Review: Therapeutic opportunities in noncutaneous melanoma

Wilkins, D.K.; Nathan, Paul

doi:10.1177/1758834009337664

Cited by 18 publications

(20 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…1,2 Mucosal melanomas account for approximately only 1.3% of all melanoma cases. 3,4 While the incidence of cutaneous melanomas has steadily increased over the last 20 years (153.5 cases per million per year), mucosal melanoma incidences have remained stable (2.2 cases per million per year). 1 Mucosal melanomas also tend to occur in an older patient population than cutaneous ones, with a mean age of 67 years.…”

Section: Discussionmentioning

confidence: 97%

“…1 Mucosal melanomas also tend to occur in an older patient population than cutaneous ones, with a mean age of 67 years. 4,5 It is well known that chronic sun exposure and sun damage are the primary risk factor for cutaneous melanomas; however, similar risk factors have not been discovered for mucosal melanomas, and these lesions lack a clear association with ultraviolet exposure. 1,5,6 They exhibit higher rates among women compared with men, mainly due to higher numbers of genital tract melanomas, which accounted for more than 56% of these lesions in women.…”

mentioning

confidence: 97%

See 1 more Smart Citation

Noncutaneous Primary Melanomas

Dominiak

Smith

2015

Pathology Case Reviews

View full text Add to dashboard Cite

Cutaneous melanoma is the fifth leading cause of new cancer diagnoses, accounting for almost 77,000 cases and more than 9000 deaths in 2013. Although these cutaneous neoplasms are so common, their mucosal counterparts are much less so. Mucosal melanomas account for approximately only 1.3% of all diagnosed melanomas. These lesions, although rare, present at a significantly advanced stage with more adverse prognoses. In addition, molecularly, these lesions have proven to be distinct entities, in that they possess mutations not usually seen in their cutaneous counterparts. They also lack the common mutations found in cutaneous melanomas. Such findings indicate different pathways in tumorigenesis for these subtypes. We present a case of a mucosal melanoma, specifically a urethral melanoma, in a 70-year-old woman, clinically diagnosed as a urethral caruncle. Only after biopsy and resection was the correct diagnosis of malignant melanoma made. As melanomas arising from the mucosal sites are a rare entity, very little has been published on staging guidelines and prognostic factors, causing a dilemma for both the patient and the physician. Further work is necessary to better define a staging system in all mucosal locations, so that accurate prognoses can be given to patients with these lesions. Lastly, metastases from a more common cutaneous site must be considered.We present a case of a 70-year-old white woman who initially presented to her primary care physician with gross hematuria. She denied any additional signs and symptoms and was referred to a urologist for further evaluation. Upon urologic evaluation, a distal urethral mass was noted, presumed to be a benign urethral caruncle, and was scheduled for surgical excision. Histologic examination of the mass proved to be a surprise, however. The excisional biopsy consisted of fragments of squamous epithelial-lined tissue with an obvious cellular malignancy extending into the urethral submucosa. The malignant cells exhibited abundant eosinophilic cytoplasm, nuclear pleomorphism, nuclear hyperchromasia, and prominent nucleoli. Numerous mitotic figures and apoptotic bodies were noted, indicating a high proliferation rate. The malignant cells extended to both the deep and peripheral margins of the tissue. Multiple immunohistochemical stains were applied to determine the origin of these cells. The tumor cells proved to be negative for CD34 and smooth muscle actin. They also proved to be negative for TTF-1, cytokeratins 7 and 20, estrogen receptor, and high-molecular-weight cytokeratin, indicating that these cells were not of an epithelial origin. They did stain positively for melan-A and S-100, confirming a melanocytic lineage. Molecular studies were performed on the biopsy and were negative for a mutation in the BRAF and c-KIT genes.The patient then underwent a formal distal urethrectomy and staging procedure. Grossly, the specimen was covered by an intact mucosa and had a semifirm submucosal mass at one aspect. Upon sectioning the specimen, a soft, fleshy, well-circumscri...

show abstract

Section: Discussionmentioning

confidence: 97%

mentioning

confidence: 97%

Noncutaneous Primary Melanomas

Dominiak

Smith

2015

Pathology Case Reviews

View full text Add to dashboard Cite

show abstract

“…Therefore, mutation(s) in alternate reading frame protein dysregulate p53 function and play a role in tumor immune evasion. It has been observed that c 4 (CDK4) gene amplification, is an independent oncogene, and is more common in acral and mucosal melanoma than the CSID and NCSID cutaneous melanomas [20,47]. It has been observed that mutations or deletions of PTEN are concurrent with mutations in BRAF but not in N-RAS [20].…”

Section: Molecular Pathwaysmentioning

confidence: 99%

Melanoma from Molecular Pathways to Clinical Treatment: An Up to Date Review

Kosmıdis¹,

Baka²,

Sapalidis³

et al. 2017

J. Biomed

View full text Add to dashboard Cite

Skin cancer is divided to melanoma and non-melanoma. Melanoma occurs due to deregulation of melanocytes. Melanoma is frequent in Caucasian population. During the last decade there is an increase in melanoma and in many cases there is a diagnostic challenge. Moreover; choosing the right treatment is a challenge for many patients. Malignant melanoma is known to be a lethal disease due to its aggressive capacity for metastasis and resistance to therapy. In the last decade, considerable efforts have gone into development of an effective immunotherapy for treatment of melanoma. The combination of macrophage activation and other treatments such as immunotherapy, surgery, chemotherapy, and radiotherapy, may provide an effective and comprehensive anti-melanoma strategy.

show abstract

“…Approximately 90% of melanomas are cutaneous, but they can also occur at any anatomic location-for example, eye, mucosa, head and neck surfaces, and along the gastrointestinal and genitourinary tracts 2,5,6 . Cutaneous malignant melanoma (cmm) is responsible for the largest proportion (60% -80%) of skin cancer-related deaths 4,[7][8][9][10][11] .…”

Section: Introductionmentioning

confidence: 99%