanotic melanoma (AHM) is the most lethal skin cancer. The diagnosis of AHM is a great challenge because of its nonspecific clinical manifestation. Early diagnosis can improve the prognosis. Dermoscopy and reflectance confocal microscopy (RCM) have high diagnostic accuracy for pigmented melanoma. What does this study add? Both dermoscopy and RCM offer good diagnostic accuracy with high specificity and moderate sensitivity for AHM. RCM might be more accurate than dermoscopy for diagnosis of AHM. More research on the diagnostic accuracy of dermoscopy and RCM for AHM is required in support of these findings., (© 2019 British Association of Dermatologists.)
- Published
- 2020
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13. Dermoscopy and reflectance confocal microscopy for early diagnosis of amelanotic/hypomelanotic melanoma: still a long way to go?
- Author
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Chi CC
- Subjects
- Dermoscopy, Early Diagnosis, Humans, Microscopy, Confocal, Melanoma, Amelanotic diagnostic imaging, Skin Neoplasms diagnosis
- Published
- 2020
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14. An Amelanotic Choroidal Mass in a Middle-aged Woman.
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Agranat JS, Moussa K, and Aronow ME
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- Choroid Neoplasms diagnostic imaging, Choroid Neoplasms drug therapy, Female, Fluorescein Angiography, Glucocorticoids therapeutic use, Humans, Intraocular Pressure physiology, Melanoma, Amelanotic diagnostic imaging, Melanoma, Amelanotic drug therapy, Middle Aged, Prednisone therapeutic use, Scleritis diagnosis, Scleritis drug therapy, Tomography, Optical Coherence, Ultrasonography, Visual Acuity physiology, Choroid Neoplasms pathology, Melanoma, Amelanotic pathology
- Published
- 2019
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15. Dermoscopy of primary cutaneous B- and T-cell lymphomas and pseudolymphomas presenting as solitary nodules and tumors: a case-control study with histopathologic correlation.
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Navarrete-Dechent C, Del Puerto C, Abarzúa-Araya Á, Molgó M, Geller S, Andreani S, Cury-Martins J, Sanches JA, Montoya J, González S, and Uribe P
- Subjects
- Adult, Aged, Aged, 80 and over, Biopsy, Carcinoma, Basal Cell diagnostic imaging, Case-Control Studies, Dermoscopy, Diagnosis, Differential, Female, Humans, Lymphoma, B-Cell pathology, Lymphoma, T-Cell, Cutaneous pathology, Male, Melanoma, Amelanotic diagnostic imaging, Middle Aged, Pseudolymphoma pathology, Retrospective Studies, Skin diagnostic imaging, Skin Neoplasms pathology, Lymphoma, B-Cell diagnostic imaging, Lymphoma, T-Cell, Cutaneous diagnosis, Pseudolymphoma diagnostic imaging, Skin pathology, Skin Neoplasms diagnostic imaging
- Abstract
Background: Primary cutaneous lymphomas (PCLs) and pseudolymphomas presenting as single pink-red nodules/tumors are highly unspecific and include a wide differential diagnosis., Objective: To describe the dermoscopic characteristics of PCL/pseudolymphoma., Methods: In this retrospective, case-control study, we evaluated the dermoscopic features of patients with solitary PCL/pseudolymphoma tumors and compared them to a control group of non-lymphomatous, nonpigmented, solitary tumors (e.g., basal cell carcinoma, amelanotic melanoma, etc)., Results: We included 14 patients with PCL/pseudolymphomas and 35 controls. T-cell and B-cell lymphoma proportions were 28.6% (n = 4) and 71.4% (n = 10), respectively. Compared to controls, most lymphomas presented dermoscopically with orange color (71.4% vs. 14.2%, P < 0.001), follicular plugs (85% vs. 2.8%, P < 0.001), and as organized lesions (85% vs. 31.4%, P = 0.001). Coexistence of orange color and follicular plugs had an odds ratio (OR) of 2.8 (P < 0.001), highly suggestive of PCL . The kappa index for independent observers was 0.66, 0.49, 0.43 for orange background, follicular plugs, and organized lesion, respectively. Histopathologic correlation was performed in six PCL cases and showed dense diffuse and perifollicular lymphocytic infiltrate in all cases and keratin plugs in five of six cases, possibly correlating with the orange color and the follicular plugs, respectively., Conclusion: Primary cutaneous lymphomas/pseudolymphomas present with characteristic dermoscopic findings irrespective of immunohistochemical subtype., (© 2019 The International Society of Dermatology.)
- Published
- 2019
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16. Reflectance confocal microscopy margin mapping and monitoring of an amelanotic melanoma in situ of the ear.
- Author
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Robinson M, Curchin C, and McMeniman E
- Subjects
- Aged, Ear Neoplasms therapy, Female, Humans, Melanoma, Amelanotic therapy, Skin Neoplasms therapy, Ear Neoplasms diagnostic imaging, Melanoma, Amelanotic diagnostic imaging, Microscopy, Confocal, Skin Neoplasms diagnostic imaging
- Abstract
In situ amelanotic melanoma represents a diagnostic and therapeutic challenge for clinicians. Poor demarcation of these lesions often results in repeated therapeutic intervention until appropriate clearance has been achieved. Reflectance confocal microscopy (RCM) is a noninvasive bedside imaging modality which allows real-time visualisation, to a near-histological level, of the epidermis and reticular dermis. We present a case of an amelanotic melanoma in situ in which reflectance confocal microscopy margin mapping allowed for demarcation of the melanocytic proliferation and targeted therapeutic intervention with topical imiquimod. Reflectance confocal microscopy was further utilised for noninvasive assessment of therapeutic response., (© 2018 The Australasian College of Dermatologists.)
- Published
- 2019
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17. Dermoscopy improves diagnostic accuracy for clinically amelanotic nodules.
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Lin MJ, Xie C, Pan Y, Jalilian C, and Kelly JW
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- Adult, Aged, Aged, 80 and over, Diagnosis, Differential, Diagnostic Errors, Female, Hemangioma diagnostic imaging, Histiocytoma, Benign Fibrous diagnostic imaging, Humans, Keratosis, Seborrheic diagnostic imaging, Male, Middle Aged, Nevus diagnostic imaging, Retrospective Studies, Sensitivity and Specificity, Young Adult, Carcinoma, Basal Cell diagnostic imaging, Carcinoma, Merkel Cell diagnostic imaging, Carcinoma, Squamous Cell diagnostic imaging, Dermoscopy, Keratoacanthoma diagnostic imaging, Melanoma, Amelanotic diagnostic imaging, Skin Neoplasms diagnostic imaging
- Abstract
Background/objectives: Amelanotic nodular melanomas are notoriously difficult to diagnose and are responsible for a disproportionate burden of melanoma mortality. It is important to distinguish them from other amelanotic nodules. This study aimed to describe the dermoscopic features of a series of nodular melanomas and other amelanotic nodules and to determine whether dermoscopy improves diagnostic accuracy., Method: Retrospective analysis of 150 clinically amelanotic nodules with macroscopic and dermoscopic images., Results: In terms of classifying the nodules as malignant, dermoscopy was superior to unaided eye (specificity 89%; 95% CI 71-98% vs 67%; 95% CI 46-83%, P = 0.03). Dermoscopy enhanced sensitivity for the diagnosis of both amelanotic melanoma and SCC. In 19% of cases, using dermoscopy, the most likely diagnosis was changed from incorrect to correct. This included 26% of amelanotic melanomas which had a macroscopic misdiagnosis overturned to the correct diagnosis. Polymorphous vascular structures were more common in malignant nodules. 76% of amelanotic melanomas/Merkel cell carcinomas had polymorphous vessels compared with 38% of SCCs/KAs/BCCs and 22% of benign nodules (P < 0.001)., Conclusion: Dermoscopy improves diagnostic accuracy for amelanotic melanomas and other amelanotic nodules. Although dermoscopy improves diagnostic accuracy for amelanotic melanomas, these aggressive melanomas remain diagnostically difficult., (© 2018 The Australasian College of Dermatologists.)
- Published
- 2019
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18. Two-Toned Lipofuscin in the Same Choroidal Melanoma: Orange versus Gray.
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Bever GJ and Seider MI
- Subjects
- Aged, Choroid Neoplasms diagnostic imaging, Choroid Neoplasms pathology, Humans, Male, Melanoma diagnostic imaging, Melanoma pathology, Melanoma, Amelanotic diagnostic imaging, Melanoma, Amelanotic pathology, Tomography, Optical Coherence, Choroid Neoplasms metabolism, Lipofuscin metabolism, Melanoma metabolism, Melanoma, Amelanotic metabolism
- Published
- 2018
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19. Dermpath and Clinic: A red scaly lesion on the forearm.
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Stembridge N, Davies A, Chan J, and Todd P
- Subjects
- Aged, Dermoscopy, Female, Forearm, Humans, Melanoma, Amelanotic diagnostic imaging, Melanoma, Amelanotic surgery, Skin Neoplasms diagnostic imaging, Skin Neoplasms surgery, Melanoma, Amelanotic pathology, Skin Neoplasms pathology
- Published
- 2018
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20. Amelanotic and Pigmented Uveal Melanoma.
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Silva AMM, Fonseca MCF, and Proença RD
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- Brachytherapy, Choroid Neoplasms diagnostic imaging, Choroid Neoplasms radiotherapy, Female, Humans, Iodine Radioisotopes therapeutic use, Melanoma diagnostic imaging, Melanoma radiotherapy, Melanoma, Amelanotic diagnostic imaging, Melanoma, Amelanotic radiotherapy, Middle Aged, Ultrasonography, Visual Acuity physiology, Choroid Neoplasms pathology, Melanoma pathology, Melanoma, Amelanotic pathology
- Published
- 2018
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21. Primary Amelanotic CNS Melanoma: Case Report and Literature Review.
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Mayer S, Mauer UM, Mathieu R, Hackenbroch C, Knupfer J, and Schulz C
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- Aged, Cerebellar Neoplasms diagnostic imaging, Cerebellar Neoplasms surgery, Humans, Magnetic Resonance Imaging, Male, Melanoma, Amelanotic diagnostic imaging, Melanoma, Amelanotic surgery, Spinal Neoplasms diagnostic imaging, Spinal Neoplasms surgery, Cerebellar Neoplasms pathology, Melanoma, Amelanotic secondary, Spinal Neoplasms secondary
- Abstract
Primary malignant melanomas of the central nervous system (CNS) are rarely seen entities in the clinical routine. Primary amelanotic melanomas are even rarer. In our literature review, we found only six case reports of primary amelanotic CNS melanomas. Our case report describes the course of a 71-year-old man with a primary amelanotic CNS melanoma with secondary spread to the spine., Competing Interests: Disclosure The authors report no conflicts of interest in this work., (Georg Thieme Verlag KG Stuttgart · New York.)
- Published
- 2018
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22. Dermoscopic diagnosis of amelanotic/hypomelanotic melanoma.
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Pizzichetta MA, Kittler H, Stanganelli I, Ghigliotti G, Corradin MT, Rubegni P, Cavicchini S, De Giorgi V, Bono R, Alaibac M, Astorino S, Ayala F, Quaglino P, Pellacani G, Argenziano G, Guardoli D, Specchio F, Serraino D, and Talamini R
- Subjects
- Case-Control Studies, Dermoscopy, Humans, Melanoma, Amelanotic pathology, Retrospective Studies, Skin Neoplasms pathology, Melanoma, Amelanotic diagnostic imaging, Skin Neoplasms diagnostic imaging
- Published
- 2017
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23. Primary giant aggressive amelanotic duodenal melanoma.
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Kilambi R, Singh AN, Dash NR, Madhusudhan KS, and Das P
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- Adult, Catheter Ablation, Humans, Male, Pancreaticoduodenectomy, Duodenal Neoplasms diagnostic imaging, Duodenal Neoplasms pathology, Duodenal Neoplasms surgery, Melanoma, Amelanotic diagnostic imaging, Melanoma, Amelanotic pathology, Melanoma, Amelanotic surgery
- Abstract
Primary malignant melanoma of the gastrointestinal tract is extremely rare. A 35-year-old man presented with complaints of abdominal pain and weight loss. Contrast enhanced computed tomography showed a large mass involving the duodenum and the superior mesenteric vessels. Upper gastrointestinal endoscopy demonstrated a large, friable mass along the duodenal wall and biopsy was suggestive of malignant melanoma. A detailed physical examination and whole body imaging (positron emission tomography and computed tomography) did not reveal any other lesion. The patient underwent a pancreaticoduodenectomy with segmental resection and anastomosis of the superior mesenteric vein as well as a segmental colectomy. His postoperative recovery was uneventful. The histopathology of the operative specimen showed a malignant amelanotic melanoma arising from the duodenum with lymph nodal involvement. He received oral temozolomide. However, he developed liver metastasis at six months and again at ten months, which was managed with radiofrequency ablation both times. He is doing well at 32 months of follow-up review. Multimodality treatment including surgery, adjuvant chemotherapy and salvage therapy appears to be a promising tool for achieving long-term survival in such patients.
- Published
- 2017
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24. Amelanotic iris melanoma.
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Ajamil Rodanés S, García-Álvarez C, and Saornil Álvarez MA
- Subjects
- Adult, Biomarkers, Tumor analysis, Biopsy, Brachytherapy, Female, Gonioscopy, Humans, Iris Neoplasms radiotherapy, Melanoma, Amelanotic radiotherapy, Microscopy, Acoustic, Slit Lamp Microscopy, Iris Neoplasms diagnostic imaging, Melanoma, Amelanotic diagnostic imaging
- Published
- 2017
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25. Similar but Different: How Reflectance Confocal Microscopy May Help in the Diagnosis of Pink Lesions.
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Ferrari F, Bassoli S, Pellacani G, Argenziano G, Cesinaro AM, and Longo C
- Subjects
- Aged, Carcinoma, Basal Cell pathology, Color, Diagnosis, Differential, Female, Humans, Male, Melanoma, Amelanotic pathology, Microscopy, Confocal methods, Middle Aged, Skin Neoplasms pathology, Carcinoma, Basal Cell diagnostic imaging, Dermoscopy, Melanoma, Amelanotic diagnostic imaging, Skin Neoplasms diagnostic imaging
- Abstract
Background: Among skin neoplasms, solitary pink tumors represent challenging lesions in clinical practice since they can mimic melanocytic and nonmelanocytic lesions or even inflammatory ones., Objective: In this case series we described dermoscopic and confocal features of 2 couples of similar lesions in order to achieve the correct diagnosis and the best therapeutic approach., Methods: During clinical routine practice, 2 couples of clinically and dermoscopically similar lesions were examined by means of confocal microscopy., Results: All lesions revealed no clear-cut diagnostic features on dermoscopy. However, confocal microscopy revealed tumor islands with palisading cells and a dark clefting at the periphery in basal cell carcinomas. In the other "false twin" lesions, atypical cells and elongated junctional nests were observed and the diagnosis of amelanotic melanomas was rendered., Conclusions: In the current case series, the combined use of dermoscopy and reflectance confocal microscopy was an optimal workup for difficult-to-diagnose lesions such as pink tumors., (© 2017 S. Karger AG, Basel.)
- Published
- 2017
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26. Dermoscopy and in vivo confocal microscopy are complementary techniques for diagnosis of difficult amelanotic and light-coloured skin lesions.
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Guitera P, Menzies SW, Argenziano G, Longo C, Losi A, Drummond M, Scolyer RA, and Pellacani G
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Child, Child, Preschool, Dermoscopy methods, Diagnosis, Differential, Female, Humans, Male, Microscopy, Confocal methods, Middle Aged, Young Adult, Carcinoma, Basal Cell diagnostic imaging, Keratosis, Actinic diagnostic imaging, Melanoma, Amelanotic diagnostic imaging, Skin Neoplasms diagnostic imaging
- Abstract
Background: Amelanotic melanomas are often difficult to diagnose., Objectives: To find and test the best methods of diagnosis using dermoscopy and reflectance confocal microscopy (RCM) tools., Methods: We selected consecutive, difficult-to-diagnose, light-coloured and amelanotic skin lesions from three centres (in Australia and Italy). Dermoscopy and RCM diagnostic utility were evaluated under blinded conditions utilizing 45 melanomas (16 in situ, 29 invasive), 68 naevi, 48 basal cell carcinomas (BCCs), 10 actinic keratoses, 10 squamous cell carcinomas (SCCs) and 13 other benign lesions., Results: Sensitivity and specificity for melanoma with dermoscopy pattern analysis by two blinded observers and their 'confidence in diagnosis' were low. The amelanotic dermoscopy method had the highest sensitivity (83%) for a diagnosis of malignancy (melanoma, BCC or SCC), but specificity was only 18%. Multivariate analysis confirmed the utility of RCM features previously identified for the diagnosis of BCC and melanoma (highest odds ratio for melanoma: epidermal disarray, dark and/or round pagetoid cells). RCM sensitivity was 67% and 73% for melanoma and BCC diagnosis, respectively, and its specificity for nonmalignant lesion diagnosis was 56%. RCM reader confidence was higher than for dermoscopy; 84% of melanomas would have been biopsied and biopsy avoided in 47% of benign lesions. All melanomas misclassified by either dermoscopy or RCM were detected by the other tool., Conclusions: Dermoscopy and RCM represent complementary/synergistic methods for diagnosis of amelanotic/light-coloured skin lesions., (© 2016 British Association of Dermatologists.)
- Published
- 2016
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27. Discriminating Nevi from Melanomas: Clues and Pitfalls.
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Carrera C and Marghoob AA
- Subjects
- Dermoscopy, Diagnosis, Differential, Humans, Intravital Microscopy, Microscopy, Confocal, Melanoma diagnostic imaging, Melanoma, Amelanotic diagnostic imaging, Nevus diagnostic imaging, Nevus, Pigmented diagnostic imaging, Skin Neoplasms diagnostic imaging
- Abstract
Reflectance confocal microscopy (RCM) together with dermoscopy enables improved differentiation of melanomas from most nevi. The resulting high sensitivity for detecting melanoma with RCM is complemented by a concomitant increased specificity, which results in the reduction of unnecessary biopsies of nevi. Although RCM can achieve high diagnostic accuracy for early melanoma detection, false-negative and false-positive cases of melanoma are occasionally encountered. This article reviews the essential clues and pitfalls for the diagnosis of melanoma via RCM and highlights the importance of evaluating RCM findings in light of the clinical scenario and dermoscopic features., (Copyright © 2016 Elsevier Inc. All rights reserved.)
- Published
- 2016
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28. Enlightening the Pink: Use of Confocal Microscopy in Pink Lesions.
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Gill M and González S
- Subjects
- Bowen's Disease diagnostic imaging, Breast Neoplasms diagnostic imaging, Carcinoma in Situ diagnostic imaging, Carcinoma, Squamous Cell diagnostic imaging, Dermoscopy, Granuloma, Pyogenic diagnostic imaging, Humans, Intravital Microscopy, Keratosis, Actinic diagnostic imaging, Keratosis, Seborrheic diagnostic imaging, Microscopy, Confocal, Paget Disease, Extramammary diagnostic imaging, Paget's Disease, Mammary diagnostic imaging, Skin Diseases diagnostic imaging, Acanthoma diagnostic imaging, Adenoma diagnostic imaging, Carcinoma diagnostic imaging, Hemangioma diagnostic imaging, Histiocytoma, Benign Fibrous diagnostic imaging, Melanoma, Amelanotic diagnostic imaging, Sebaceous Gland Neoplasms diagnostic imaging, Skin Neoplasms diagnostic imaging
- Abstract
Solitary pink lesions can pose a particular challenge to dermatologists because they may be almost or completely featureless clinically and dermoscopically, previously requiring biopsy to exclude malignancy. However, these lesions usually are not particularly challenging histopathologically. Thus, the incorporation of in vivo reflectance confocal microscopy into the clinical practice, which allows for noninvasive examination of the skin at the cellular level revealing features previously seen only on histopathology, is particularly useful for this subset of clinically difficult lesions., (Copyright © 2016 Elsevier Inc. All rights reserved.)
- Published
- 2016
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29. Primary Amelanotic Leptomeningeal Melanomatosis in a Child: A Rare but Severe Disease.
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Szathmari A, Perbet R, Hermier M, Di Rocco F, Frappaz D, and Mottolese C
- Subjects
- Child, Preschool, Female, Humans, Magnetic Resonance Imaging, Melanoma, Amelanotic diagnostic imaging, Meningeal Neoplasms diagnostic imaging, Tomography Scanners, X-Ray Computed, Craniotomy, Endoscopy, Melanoma, Amelanotic surgery, Meningeal Neoplasms surgery
- Abstract
Background: Primary leptomeningeal melanomatosis (PLM) is a rare and aggressive form of nonmetastatic invasion of leptomeninges by malignant melanocytic cells. Clinical presentation includes nonspecific meningism with various forms of cerebrospinal fluid circulation or absorption disorders leading to hydrocephalus., Case Description: A 5-year-old child with PLM without neurocutaneous melanosis presented with cystic enlargement of the brainstem surrounding cisterns and hydrocephalus requiring occipitoaxial decompression and endoscopic cystostomy. Initial cerebrospinal fluid cytology screening and frontal meningeal and brain biopsy specimens showed negative results. The diagnosis of unpigmented (amelanotic) malignant melanocytic cells was made after a biopsy specimen of the bulbar leptomeninges was obtained. Despite continuous management of hydrocephalus and chemotherapy, the disease progressed, and the patient died 11 months after diagnosis., Conclusions: To the best of our knowledge, this is the first report of an amelanotic form of PLM without association of neurocutaneous melanosis in a child. This case report illustrates the difficulty of diagnosis in the absence of cutaneous lesions and lack of melanin., (Copyright © 2016 Elsevier Inc. All rights reserved.)
- Published
- 2016
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30. Eccrine porocarcinoma shares dermoscopic characteristics with eccrine poroma: A report of three cases and review of the published work.
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Edamitsu T, Minagawa A, Koga H, Uhara H, and Okuyama R
- Subjects
- Aged, Dermoscopy, Diagnosis, Differential, Eccrine Porocarcinoma blood supply, Eccrine Porocarcinoma pathology, Humans, Male, Melanoma, Amelanotic diagnostic imaging, Melanoma, Amelanotic pathology, Poroma pathology, Skin Neoplasms diagnostic imaging, Skin Neoplasms pathology, Sweat Gland Neoplasms blood supply, Sweat Gland Neoplasms pathology, Eccrine Porocarcinoma diagnostic imaging, Poroma diagnostic imaging, Sweat Gland Neoplasms diagnostic imaging
- Abstract
Eccrine porocarcinoma (EPC) is a rare malignant skin tumor presumably arising from the intraepidermal ductal portion of the sweat gland. EPC occasionally mimics eccrine poroma (EP), seborrhea keratosis (SK), basal cell carcinoma (BCC), pyogenic granuloma (PG) and amelanotic melanoma with its clinical appearance as a pink nodule. Dermoscopy is an invaluable technique in diagnosing skin tumors. However, few cases of EPC have been reported using dermoscopic images, and their details were not well examined. Here, we present three histopathologically proven cases of EPC and summarize their dermoscopic findings together with five previously reported cases. None of the eight cases showed dermoscopic evidence indicative of SK (comedo-like openings, milia-like cysts, fissures and ridges, and hairpin vessels with white halo), BCC (blue-gray ovoid nests, multiple blue-gray globules, wheel-like structures, shiny white areas, leaf-like areas and arborizing vessels) or PG (reddish homogeneous area with collarette and white rail lines). A milky red area, which was suggestive of amelanotic melanoma, was not detectable in any cases. Seven cases exhibited a polymorphous vascular pattern mainly consisting of hairpin, linear-irregular and dotted vessels. A combination of round-to-oval pink-white structureless areas and white-to-pink halo was observed in five of eight cases, with one case showing the white-to-pink halo alone. Our investigation revealed that the dermoscopic characteristic of EP was also observed in discrete areas of EPC lesions. Thus, it is possible that the histopathological architecture of EPC contains portions of benign EP-like components. Awareness of this dermoscopic aspect of EPC may be helpful when diagnosing pink nodules., (© 2015 Japanese Dermatological Association.)
- Published
- 2016
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31. [Amelanotic pulmonary melanoma].
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Caidi M, Zouidia F, Bouchikh M, and Benosman A
- Subjects
- Humans, Lung Neoplasms diagnostic imaging, Lung Neoplasms surgery, Male, Melanoma, Amelanotic diagnostic imaging, Melanoma, Amelanotic surgery, Middle Aged, Radiography, Thoracic, Smoking, Lung Neoplasms pathology, Melanoma, Amelanotic pathology
- Abstract
We report a case of amelanotic pulmonary melanoma in a 52-year-old man. Histological diagnosis was established after right lower lobectomy. The primary source was not found. We describe the diagnosis, treatment and surgical follow-up of this type of pulmonary tumour., (Copyright © 2015 SPLF. Published by Elsevier Masson SAS. All rights reserved.)
- Published
- 2016
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32. Bilateral uveal melanomas with different gene expression detected with 7 years interval.
- Author
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Eide N, Garred Ø, Beiske K, and Fodstad Ø
- Subjects
- Aged, Choroid Neoplasms diagnostic imaging, Choroid Neoplasms pathology, Fluorescein Angiography, Humans, In Situ Hybridization, Fluorescence, Male, Melanoma, Amelanotic diagnostic imaging, Melanoma, Amelanotic pathology, Melanosis diagnostic imaging, Melanosis pathology, Neoplasm Staging, Nevus, Pigmented diagnostic imaging, Nevus, Pigmented pathology, Ultrasonography, Choroid Neoplasms genetics, Chromosomes, Human, Pair 3 genetics, Melanoma, Amelanotic genetics, Melanosis genetics, Monosomy genetics, Nevus, Pigmented genetics, Tumor Suppressor Proteins genetics, Ubiquitin Thiolesterase genetics
- Abstract
Purpose: To report a bilateral uveal melanoma detected in a micrometastasis study., Method: Case report., Results: At enucleation of a circumpapillary amelanotic mixed melanoma in a patient with ocular melanocytosis, a pigmented lesion in the other eye was detected, thought to be a naevus. BAP1 was positive showing nuclear staining of the tumour cells. Seven years later the naevus showed growth and development of a retinal detachment. FNAB disclosed monosomy 3 in the spindle tumour cells., Conclusion: A case of bilateral melanoma with long-term survival without metastatic diseases is reported. Different gene expressions in the two eyes were revealed. The case is a reminder that follow-up over years is essential in patients with a uveal melanoma, especially with ocular melanocytosis., (© 2015 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.)
- Published
- 2016
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33. NODULAR POSTERIOR SCLERITIS: Clinico-Sonographic Characteristics and Proposed Diagnostic Criteria.
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Agrawal R, Lavric A, Restori M, Pavesio C, and Sagoo MS
- Subjects
- Adult, Aged, Aged, 80 and over, Anti-Inflammatory Agents, Non-Steroidal therapeutic use, Choroid Neoplasms pathology, Diagnosis, Differential, Eye Pain diagnosis, Female, Fluorescein Angiography, Glucocorticoids therapeutic use, Humans, Macular Edema diagnosis, Male, Melanoma, Amelanotic pathology, Middle Aged, Retrospective Studies, Scleritis drug therapy, Scleritis physiopathology, Subretinal Fluid, Tomography, Optical Coherence, Ultrasonography, Vision Disorders diagnosis, Visual Acuity physiology, Choroid Neoplasms diagnostic imaging, Melanoma, Amelanotic diagnostic imaging, Scleritis diagnostic imaging
- Abstract
Purpose: To report the clinical and ultrasound features and outcomes of a series of nodular posterior scleritis., Methods: Retrospective medical record review of 11 consecutive patients with nodular posterior scleritis. Patient demographics, ocular and systemic findings, ultrasound features, and final anatomical and visual outcomes were recorded., Results: There were 9 females and 2 males (11 eyes) with mean age at presentation of 57 years (range, 30-84 years). Underlying systemic inflammatory disease was present in 73%. Symptoms included pain in 73% and blurred vision in 45%. A solitary amelanotic mass without the presence of lipofuscin was found in all cases. Associated ocular features included retinal pigment epithelial changes (67%), intraocular inflammation (55%), subretinal fluid (50%), macular edema (50%), and choroidal folds (30%). B-mode ultrasound showed a sclerochoroidal mass with high internal reflectivity (100%) of mean elevation of 4.1 mm. There was nodular thickening of the sclera (100%) and fluid in Tenon space or "T" sign (36%). A complete regression of the nodule after the treatment was observed only in 1 patient (11%) and partial regression in 4 patients (44%)., Conclusion: Nodular posterior scleritis should be considered in the differential diagnosis of a single amelanotic choroidal mass showing high internal reflectivity on ultrasound B-scan. It can produce intraocular inflammation in 50% of the cases and may be painless in 25%. It has a high association with a systemic underlying disease.
- Published
- 2016
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34. False-Negative Cases on Confocal Microscopy Examination: A Retrospective Evaluation and Critical Reappraisal.
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Coco V, Farnetani F, Cesinaro AM, Ciardo S, Argenziano G, Peris K, Pellacani G, and Longo C
- Subjects
- Adult, Aged, Aged, 80 and over, Dermoscopy, False Negative Reactions, Female, Humans, Male, Melanoma pathology, Melanoma, Amelanotic diagnostic imaging, Melanoma, Amelanotic pathology, Middle Aged, Retrospective Studies, Skin Neoplasms pathology, Melanoma diagnostic imaging, Microscopy, Confocal, Skin Neoplasms diagnostic imaging
- Abstract
Background: Confocal microscopy is a second-level examination for dermoscopically equivocal melanocytic lesions. However, the number of false-negative cases on confocal microscopy and the scenarios in which confocal microscopy may fail have not been fully elucidated., Objective: To calculate the percentage of false-negative melanomas upon reflectance confocal microscopy examination in a large series of cases., Methods: A retrospective analysis on 201 melanomas, evaluated for dermoscopic/confocal criteria of melanoma, was carried out., Results: Twenty-three melanomas out of 201 cases (11.4%) revealed a low 7-point checklist score. On confocal examination, 22 out of 23 lesions have been diagnosed correctly as melanomas. Only 1 lesion did not display melanoma features, neither upon dermoscopy nor upon confocal microscopy examination. Seven lesions out of 201 cases (3.5%) were judged as negative on confocal examination, even if 6 of them were diagnosed as melanomas by clinical and/or dermoscopic evaluation. After histopathological revision, these cases were grouped into 5 categories: (1) amelanotic melanoma (n = 1), (2) hyperkeratotic melanomas (n = 2), (3) lentiginous melanomas (n = 2), (4) melanoma with small pagetoid cells (n = 1), (5) spitzoid melanoma (n = 1)., Conclusion: Confocal and dermoscopic examination, along with patient-related information and clinical history, can lead to an optimal patient management., (© 2016 S. Karger AG, Basel.)
- Published
- 2016
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35. A case of giant nodular posterior scleritis mimicking choroidal malignancy.
- Author
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Liu AT, Luk FO, and Chan CK
- Subjects
- Administration, Oral, Adult, Anti-Inflammatory Agents, Non-Steroidal therapeutic use, Choroid Neoplasms diagnostic imaging, Choroid Neoplasms drug therapy, Diagnosis, Differential, Female, Fluorescein Angiography, Humans, Indomethacin therapeutic use, Magnetic Resonance Imaging, Melanoma, Amelanotic diagnostic imaging, Melanoma, Amelanotic drug therapy, Scleritis diagnostic imaging, Scleritis drug therapy, Ultrasonography, Choroid Neoplasms diagnosis, Melanoma, Amelanotic diagnosis, Posterior Eye Segment pathology, Scleritis diagnosis
- Abstract
To report a case of giant nodular posterior scleritis mimicking a choroidal tumor. A 42-year-old lady with systemic hypertension presented with a 1-week history of unilateral visual loss, pain and redness in her left eye. Examination showed sectoral anterior episcleritis in her left eye as well as a dome-shaped choroidal mass at the inferior-temporal periphery, associated with retinal hemorrhages and subretinal fluid. Systemic evaluation and imaging of the choroidal mass were performed and could not rule out amelanotic choroidal melanoma. At the same time, she was prescribed a 2-week course of oral nonsteroidal anti-inflammatory drug (NSAID) for her sectoral anterior episcleritis. The choroidal mass was found to have resolved completely right before her scheduled fine needle biopsy. Diagnosis of nodular posterior scleritis and a trial of oral NSAID can be considered in patients presenting with a choroidal mass before any invasive procedure.
- Published
- 2015
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36. Molecular imaging with bioluminescence and PET reveals viral oncolysis kinetics and tumor viability.
- Author
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Kuruppu D, Brownell AL, Shah K, Mahmood U, and Tanabe KK
- Subjects
- Animals, Breast Neoplasms diagnostic imaging, Breast Neoplasms pathology, Breast Neoplasms therapy, Breast Neoplasms virology, Cell Line, Tumor, Chlorocebus aethiops, Colonic Neoplasms diagnostic imaging, Colonic Neoplasms pathology, Colonic Neoplasms therapy, Colonic Neoplasms virology, Female, HT29 Cells, Humans, Melanoma, Amelanotic diagnostic imaging, Melanoma, Amelanotic pathology, Melanoma, Amelanotic therapy, Melanoma, Amelanotic virology, Mice, Mice, Inbred BALB C, Mice, Nude, Vero Cells, Luminescent Measurements methods, Molecular Imaging methods, Oncolytic Virotherapy methods, Oncolytic Viruses physiology, Positron-Emission Tomography methods
- Abstract
Viral oncolysis, the destruction of cancer cells by replicating virus, is an experimental cancer therapy that continues to be explored. The treatment paradigm for this therapy involves successive waves of lytic replication in cancer cells. At present, monitoring viral titer at sites of replication requires biopsy. However, repeat serial biopsies are not practically feasible for temporal monitoring of viral replication and tumor response in patients. Molecular imaging provides a noninvasive method to identify intracellular viral gene expression in real time. We imaged viral oncolysis and tumor response to oncolysis sequentially with bioluminescence and positron emission tomography (PET), revealing the kinetics of both processes in tumor xenografts. We demonstrate that virus replication cycles can be identified as successive waves of reporter expression that occur ∼2 days after the initial viral tumor infection peak. These waves correspond to virions that are released following a replication cycle. The viral and cellular kinetics were imaged with Fluc and Rluc bioluminescence reporters plus two 18F-labeled PET reporters FHBG [9-(4-18F-fluoro-3-[hydroxymethyl] butyl) guanine] and FLT (18F-3'-deoxy-3-'fluorothymidine), respectively. Correlative immunohistochemistry on tumor xenograft sections confirmed in vivo results. Our findings show how PET can be used to identify virus replication cycles and for real-time measurements of intratumoral replicating virus levels. This noninvasive imaging approach has potential utility for monitoring viral oncolysis therapy in patients., (©2014 American Association for Cancer Research.)
- Published
- 2014
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37. Tapioca melanoma of the iris without iris heterochromia.
- Author
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Bach A, McGowan S, Gold AS, Villegas VM, Wildner AC, Ehlies FJ, Thompson JM, Bermudez-Magner JA, Dubovy SR, and Murray TG
- Subjects
- Adolescent, Eye Enucleation, Female, Humans, Iris Neoplasms diagnostic imaging, Iris Neoplasms surgery, Melanoma, Amelanotic diagnostic imaging, Melanoma, Amelanotic surgery, Ultrasonography, Iris Diseases pathology, Iris Neoplasms pathology, Melanoma, Amelanotic pathology, Pigmentation Disorders pathology
- Abstract
Purpose: A case of a teenage girl with tapioca melanoma of the iris is presented. This case is unusual, as the patient did not have heterochromia and did not present with elevated intraocular pressure., Case Report: A 14-year-old female patient presented with an amelanotic, multinodular, multifocal lesion of the right iris. Pathology confirmed a diagnosis of tapioca melanoma using immunohistologic staining. The patient underwent enucleation of her right eye and has been free of metastatic disease 3 years later., Conclusions: Tapioca melanoma of the iris must be included among the other differential diagnoses when examining patients with amelanotic iris lesions, even when iris heterochromia is not clearly evident.
- Published
- 2014
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38. Diagnostic usefulness of findings in Doppler sonography for amelanotic melanoma.
- Author
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Kato M, Mabuchi T, Yamaoka H, Ikoma N, Tamiya S, Ozawa A, Taguchi M, Kuramochi A, and Tsuchida T
- Subjects
- Carcinoma, Basal Cell diagnostic imaging, Carcinoma, Squamous Cell diagnostic imaging, Dermoscopy, Humans, Poroma diagnostic imaging, Retrospective Studies, Ultrasonography, Doppler, Melanoma, Amelanotic diagnostic imaging, Skin Neoplasms diagnostic imaging
- Abstract
To evaluate the diagnostic usefulness of Doppler sonography for amelanotic melanoma (AM), the correspondence between the findings of dermoscopy and Doppler sonography was investigated in AM in comparison with other hypopigmented tumors. Seven cases with AM and 11 cases with squamous cell carcinoma (SCC), 10 cases with non- or hypopigmented basal cell carcinoma (NP-BCC) and six cases with eccrine poroma (EP) as hypopigmented tumors were investigated. EP is readily recognized by differences from AM and SCC based on a single vertical and non-torvtuous vessels. NP-BCC is distinguished from AM based on tortuosity running in a vertical direction. Though findings of tortuosity in vessels and heterogeneity of vessel size are recognized both in AM and SCC: (i) abundant blood flow was recognized more clearly in AM; (ii) total blood flow was more than 40% in most cases of AM (average, 60.9%); and (iii) more vessels which flow into a tumor are found in AM (85.7%). There is no relationship between dermoscopic findings of vessel types and Doppler sonography findings of vessels. In this study, the diagnostic usefulness of the above-mentioned specific findings in examination may suggest using Doppler sonography for AM as one non-invasive method., (© 2013 Japanese Dermatological Association.)
- Published
- 2013
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39. Amelanotic choroidal melanoma in 16-month-old child.
- Author
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Nawaiseh I, Sultan I, Mehyar M, Haddad H, and Yousef YA
- Subjects
- Biomarkers, Tumor analysis, Choroid Neoplasms chemistry, Choroid Neoplasms diagnostic imaging, Eye Enucleation, Female, Humans, Infant, Melanoma, Amelanotic chemistry, Melanoma, Amelanotic diagnostic imaging, Retinal Detachment diagnosis, Tomography, X-Ray Computed, Ultrasonography, Choroid Neoplasms pathology, Melanoma, Amelanotic pathology
- Published
- 2013
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40. Malignant amelanotic melanoma--a diagnostic surprise: Flurodeoxyglocose Positron Emission Tomography-Computed Tomography and immunohistochemistry clinch the 'final diagnosis'.
- Author
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Joshi PV, Lele VR, Aland NJ, Bhat G, Ajinkya SP, and Patel RP
- Subjects
- Adenocarcinoma diagnosis, Diagnosis, Differential, Fluorodeoxyglucose F18, Humans, Liver Neoplasms drug therapy, Liver Neoplasms secondary, Male, Melanoma, Amelanotic diagnostic imaging, Melanoma, Amelanotic surgery, Middle Aged, Radiopharmaceuticals, Skin pathology, Skin Neoplasms diagnostic imaging, Skin Neoplasms surgery, Immunohistochemistry methods, Melanoma, Amelanotic diagnosis, Multimodal Imaging methods, Positron-Emission Tomography, Skin Neoplasms diagnosis, Tomography, X-Ray Computed
- Abstract
Amelanotic melanoma is a rare malignancy and the prognosis is usually poorer than that of pigmented melanomas, because of delay in establishing the correct diagnosis, and in treatment initiation. In our case report, we present a the Flurodeoxyglocose Positron Emission Tomography-Computed Tomography (FDG PET/CT) findings of a patient suffering from malignant amelanotic melanoma and its histopathological confirmation and immunohistochemistry (IHC) correlation In the described case, amelanotic melanoma masqueraded as adenocarcinoma of the rectum in the pathology as well the clinical course. Our case highlights the importance of obtaining a tissue diagnosis and IHC confirmation whenever unusual PET/CT findings are encountered.
- Published
- 2012
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41. Treatment of amelanotic choroidal melanoma with photodynamic therapy.
- Author
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Campbell WG and Pejnovic TM
- Subjects
- Adult, Aged, Choroid Neoplasms diagnostic imaging, Choroid Neoplasms pathology, Female, Humans, Male, Melanoma, Amelanotic diagnostic imaging, Melanoma, Amelanotic pathology, Middle Aged, Photosensitizing Agents adverse effects, Porphyrins adverse effects, Treatment Outcome, Ultrasonography, Verteporfin, Choroid Neoplasms drug therapy, Melanoma, Amelanotic drug therapy, Photochemotherapy, Photosensitizing Agents therapeutic use, Porphyrins therapeutic use
- Abstract
Purpose: To evaluate the effect of photodynamic therapy on amelanotic choroidal melanoma., Methods: Nine patients with posteriorly located amelanotic choroidal melanomas, one with a pigmented portion, underwent photodynamic therapy using verteporfin as the photosensitizing agent. The basal diameters ranged from 4 mm to 16 mm and the heights from 1.3 mm to 5.7 mm. Treatment was repeated until the melanoma was completely flat or its height had reached a stable end point. Tumor response was assessed by clinical examination, photography, and ultrasonography. Annual screening for hepatic metastases was performed., Results: Eight tumors demonstrated apparent complete regression over 1 month to 14 months. The amelanotic portion of the mixed tumor flattened, whereas the height of the pigmented part remained stable at 2 mm. In 8 patients there has been no recurrence during follow-up of between 34 months and 81 months. One case developed 2 separate local recurrences at 21 months and 34 months. There were no serious complications, no patient lost vision after treatment, and none developed metastatic disease., Conclusion: In this series photodynamic therapy was highly effective in causing regression of posteriorly located amelanotic choroidal melanomas, without a detrimental effect on vision. While the short-term results are encouraging, there is some uncertainty regarding complete tumor destruction and long-term efficacy.
- Published
- 2012
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42. Dramatic regression of amelanotic choroidal melanoma with PDT following poor response to brachytherapy.
- Author
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Tuncer S, Kir N, and Shields CL
- Subjects
- Adult, Brachytherapy, Choroid Neoplasms diagnostic imaging, Choroid Neoplasms pathology, Choroid Neoplasms radiotherapy, Female, Fluorescein Angiography, Humans, Iodine Radioisotopes therapeutic use, Melanoma, Amelanotic diagnostic imaging, Melanoma, Amelanotic pathology, Melanoma, Amelanotic radiotherapy, Ultrasonography, Verteporfin, Visual Acuity physiology, Choroid Neoplasms drug therapy, Melanoma, Amelanotic drug therapy, Photochemotherapy, Photosensitizing Agents therapeutic use, Porphyrins therapeutic use
- Abstract
Photodynamic therapy (PDT) has been used for treatment of choroidal neovascular membrane from exudative macular degeneration. Other applications include treatment of some intraocular tumors, such as choroidal hemangioma, vasoproliferative tumor, and choroidal osteoma. The authors report the effect of PDT for amelanotic choroidal melanoma. A 40-year-old woman with an amelanotic choroidal melanoma of 6.5 mm thickness showed poor response to iodine brachytherapy (80 Gy apical dose) with no reduction in thickness at 16 months of follow-up. There was prominent residual tumor. The amelanotic tumor was treated with verteporfin PDT using three overlapping spots (8,600 microns), with avoidance of the optic disc using standard treatment parameters. Dramatic tumor regression over 2 months to a completely flat scar (1.3 mm thickness) was documented and remained stable at 50 months of follow-up. Amelanotic choroidal melanoma with incomplete response following conventional plaque radiotherapy can be treated with verteporfin PDT for consolidation., (Copyright 2012, SLACK Incorporated.)
- Published
- 2012
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43. Whole-body 18F FDG positron emission tomography/computed tomography evaluation of patients with uveal metastasis.
- Author
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Patel P and Finger PT
- Subjects
- Adult, Aged, Aged, 80 and over, Female, Fluorescein Angiography, Humans, Lymphatic Metastasis, Male, Melanoma, Amelanotic secondary, Middle Aged, Retrospective Studies, Tomography, Optical Coherence, Uveal Neoplasms secondary, Fluorodeoxyglucose F18, Melanoma, Amelanotic diagnostic imaging, Positron-Emission Tomography, Radiopharmaceuticals, Tomography, X-Ray Computed methods, Uveal Neoplasms diagnostic imaging, Whole Body Imaging methods
- Abstract
Purpose: To investigate the value of whole-body positron emission tomography/computed tomography (PET/CT) as a screening tool for patients with uveal metastasis., Design: Retrospective observational case series., Methods: setting: Clinical practice. study population: Eighteen patients with uveal metastatic tumors were evaluated. Patients had no history of malignancy or a past medical history of malignancy without known active metastasis or known systemic cancer. intervention: Whole-body PET/CT was used as a screening tool to evaluate the intraocular tumor, to evaluate for multi-organ metastatic disease, and for cancer staging. main outcome measures: Detection and PET/CT uptake of primary tumors and metastatic disease., Results: PET/CT imaging uncovered previously occult primary nonocular cancers (11/18, 61%), revealed progression of known primary systemic cancer (7/18, 39%), and confirmed multi-organ metastases in all cases (18/18, 100%). PET/CT findings were used to direct nonocular, confirmatory biopsy in 67% of cases (12/18). No uveal biopsies were required. PET/CT revealed lymph nodes and bone as the most common metastatic sites. The intraocular tumor was detectable in 28% of cases. Small, non-avid tumors and those within the hypermetabolic, PET-avid brain were falsely negative., Conclusion: This study suggests that whole-body PET/CT can be useful for clinical evaluation of patients with uveal metastases. It allowed for screening of the entire body and directed extraocular biopsy. Commonly used for tumor staging, PET/CT aided in the detection of the primary cancer in patients with metastatic uveal tumors., (Copyright © 2012 Elsevier Inc. All rights reserved.)
- Published
- 2012
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44. Rapidly enlarging nodular lesion of the anterior maxilla.
- Author
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Boyd BC, Au J, Aguirre A, and Votta TJ
- Subjects
- Adult, Antineoplastic Combined Chemotherapy Protocols, Combined Modality Therapy, Diagnosis, Differential, Fatal Outcome, Humans, Lymphoma diagnostic imaging, Lymphoma pathology, Male, Maxilla diagnostic imaging, Maxilla surgery, Maxillary Diseases diagnostic imaging, Maxillary Diseases therapy, Melanoma, Amelanotic diagnostic imaging, Melanoma, Amelanotic therapy, Mouth Mucosa surgery, Mouth Neoplasms diagnostic imaging, Mouth Neoplasms therapy, Neoadjuvant Therapy, Radiography, Sarcoma diagnostic imaging, Sarcoma pathology, Skin Neoplasms diagnostic imaging, Skin Neoplasms therapy, Maxillary Diseases pathology, Melanoma, Amelanotic pathology, Mouth Mucosa pathology, Mouth Neoplasms pathology, Skin Neoplasms pathology
- Published
- 2011
- Full Text
- View/download PDF
45. [Identification of the lymph node drainage and selective sentinel lymph node biopsy in a patient with amelanotic melanoma of the uvula].
- Author
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Domínguez-Prado I, Rodríguez-Fraile M, Alcalde JM, de Abajo J, Martín-Algarra S, and García-Velloso MJ
- Subjects
- Fluorine Radioisotopes, Fluorodeoxyglucose F18, Humans, Male, Melanoma, Amelanotic diagnostic imaging, Melanoma, Amelanotic surgery, Middle Aged, Neck Dissection, Palatal Neoplasms surgery, Radiopharmaceuticals, Uvula surgery, Lymphatic Metastasis diagnostic imaging, Lymphatic Vessels diagnostic imaging, Melanoma, Amelanotic secondary, Multimodal Imaging, Palatal Neoplasms pathology, Positron-Emission Tomography, Sentinel Lymph Node Biopsy, Tomography, X-Ray Computed, Uvula pathology
- Published
- 2011
- Full Text
- View/download PDF
46. Conjunctival amelanotic melanoma--a case report.
- Author
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Kovacević D, Lukanović-Primc K, Markusić V, Babić MB, and Ledić D
- Subjects
- Aged, 80 and over, Biomarkers, Tumor metabolism, Biopsy, Brain Neoplasms diagnostic imaging, Brain Neoplasms metabolism, Conjunctival Neoplasms metabolism, Female, Humans, MART-1 Antigen metabolism, Melanoma, Amelanotic diagnostic imaging, Melanoma, Amelanotic metabolism, S100 Proteins metabolism, Tomography, X-Ray Computed, Brain Neoplasms secondary, Conjunctival Neoplasms pathology, Melanoma, Amelanotic secondary
- Abstract
Conjunctival melanoma is a relatively rare malignancy. It is presented as pigmented nodule in any area of conjunctiva, amelanotic tumors are pink with smooth appearance. The authors describe an amelanotic melanoma of the conjunctiva in an 82-year-old female patient. Cytological, histopathological and immunohistochemical studies revealed an invasive amelanotic melanoma exhibiting S-100 and MART-1 positivity. The patient undervent surgical and chemotherapy treatment and three years after the initial treatment is in the terminal stage of metastatic disease. Absence of pigmentation delayed early clinical detection and treatment. Awareness of this nonpigmented melanoma is crucial for early recognition and appropriate management.
- Published
- 2011
47. [Amelanotic anorectal melanoma].
- Author
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González QH, Bahena-Aponte JA, and Martínez-Benítez B
- Subjects
- Colonoscopy, Humans, Male, Melanoma, Amelanotic diagnostic imaging, Melanoma, Amelanotic surgery, Middle Aged, Rectal Neoplasms diagnostic imaging, Rectal Neoplasms surgery, Tomography, X-Ray Computed, Melanoma, Amelanotic pathology, Rectal Neoplasms pathology
- Published
- 2011
48. Amelanotic malignant melanoma where primary lesion was discovered 5 years after metastasis in the lymph node.
- Author
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Kato H, Inoue Y, Ishihara T, Kageshita T, and Ihn H
- Subjects
- Antineoplastic Combined Chemotherapy Protocols therapeutic use, Cyclophosphamide therapeutic use, Dacarbazine therapeutic use, Doxorubicin therapeutic use, Foot Diseases diagnostic imaging, Foot Diseases drug therapy, Heel pathology, Heel surgery, Humans, Lymphatic Metastasis, Male, Melanoma, Amelanotic diagnostic imaging, Melanoma, Amelanotic drug therapy, Middle Aged, Neoplasm Staging, Prognosis, Skin Neoplasms diagnostic imaging, Skin Neoplasms drug therapy, Tomography, Emission-Computed, Vincristine therapeutic use, Foot Diseases pathology, Melanoma, Amelanotic pathology, Skin Neoplasms pathology
- Abstract
A 53-year-old Japanese man presented with a subcutaneous nodule in his left inguinal region in 2002. He was diagnosed as having a malignant tumor of the soft tissues at a local hospital; however, an exact diagnosis was not obtained. CYVADIC (cyclophosphamide, vincristine, doxorubicin, and dacarbazine) therapy was done for adjuvant therapy. In 2004, he noticed a nodule on the left heel. Positron emission computed tomography showed abnormal up-take and he consulted our department. He was diagnosed as having amelanotic malignant melanoma and the lesion was resected. There were no metastases in the groin or popliteal lymph nodes. After the evaluation, the tumor was staged at pT3b N1b M0 stage IIIC (Breslow's tumor thickness was 7 mm). In our hospital, we have experienced 16 cases of amelanotic malignant melanoma. Generally, it is reported that the patients with amelanotic malignant melanoma have a poor prognosis, but we have observed no difference in the outcome between the patients with amelanotic malignant melanoma and those with malignant melanoma.
- Published
- 2010
- Full Text
- View/download PDF
49. Large amelanotic melanoma and vitiligo.
- Author
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Silver EA, Hofmann AE, Williams D, Srolovitz H, Tahiri Y, and Khanna M
- Subjects
- Adult, Back, Biopsy, Needle, Fatal Outcome, Female, Hand Dermatoses diagnosis, Humans, Immunohistochemistry, Melanoma, Amelanotic diagnostic imaging, Melanoma, Amelanotic therapy, Neoplasm Staging, Positron-Emission Tomography, Skin Neoplasms diagnostic imaging, Skin Neoplasms therapy, Terminally Ill, Melanoma, Amelanotic pathology, Palliative Care, Skin Neoplasms pathology, Vitiligo diagnosis
- Published
- 2009
- Full Text
- View/download PDF
50. Massive cardiac invasion by amelanotic melanoma with obstructive clinical features.
- Author
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Dubrey S, Grocott-Mason R, Mittal T, and Burke M
- Subjects
- Aged, Cardiac Tamponade diagnostic imaging, Echocardiography, Fatal Outcome, Heart Neoplasms diagnostic imaging, Humans, Melanoma, Amelanotic diagnostic imaging, Ventricular Outflow Obstruction diagnostic imaging, Ventricular Outflow Obstruction etiology, Cardiac Tamponade etiology, Heart Neoplasms secondary, Melanoma, Amelanotic secondary, Skin Neoplasms
- Abstract
Reports of malignant melanoma involving the heart usually describe metastatic spread of pigmented (melanotic) forms of this tumour. We describe, and illustrate, a patient presenting with features related to cardiac tamponade and intracardiac obstruction. Transthoracic echocardiography initially showed a large mass within the right ventricular outflow tract. The full extent of infiltration of this tumour was demonstrated by computed tomography scanning and the specific tumour type by immunohistochemical staining procedures. The case is unusual in relation to the extreme size of this amelanotic melanoma at presentation and the fact that it appears to be a solitary metastasis.
- Published
- 2008
- Full Text
- View/download PDF
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